Outpatient Diabetes Clinical Decision Support (CDS)
Problem
Current clinical decision support (CDS) solutions for diabetes patient monitoring have been inconsistent in their ability to positively impact care coordination and improve patient outcomes. Underutilization of current systems among patients and providers has been a major barrier to successful utilization of these systems in improving glucose, blood pressure, and lipid management (O'Connor et al., 2016). Future diabetes CDS solutions should focus on providing timely and actionable care recommendations, improve care coordination and communication between providers, ensuring patient access to necessary information, and better integrate patient- and provider-reported data (O'Connor et al., 2016).
Gaps in existing diabetes decision support systems
An effective diabetes CDS solution can substantially improve providers’ ability to identify high-risk patients and prioritize treatment options for individual patients, allowing for improved levels of important clinical indicators, lower death rates and complications among diabetes patients, and reduced costs of care (O'Connor et al., 2016). However, current CDS solutions fall short in crucial areas such as effective user interface, workflow integration, integration of clinical information from multiple sources, and lack of emphasis on provider-patient interaction.
Vision for proposed solution
The proposed outpatient decision support for diabetes will include the integration of clinical information from multiple sources and care settings. Once this information is gathered, it will present the providers and patients with a visualization to effectively track trends in relevant clinical information, including lab results and patient gathered information.
Incorporating clinical data from various sources and settings
Current diabetes CDS solutions do not successfully integrate all relevant clinical data from all sources and care settings. The proposed solution would focus on allowing for integration of lab tests and other important information related to the patient’s current health and diabetes management. This timeline may also provide users with a visual aid with appointment and prescription reminders, along with reminders regarding upcoming screenings. The goal of this functionality would be to increase patient adherence to beneficial treatment programs and improve patient care coordination. Providing a timeline of relevant clinical information to both patients and providers will allow for better care management and communication throughout the entire spectrum of care.
Patient-centeredness and user interface
In many cases, diabetes CDS lacks the user interface to allow for high levels of accessibility and use of relevant information. The proposed solution would be tested for usability with providers and patients to assure an improved interface and patient-centeredness.

References
O'Connor, P. J., Sperl-Hillen, J. M., Fazio, C. J., Averbeck, B. M., Rank, B. H., & Margolis, K. L. (2016, June). Outpatient diabetes clinical decision support: Current status and future directions. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642968/

Authors:

Bradley Tipper (Presenter)
University of Alabama at Birmingham

Alfredo Guzman, University of Alabama at Birmingham
Nick Timkovich, University of Alabama at Birmingham
Irushi Dissanayake, University of Alabama at Birmingham