Abstract
BackgroundDiabetes educators are integral to a clinical team in providing diabetes self-management education and support; however, current mobile and Web-based self-management tools are not integrated into clinical diabetes care to support diabetes educators’ education efforts.ObjectiveThe objective of our study was to seek diabetes educators’ insights regarding the development of an interface within the Chronicle Diabetes system, a nationally used electronic health record (EHR) system for diabetes education documentation with behavioral goal-setting functions, to transfer mobile phone- and wearable tracker-collected self-monitoring information from patients to diabetes educators to facilitate behavioral goal monitoring.MethodsA descriptive qualitative study was conducted to seek educators’ perspectives on usability and interface development preferences in developing a connected system. Educators can use the Chronicle Diabetes system to set behavioral goals with their patients. Individual and group interviews were used to seek educators’ preferences for viewing mobile phone- and wearable tracker-collected information on diet, physical activity, and sleep in the Chronicle Diabetes system using open-ended questions. Interview data were transcribed verbatim and analyzed for common themes.ResultsFive common themes emerged from the discussion. First, educators expressed enthusiasm for and concerns about viewing diet and physical activity data in Chronicle Diabetes system. Second, educators valued viewing detailed dietary macronutrients and activity data; however, they preferred different kinds of details depending on patients’ needs, conditions, and behavioral goals and educators’ training background. Third, all educators liked the integration of mobile phone-collected data into Chronicle Diabetes system and preferably with current EHR systems. Fourth, a need for a health care team and a central EHR system to be formed was realized for educators to share summaries of self-monitoring data with other providers. Fifth, educators desired advanced features for the mobile app and the connected interface that can show self-monitoring data.ConclusionsFlexibility is needed for educators to track the details of mobile phone- and wearable tracker-collected diet and activity information, and the integration of such data into Chronicle Diabetes and EHR systems is valuable for educators to track patients’ behavioral goals, provide diabetes self-management education and support, and share data with other health care team members to faciliate team-based care in clinical practice.
Highlights
Research has demonstrated the effectiveness of behavioral lifestyle interventions that focus on goal setting and diet and physical activity self-monitoring to improve glycemic control for patients with type 2 diabetes [1]
Flexibility is needed for educators to track the details of mobile phone- and wearable tracker-collected diet and activity information, and the integration of such data into Chronicle Diabetes and electronic health record (EHR) systems is valuable for educators to track patients’ behavioral goals, provide diabetes self-management education and support, and share data with other health care team members to faciliate team-based care in clinical practice
Our study demonstrates that diabetes educators are enthusiastic about the incorporation of self-monitoring information into the Chronicle Diabetes system to monitor patients and ensure patient adherence to behavioral goals during diabetes self-management education and support
Summary
Research has demonstrated the effectiveness of behavioral lifestyle interventions that focus on goal setting and diet and physical activity self-monitoring to improve glycemic control for patients with type 2 diabetes [1]. A recent systematic review of the literature on technologies used for diabetes self-management education and support revealed that there were four essential elements in effective technologies that worked on improving glycemic control: two-way communication, analyzed patient-generated health data (PGHD), tailored education, and individualized feedback [4]. The highlighted technologies that enabled two-way communication and PGHD did not include the use of electronic health record (EHR) systems that health care provider teams use on a daily basis for care management or for connecting PGHD to EHRs. previous studies have only demonstrated the effective use of mobile [5,6] and Web-based systems [7,8] that were not connected with EHRs in supporting diabetes self-management behaviors. Diabetes educators are integral to a clinical team in providing diabetes self-management education and support; current mobile and Web-based self-management tools are not integrated into clinical diabetes care to support diabetes educators’ education efforts
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