February 7, 2023

• T1DX-QI is working to map Cornell OMOP files to the data spec 
• Working through Core files first 
• Anton wanted to clarify whether if Cornell differentiates “other” and “unknown” racial identities 

• This doesn’t appear to be current distinguished in the OMOP mapping 
• We would like to be able to distinguish this for the QI Portal and population health research 

• T1DX-QI team will continue work and reach out with any other questions 

• Pump August and beyond may be explained by follow-ups with patients who started Omnipod 5 
• Doris is helping with depression screening 

• See an increase since October 

• Team is curious when other T1DX-QI centers identify when pediatric patients are ready for transition 

• There may be an opportunity for Cornell team to use a transition note to track these measures 

• Team is curious what the difference is in the measures between 3a (sensor-augmented insulin pump) and 3b (HCLS on automated mode) 
• Patients who are already seeing a therapist won’t trigger a referral (but are still receiving the services they need) 
• Team does not currently collect SDOH 

• Ann to clarify question on pump measure (3) 

• Team has a new nurse that is leading the depression screening 

• Will expand to other providers’ visits 

HCLS 

• Now 75% of patients using pumps are on HCL 

• Team can really tell the difference in attitude of the appointment – much calmer families 😊 

• Team is incorporating the new pump policy 

Decrease health inequities 

• Team is very excited to think through how their practice can support more equitable outcomes 
• Isabel shared some outcome data by insurance payer and race-ethnicity 
• Like we see in collaborative-wide data, outcomes are less favorable for publicly insured and Hispanic/non-Hispanic Black patients  

• For NHB patients, average HbA1c is 10.2% 

• Team put together a Fishbone diagram identifying root causes of health inequities, overall 
• Team is interested in identifying screeners that may give information around things like “negative life events” to capture additional challenges patients may be facing 

• Coddington Life Event Scales 
• Perceived stress questionnaire 

• Ann recommended team to pair down on a specific goal/outcome they want to focus on first 

• We won’t fix it all overnight – where should we start? 
• Identify the what and the who 
• i.e., NHB and Hispanic patients and technology use  

• Also a recommendation to share the Fishbone/project plan with a few patients of color/publicly insured patients to get their perspective if the screening would support them in their diabetes care 
• To have bias is to be human 

• Which can be scary – but let’s challenge assumes when they arise 
• “I think these patients may be struggling with ___” à “Let me ask 3 patients if ___ is a challenge for them and what would help” 
• We want to validate our thinking and not build more bias into the system 

TIR 

• Team is also looking to improve TIR 

• Ann to share health equity change package and other resources for team’s consideration 

• Next Pediatric QI Collaborative call is 3/16/23 at 11 AM EST  
• Next QI check-in is scheduled for Tuesday 4/4/23 at 1:00 PM EST