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Electronic ‘smart forms’ provide essential information for diabetes management
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NEW ORLEANS – Health care providers can harness existing technology to better track patients with diabetes and help them manage their care, according to a presentation here.
Finding a more efficient way to use electronic medical records (EMRs), providing educational tools via the Internet and using continuous glucose monitoring more often can help both patients and clinicians learn more about efficient diabetes management, said Jodi Lavin-Tompkins, RN, MSN, CDE, BC-ADM, program coordinator of the HealthPartners Diabetes Program in Bloomington, Minnesota. HealthPartners is an integrated, non-profit health care provider and health insurance company.
Jodi Lavin-Tompkins
Working with the HealthPartners IT department, Lavin-Tompkins and colleagues devised a “smart form” built into the patients’ EMRs to monitor diabetes education goals. Staff can check “yes” or “no” to goals like “eats breakfast,” at each visit, to better track how a patient is managing their care.
“All these clicks are recordable as unique data that can be pulled into a report,” Lavin-Tompkins said.
The result has been an increase in patients with diabetes referred to diabetes self-management education (DSME) programs, she said.
“None of us have achieved the goal of having all patients with diabetes automatically referred to the program,” Lavin-Tompkins said. “We still rely on provider referrals to DSME. We don’t see all the patients.”
Using continuous glucose monitoring in primary care practices also helped to improve outcome measures, she said.
HealthPartners completed a pilot program with two lower-performing diabetes providers, selecting ten of their patients with type 2 diabetes who were not meeting diabetes measures, Lavin-Tompkins said. The diabetes nurses assigned continuous glucose monitoring to the patients and downloaded and interpreted data.
“It was a win-win,” Lavin-Tompkins said. “Providers learned a lot about managing diabetes, it increased awareness for patients and it got the diabetes nurses more involved in team management. [HbA1c] improved and departments earned revenue.”
Lavin-Tompkins gave the example of one patient in the pilot program living with diabetes for 50 years. The provider, she said, assumed the patient already knew how to manage his care after so many years.
“So they did the continuous glucose monitoring and discovered he was waiting to take meal insulin until way after he ate, and he was injecting insulin in his calf,” Lavin-Tompkins said.
HealthPartners also incorporated televideo case study reviews to educate primary providers at their remote sites, using Webex as a platform, she said. Seven primary care providers submitted eight patients each per cohort for case studies to take place via televideo conference, for four sessions per cohort lasting 2 hours each. A nurse and endocrinologist reviewed the cases with providers live via video connection.
“We can see them on the screen, they can see us, ask questions about the cases, so it’s very interactive,” Lavin-Tompkins said. “It seems to be very well received and we feel like we’re getting through.” – by Regina Schaffer
Reference:
Lavin-Tompkins, J. T02. Presented at: The American Association of Diabetes Educators Annual Meeting; Aug. 5-8; New Orleans.
Disclosure: Lavin-Thompkins reports no relevant financial disclosures.