Online Program

Development and evaluation of a dashboard to improve diabetes patient appointment efficacy

Tuesday, November 5, 2013 : 2:50 p.m. - 3:10 p.m.

Richard Goldsworthy, PhD, MSEd, Academic Edge, Inc., Bloomington, IN
David Marrero, PhD, Director, Diabetes Translational Research Center, Division of Endocrinology & Metabolism, Indiana University School of Medicine, Indianapolis
Paul Whitener Jr., BA, Academic Edge, Inc., Bloomington, IN
Erin O'Kelly Phillips, BA, Indiana University School of Medicine, Indianapolis, IN
Brian Kaplan, BA, Academic Edge, Inc., Indianapolis, IN
Background: Diabetes remains one of the most common chronic diseases in the U.S., affecting over 24 million individuals. Although our understanding of diabetes management has improved considerably over the past two decades, patient implementation of optimal management lags far behind the ideal.

Objective: We sought to develop tools that would assist patients with inter-visit management of their diabetes, especially as it relates to preparing for a clinical encounter and recording and understanding what occurs during the encounter.

Methods: The effort relied on iterative, user-centered development processes grounded in behavioral change theory, coupled with extensive input from nationally respected diabetes care experts and healthcare providers, to develop management and appointment forms, tools, and learning and support resources and embed them in a patient diabetes dashboard. Evaluation activities included subject-matter-expert review, mixed-methods single-subject usability sessions, and a pilot multi-site field trial.

Results: Paper-based Patient Appointment Readiness and Patient Visit Journal forms were created. These tools assist the patient to capture and bring with them things that either they want to discuss with their provider or which would benefit the provider, and to capture the outcomes of the clinical encounter for later reference. These tools were then migrated to electronic, interactive versions. The web-based versions walk the patient through the forms, provide tools and resources to tracking relevant information and/or for implementing and maintaining prescribed behaviors, ranging from medication adherence to glucose monitoring, to lifestyle change.

Discussion: Diabetes management is a recalcitrant problem. This effort demonstrated that clinical inertia and care continuity gaps can be partially mitigated by activating patients and providing them with relatively simple dashboard-integrated tools for preparing for and capturing the outcomes of the clinical visit. Varying levels of technology integration appear to offer advantages, although not without challenges and potential limitations.

Supported in part by NIH Challenge Grant #1RC1LM010484-01

Learning Areas:

Communication and informatics
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the rationale and theory behind creation of the patient appointment support tools List the features of the dashboard and surrounding web portal Describe the formative and summative evaluation of the resources Access and freely use for themselves components of the dashboard and tools

Keyword(s): Diabetes, Medical Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 15 years experience as principle investigator and lead researcher on a variety of public health educational and behavioral change effort. I am presently the principle investigator on the large scale NIH challenge grant supporting the research described in this abstract. My colleague is a nationally recognized expert in diabetes management and in technological efforts to augment care and is incoming Vice President of the American Diabetes Association.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.