Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system

Contemporary Clinical Trials
Richard W GrantMichele Heisler

Abstract

Despite robust evidence to guide clinical care, most patients with diabetes do not meet all goals of risk factor control. Improved patient-provider communication during time-limited primary care visits may represent one strategy for improving diabetes care. We designed a controlled, cluster-randomized, multi-site intervention (Pre-Visit Prioritization for Complex Patients with Diabetes) that enables patients with poorly controlled type 2 diabetes to identify their top priorities prior to a scheduled visit and sends these priorities to the primary care physician progress note in the electronic medical record. In this paper, we describe strategies to address challenges to implementing our health IT-based intervention study within a large health care system. This study is being conducted in 30 primary care practices within a large integrated care delivery system in Northern California. Over a 12-week period (3/1/2015-6/6/2015), 146 primary care physicians consented to enroll in the study (90.1%) and approved contact with 2496 of their patients (97.6%). Implementation challenges included: (1) navigating research vs. quality improvement requirements; (2) addressing informed consent considerations; and (3) introducing a new clinical ...Continue Reading

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Citations

Jun 28, 2018·Journal of Medical Internet Research·Seuli Bose-BrillStephen Koesters
Jun 25, 2021·BMC Family Practice·Danielle M NashMerrick Zwarenstein

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