October 27, 2023

Francesco : Just to follow-up on this topic . These power forms may be easier to fill out but it’s something I cant’ replicate in EPIC. That said, this topic about CGM/pumps data capture is a recurring issue across different subgroups. Every site is trying to make it happen using different strategies but I wonder if we want to move on as T1DX group and start interacting directly with the manufacturing companies in order to find a better solution which can be widely adapted. We can also reach the  Diabetes Technology Society and combine our efforts since this a topic of interest to them as well. We can also discuss more when we meet in New York.

Marina :Totally agree that integration of these devices directly with EPIC would be the best options. We’ve been trying to work with Dexcom and epic on this for some time but then gave up . I believe this was via My health app and apple health app.

Priya, is it available in LPCH Epic? Rajiv was working on this.

Lily  :Is there any site using Epic that has Dexcom integrated? I like the idea of working with Diabetes Technology Society. I’d imagine though that every site needs to have institutional support for the integration.  Our institution is having the internal discussion of if and how ($$) to support the integration from these various vendors who want to work with us. Do you think Mark Clements/Mercy’s would have a better pulse on this process?

Francesco: Just to follow-up on what Marina and Lily mentioned. I had also a brief conversation with Dexcom and it seems the integration is possible but there are issues about HIPAA

Carla Demeterco is able to integrate data in EPIC. I discussed this with her in the past and then also with Nicole. What’s needed is the upgraded version of Glooko which allows to extract discrete data and a third party intervention for coding that was done by a company called Tegria. I don’t know about Mark/Mercy progress. We should probably reach him as well.

Manu: I reached out to our wonderful team member Haley Stinson with the Dexcom-EPIC integration question. She has prepared a powerpoint (in 1/2day!) that she wanted me to share with you all. I propose she can present this at our next meeting for the group.  In the mean time, feel free to review and reach out to Haley for any further questions/guidance that we can help you with.

Manu: Haley, do the data fields get integrated into Epic? i.e. mean glucose, time in range etc? Epic may also be more user friendly than Cerner. We previously had Dexcom integration where the 14 day report would get pulled in as a PDF. But in Cerner, we could not have a PDF file open and navigate anywhere else in Cerner (i.e. we could not view the report and chart at the same time). Hopefully you don’t have that problem.

Haley: Based off the data from the AGP on the integrated report, we (the rooming nurses) enter that data into fields within our flowsheets for charting during the rooming process for our patients. Our providers then have the data we entered into the chart from the AGP on the integrated report pull into their note. We also can look at previously entered CGM data within our flowsheets in Epic to compare results previously entered for the patient. I have entered screenshots below.

The data then pulls into our provider’s note as well for their review.

This is how the nurses document the data from the AGP into the patient’s chart during the rooming process

• This is the data that you can view within our “flowsheets” within EPIC to compare data for the CGM.