RT Journal Article
SR Electronic
T1 Increasing Diabetes Self-Management Education and Support Referrals with an Electronic Best Practice Advisory
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 157909
DO 10.3122/jabfm.2025.250280R1
VO 39
IS 1
A1 Young, Laura A
A1 Halladay, Jacqueline R
A1 Chen, Ping
A1 Mottus, Kathleen
A1 Goeke-Austin, Karen
A1 Rees, Jennifer
A1 Vu, Maihan B
A1 Richman, Erica L
A1 Sharpe, Jordan
A1 Thomas, Aaron
A1 Donahue, Katrina E
YR 2026
UL http://www.jabfm.org/content/39/1/157909.abstract
AB Introduction Diabetes self-management education and support (DSMES) services are often underutilized, partly due to low referral rates by clinicians. This examines if using a Best Practice Advisory (BPA) integrated into the electronic health record (EHR) during clinic visits increases DSMES referral rates.Methods We developed a BPA within the Epic EHR for patients with type 2 diabetes (T2D) eligible for DSMES services. This BPA was implemented in four primary care practices within a university-based health system, while two additional practices served as controls. We analyzed data using multilevel logistic regression with patient data nested within clinicians. We employed binary logit functions and maximum likelihood estimation to assess the odds of DSMES referrals postvisit. Both unadjusted and adjusted models were tested, accounting for clinic and patient variables.Results From April 1, 2023, to March 31, 2024, 2,526 BPAs were deployed in intervention clinics, resulting in a 12.9% DSMES referral rate. In contrast, control clinics had 1,444 eligible patient visits with a 1.2% referral rate (p<0.001).Conclusions Integrating BPA prompts into the EHR significantly enhances DSMES referral rates. This approach effectively identifies eligible patients and simplifies the referral process, addressing some barriers to DSMES utilization.