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Slide Presentation from the AHRQ 2007 Annual Conference

This is the text version of the slide presentation titled Clinical Decision Support to Improve Diabetes Care: A Search for Unintended Consequences.

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Clinical Decision Support to Improve Diabetes Care: A Search for Unintended Consequences

Clinical Decision Support to Improve Diabetes Care: A Search for Unintended Consequences
Purpose/Overview
The Search for Unintended Consequences
Diabetes Improvement Group—Intervention Trial (DIG-IT*): Overview
Map of Race and Practices
Design: Random Assignment of Practices to CDS - Disease Management (DM²) -MHS
"Table 1." Pre-trial Practice Characteristics
Clinical Decision Support—DM²
Illustrative encounter-based Alerts
SmartSet Linked to ACE/ARB Alert
Practice Performance Feedback
Individual Practice Registry
Real-time Access to Nurse Case Management
Unintended consequences
Were there more clinically important episodes of hypoglycemia in the CDS group?
Were there fewer indicated mammograms, Pap smears, or evaluations for CHF in the CDS group?
Were there more ED visits or hospitalizations for asthma ("unrelated") or CHF?
Planned Safety Comparisons Related to Alerts and Order sets
Alert Fatigue? PCP Satisfaction with CDS (n=51)
Early Returns (71% response): "Should "X" remain after the trial?"
Summary: Work-in-Progress
Unintended Consequences: Closing Thoughts
Blank Slide
Illustrative Performance Measures: "ADA Scores" Measured Every Week
Changes in ADA Scores for MHS Experimental Group Patients (n=5288)