Idea shared of working offline ( potentially find a day where everyone can contribute to work and discussion on their own time and communicate through email)
Project Idea- develop a plan for outcome CGM reporting for the sites that are mapping and this would include time in range hypoglycemia and hyperglycemia.
For the sites who are willing to try it, we would basically create a smart phrase, and build your own smart link from epic that can be extracted from the notes.
Question Asked- How does the smart link in this specific case work?
Mentioned how Joyce Lee is a champion in smart phrases and smart notes.
Stanford is just beginning to use smart links. Previously we had been taking snippets from DEXCOM, Libre View and Metronik and putting these snipping’s into the notes. But when we do this the data is not extractable. But if we enter this info into the smart phrase then we would be able to. As of now we aren’t doing this. So our data is just CGM? yes or no.
Concern that this idea may not be so easy to implement . Has been trying to implement the use of smart sheets in order to go beyond the data that is normally captured in our charts but is not easy. Says, If I ask a colleague to please, every time you see a patient, I need you to enter this information. I’m not sure if he will listen to me. (physicians are busy)
Instead of the physician, we have the MA front desk staff collect this by doing pre-calls either the morning of the appointment or day before. For type 1 patients the staff asks if they are using a CGM and the front desk staff records this on the blue sticky notes located in Epic.
It was mentioned that this training of MA front desk staff was one of our QI initiatives for T1DExchange. And by doing this it is so much easier for the providers because now I don’t need to ask the patient what they are using. I just open up the chart and view the Epic blue sticky note and I know if this information is up to date or not and this saves time.
Thinks there will be some errors like for example sometimes I look and a patient has set their range of 80 to 120 and I’m surprised their time in range looks so low and then I figure out what they did so I know that some of these aren’t going to be so accurate, but I think for all of our data mapping, there’s occasionally instances where its not perfect but I think its still better than without it. I agree that if we ask doctors to manually move more numbers into their notes, I think they are just already overloaded so having an MA do this ahead of time works better.
Could be easier for entering time in range if we split them up by less than 50% or 50-70% or whatever numbers we choose which could make it even easier for the provider to just put one check mark.
Continuing with the checkmark idea we can see if they are having over 5% hypos and have a yes or no checkbox.
Agrees that clickable checks for time in range below and above a specific number would be simplest for everyone.
Plan on doing some sort of staff education part for our goals and aim for obtaining information from CGM on time in range and below or above the range to make it simple.
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