Using Practice Facilitation and Operationalizing Referral Information Technology to Increase DSMES Utilization

Diabetes Clinical Trial

Official title:

Clinical Trial Protocol: Using Practice Facilitation and Operationalizing Referral Information Technology (UP FOR IT) to Increase DSMES Utilization

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05472142
• Other study ID #: 75928
• Secondary ID: R34DK132548
• Status: Active, not recruiting
• Phase: N/A
• Start date: May 30, 2023
• Est. completion date: July 2024

Study information

• Verified date: July 2023
• Source: University of Kentucky
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a pilot and feasibility study of a pragmatic cluster randomized trial that utilizes health information technology and practice facilitation to address referral barriers and increase clinician awareness and motivation to refer patients with diabetes to diabetes self-management education and services (DSMES).

Description:

Diabetes self-management education and support (DSMES) is an evidence-based educational program that helps people with diabetes better control their blood sugar (improved hemoglobin A1c) and reduce diabetes-related complications and healthcare costs. DSMES is strikingly underutilized with fewer than 10% of eligible patients receiving this helpful service due to patient-, clinician-, and health system-level barriers that include low clinician awareness and lack of integrated referral processes between clinics and community-based DSMES programs. In this study, we will conduct a pilot and feasibility study of a pragmatic cluster randomized trial that utilizes health information technology and practice facilitation to address referral barriers and increase clinician awareness and motivation to refer patients with diabetes to DSMES. We have partnered with the Kentucky Department of Public Health (KDPH, statewide DSMES provider), the Kentucky Regional Extension Center (KY-REC, practice facilitation partner), and the Kentucky Health Information Exchange (health information technology (HIT) partner). We will recruit two healthcare systems in rural Kentucky to participate in the study. Within each healthcare organization, we will randomize control and intervention clusters at the clinic level. Clinics in the intervention group will participate in the 12-month intervention which incorporates health information technology and practice facilitation. The health information technology component provides the scaffolding for quality improvement efforts by automating patient identification and enabling bi-directional referral communication between providers and DSMES programs. Health information technology support will be available at all clinic sites within participating health care organizations, including the control clinics. The practice facilitation collaborative trains and supports clinical teams to use the Model for Improvement to make "breakthrough" improvements in diabetes care and DSMES utilization by recognizing barriers and changing clinical systems and care practices.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 22
• Est. completion date: July 2024
• Est. primary completion date: July 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Clinics are being recruited to participate in the intervention. All clinic staff at participating clinics are eligible for inclusion in the study.

Exclusion Criteria:

• There are no exclusion criteria beyond employment at a participating clinic.

Related Conditions & MeSH terms

• Diabetes

Intervention

Other:
• UP FOR IT - practice facilitation
Using Practice Facilitation and Operationalizing Referral Information Technology (UP FOR IT) involves incorporation of health information technology and practice facilitation. The practice facilitation collaborative trains and supports clinical teams to use the Model for Improvement to make "breakthrough" improvements in diabetes care and DSMES utilization by recognizing barriers and changing clinical systems and care practices.
• UP FOR IT - health information technology
Using Practice Facilitation and Operationalizing Referral Information Technology (UP FOR IT) involves incorporation of health information technology and practice facilitation. The health information technology component provides the scaffolding for quality improvement efforts by automating patient identification and enabling bi-directional referral communication between providers and diabetes self-management education and services (DSMES) programs.

Locations

Country	Name	City	State
United States	University of Kentukcy	Lexington	Kentucky

Sponsors (2)

Lead Sponsor	Collaborator
Mary Lacy	National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in DSMES Referrals	DSMES referrals will be measured as change in clinic-level referral rate from baseline to the end of the active intervention and follow-up period. The outcome will be assessed through clinic electronic health record data.	18 months (baseline and post-study)
Secondary	Change in DSMES Attendance	DSMES attendance will be measured as the change in clinic-level attendance rate from baseline to the end of the active intervention and follow-up period. The outcome will be assessed through aggregated, de-identified data that is routinely collected by DSMES providers.	18 months (baseline and post-study)
Secondary	Change in A1c Levels	Participant A1c levels will be measured from baseline to the end of the active intervention and follow-up period. The outcome will be assessed through clinic-level aggregate data extracted from electronic health record data.	18 months (baseline and post-study)