Evaluation of a Diabetes Screening Clinical Decision Support Tool

Abstract

IntroductionWe evaluated if an electronic health record clinical decision support system (EHR CDSS) improves diabetes screening across a health system. MethodsStudy population included adults without diabetes attending a visit at 27 primary care clinics. Outcomes including the monthly screening laboratory order rate and completion rate among eligible patient visits. We performed logistic regression using a Generalized Estimating Equations model and interrupted time series (ITS) analysis to evaluate the change in the outcome from baseline to implementation and post-implementation periods. ResultsFrom the baseline to post-implementation period, screening laboratory order rates increased from 53% to 66% and completion rates increased from 46% to 54%, respectively. Odds of laboratory order and completion increased significantly from the baseline to post-implementation period (test order: OR 3.7, 95%CI 3.4-4.1, p<0.001; test completion: OR 2.1, 95%CI 2.0-2.3, p<0.001). In the ITS analysis, laboratory order and completion rates increased significantly from the baseline period (p<0.001 for both). ConclusionsWe developed and implemented a CDSS alert that automatically identifies eligible patients and facilitates single-click ordering of a diabetes screening test. An easily implementable and scalable CDSS alert can improve diabetes screening.