1. The Design of the Electronic Health Record in Type 1 Diabetes Centers: Implications for Metrics and Data Availability for a Quality Collaborative.
- Author
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Eng D, Ospelt E, Miyazaki B, McDonough R, Indyk JA, Wolf R, Lyons S, Neyman A, Fogel NR, Basina M, Gallagher MP, Ebekozien O, Alonso GT, Jones NY, and Lee JM
- Subjects
- Adult, Humans, Electronic Health Records, Quality Improvement, Benchmarking, Patient Care Team, Diabetes Mellitus, Type 1 therapy
- Abstract
Background: Systematic and comprehensive data acquisition from the electronic health record (EHR) is critical to the quality of data used to improve patient care. We described EHR tools, workflows, and data elements that contribute to core quality metrics in the Type 1 Diabetes Exchange Quality Improvement Collaborative (T1DX-QI)., Method: We conducted interviews with quality improvement (QI) representatives at 13 T1DX-QI centers about their EHR tools, clinic workflows, and data elements., Results: All centers had access to structured data tools, nine had access to patient questionnaires and two had integration with a device platform. There was significant variability in EHR tools, workflows, and data elements, thus the number of available metrics per center ranged from four to 17 at each site. Thirteen centers had information about glycemic outcomes and diabetes technology use. Seven centers had measurements of additional self-management behaviors. Centers captured patient-reported outcomes including social determinants of health (n = 9), depression (n = 11), transition to adult care (n = 7), and diabetes distress (n = 3). Various stakeholders captured data including health care professionals, educators, medical assistants, and QI coordinators. Centers that had a paired staffing model in clinic encounters distributed the burden of data capture across the health care team and was associated with a higher number of available data elements., Conclusions: The lack of standardization in EHR tools, workflows, and data elements captured resulted in variability in available metrics across centers. Further work is needed to support measurement and subsequent improvement in quality of care for individuals with type 1 diabetes., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JL is on the GoodRx medical advisory board, is a consultant for Tandem Diabetes Care and has participated on a Sanofi Digital Advisory Board. OE is an advisor for Medtronic Diabetes and Sanofi Diabetes. He has received research support through his institution (T1D Exchange) from Abbott, Vertex, Eli Lilly, Dexcom and Medtronic. RW receives research support through her institution (Johns Hopkins) from Novo Nordisk as the center PI of a trial. more...
- Published
- 2024
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