RT Journal Article
SR Electronic
T1 Low-Intensity Intervention Supports Diabetes Registry Implementation: A Cluster-Randomized Trial in the Ambulatory Care Outcomes Research Network (ACORN)
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 728
OP 735
DO 10.3122/jabfm.2020.05.190455
VO 33
IS 5
A1 Sabo, Roy T.
A1 Etz, Rebecca S.
A1 Gonzalez, Martha M.
A1 Johnson, Nicole J.
A1 O'Neal, Jonathan P.
A1 Reves, Sarah R.
A1 Crosson, Jesse C.
YR 2020
UL http://www.jabfm.org/content/33/5/728.abstract
AB Background: Previous research demonstrated that registries are effective for improving clinical guideline adherence for the care of patients with type 2 diabetes. However, registry implementation has typically relied on intensive support (such as practice facilitators) for practice change and care improvement.Objective: To determine whether a remotely delivered, low-intensity organizational change intervention supports implementation and use of diabetes registries in primary care.Design: Cluster-randomized controlled effectiveness trial of providing limited external support leveraging internal practice resources and problem-solving capacities for driving diabetes registry implementation in 32 practices in Virginia.Intervention: All practices identified local implementation champions who participated in an in-person education session on the value and use of diabetes registries, while intervention practices were also paired with peer mentors and had access to a physician informaticist, who worked remotely to assist practices with implementation.Main Measures: Practice champions reported progress on registry implementation milestone achievement, and reported practice-level organizational capacity by using a modified version of the Assessment of Chronic Illness Care (ACIC).Key Results: Intervention practices were significantly more likely to have implemented a registry (44% vs 6%, P = .04) and to have achieved more implementation milestones (5.5 vs 2.6, P < .0001) than control practices. Baseline ACIC scores indicated room for organizational improvement with regard to chronic illness care (overall median, 6.4; range, 3.8 to 10.8) and clinical information systems use (median, 6.0; range, 0 to 11) with no significant differences between intervention and control practices.Conclusions: Remotely provided guidance paired with limited in-person assistance can support rapid implementation of diabetes registries in typical primary care practices.