Using Electronic Clinical Decision Support in Patient-Centered Medical Homes to Improve Management of Diabetes in Primary Care: The DECIDE Study.

James Gill, Kathrin Kucharski, Barbara Turk, Chunshen Pan, Wenhui Wei

Journal: The Journal of ambulatory care management 2020;42(2):105-115

PMID: 30768429

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Abstract

This prospective, randomized, real-world study aimed to examine the impact of electronic health record-based clinical decision support (CDS) tools on the management of diabetes in small- to medium-sized primary care practices participating in Delaware's patient-centered medical home project. Overall, use of CDS systems was associated with greater reductions from baseline in hemoglobin A1c and low-density lipoprotein cholesterol, and more patients achieving treatment goals. Physicians and staff reported that the CDS toolkit empowered them to be more involved in clinical decision-making, thereby helping to improve diabetes care. However, all cited significant barriers to fully implementing team-based CDS, predominantly involving time and reimbursement.

Address: Delaware Valley Outcomes Research, Newark, Delaware (Dr Gill and Ms Turk); independent consultant (Dr Kucharski); Sanofi US, Inc, Bridgewater, New Jersey (Dr Pan); and Regeneron Pharmaceuticals Inc, Tarrytown, New York (Dr Wei).

DOI: 10.1097/JAC.0000000000000267

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MeSH Terms: Adolescent, Adult, Aged, Decision Support Systems, Clinical, Delaware, Diabetes Mellitus, Electronic Health Records, Female, Glycated Hemoglobin, Humans, Longitudinal Studies, Male, Middle Aged, Patient-Centered Care, Primary Health Care, Prospective Studies, Quality Improvement