Implementing Best Practice Advisories to Reduce Inequities in Technology Use for People With Type 1 Diabetes
T1D Exchange, United States
Summary
The overall goal of the study is to create a standardized, stakeholder-informed system within EMRs, that will enable an equitable and regular prescription and documentation of advanced diabetes technologies. This will reduce racial disparities and generate an understanding of the reasons behind prescription decisions. The study will highlight the development and implementation an EMR-based Best Practice Advisory (BPA). The study will answer whether the EMR-based BPA can effectively reduce disparities. Additionally, it will explore why providers may not prescribe advanced diabetes technologies. Patients will also be surveyed to understand their perspectives on developing the EMR-based BPA.
Description
For the proposed study we intend to implement an automatically delivered center decision support system provided at the time and location of the decision making along with actionable recommendations and computer based actionable recommendations. The provider will be required to opt out if not prescribing ADT and to provide a reason for not prescribing in order to advance on the EMR screen (Kawamoto et al, 2015). Project Objectives Aim 1: To develop and implement an EMR-based BPA using stakeholder feedback to standardize the approach for prescribing and documentation of advanced diabetes techn…
Eligibility
- Age range
- 2–95 years
- Sex
- All
- Healthy volunteers
- Yes
Age ≥ 2 years with an EMR diagnosis of T1D for at least 6 months at baseline and receiving care at one of six intervention centers or a matched control at another T1DX-QI center. Inclusion Criteria: * non-Hispanic Black and Hispanic individuals Exclusion Criteria: * PwT1D with evidence of use of AID at baseline
Interventions
- OtherEMR-based BPA model
Advanced Diabetes Technologies including AIDs, insulin pumps and CGMs will be prescribed to patients after an EMR-based BPA implementation at six centers.
- BehavioralPlacebo (EMR-based without BPA model)
Advanced Diabetes Technologies including AIDs, insulin pumps and CGMs will be prescribed to patients after an EMR-based system without BPA at the implementation at six centers.
Locations (2)
- T1D ExchangeBoston, Massachusetts
- T1D ExchangeBoston, Massachusetts