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5. Lessons Learned when Implementing Electronic Health Record-based Referrals to Diabetes Prevention


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Background: One in three Americans has prediabetes, yet 90% are unaware they have this condition which increases risk of type 2 diabetes. The National Diabetes Prevention Program (DPP) is a lifestyle change intervention that can delay or prevent progression from prediabetes to type 2 diabetes. Since 2016, public health professionals in a rural Midwest county have collaborated with local healthcare organizations to implement electronic health record (EHR)-based systems for identifying patients with prediabetes and referring them to NDPP classes. Aim: The purpose of this study was to identify barriers, best practices, and lessons learned in two healthcare organizations involved in this project.  Design and Methodology: A qualitative design was used for this program evaluation study. Participants were purposively selected staff members involved with program implementation (N=4). They included DPP key informants from each organization, a provider, and an information technology administrator. Data were collected using open-ended questions in electronic survey format and analyzed for themes.  Results: Two barrier themes were identified: Timely, clear communication is challenging; and More education is needed for both patients and providers. Best practice themes included Start small with one provider champion; Create a referral process that doesn't exceed resources; and Providers should be actively involved in referral discussions and decisions. Lessons learned included Interest in the DPP was higher than expected; and Start with a passionate provider champion and then expand.  Conclusion: Healthcare organizations implementing EHR-based DPP referral programs should start small with one passionate provider champion and expand within available resources. Effective communication and education may help support success.  Public health professionals can play an important role in advancing regional, collaborative initiatives to increase prediabetes screening and referrals to NDPP classes in rural areas.

Samantha Peterson -
UW- Eau Claire, College of Nursing and Health Sciences

Alisyn Stevens, UW- Eau Claire, College of Nursing and Health Sciences, Jeanette Olsen PhD, RN, CNE, UW- Eau Claire, College of Nursing and Health Sciences


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