August 13, 2024 (Kickoff)

Attendees:

Trevon Wright, Osagie Ebekozien, Nicole Rioles, Emma Ospelt, McKing Amedari, Susan Thapa, Ori Odugbesan, Nestoras Mathioudakis, Kelly Graf, Risa Wolf, Mary Pat Gallagher, Abha Choudhary, Elizabeth Brown, Manu Kamboj, Ruth Weinstock, Meenel Gupta, Jerusha Owusu-Barnie, Georgia Davis, Vijay Yeruva, Emmie Dial, Justin Indyk, Beth Wells,

Introductions and Welcome

• Background: trying to identify address barriers to equity, including bias
o Resolve waste in the system with the network
o Think about the customer and support them
o Mult-center meta-analysis, robust, comprehensive approach
o Demonstrate improvement and overall outcomes

• Participating center BPA examples
o Nationwide Children’s: Examples include Urine Microalbumin in T1D; High BP in T1D; Urine Microalbumin in T2D; Bundled BPA for lab orders for BPA
o UT Southwestern: BPA for diluted insulin (it took a few weeks) New BPA estimate: 6-8 weeks
o SUNY, Adult: PHQ9, SDOH. Determined that they needed resources to develop. Also can cause staff burnout so combined the BPA into one.
o Hassenfeld Children’s: Depression/anxiety screener BPA . Necessary to consider impact on workflow. Decided to discontinue. Need to create notification that provider can see for positive screeners (moderate-severe)
o Seattle Children’s: sepsis alert; Adrenal suppression risk for endocrine; ICD10 codes linked to BPA on storyboard, “quiet BPA”). Important to think about impact on workflow and Alert fatigue
o Grady: Diabetes retinopathy, done in partnership with Ophthalmology clinic. Implementation: 6 months includes reviews and approvals. The “creation” was fairly quick.

• Project Overview
o Aim 1: develop and implement a BPA using stakeholder feedback for standardizing prescription and documentation of ATD use
o Aim 2: determine the effectiveness of BPA in reducing racial inequities in ADT
o Aim 3 explore reasons identified for providers’ decision not to prescribe ADT and if there is a connection in reason and patient race/ethnicity
• Mixed methods study
• Focus groups, surveys, structured interviews
• Aim 1: 5 rights of CDS: Right information, right person, right intervention, right
channel, right timing. Want to get PWD input as well.
o Prototype testing
• Aim 2: Effectiveness of non-randomized matched pair intervention design. Compare
ATD use following BPA intervention among on-Hispanic Black and Hispanic PwT1D
with control centers over a 12-month period. Provide diverse group that can be
generalizable
o Progression in device use compared with the control group
• Aim 3: explore reasons for not prescribing. Determine if they are PwT1D or provider
led. Analyze the reasons.

• Project timeline and scope
o Timeline: 7/1/2024-4/30/2027
o Complete Doodle poll so that we can plan schedule for meetings
• Before next meeting: share process map, timeframe; set up a time to meet for focus
groups. Trevon will email to set up time

• Questions/comments:
o Other large % populations of PwT1D who are non-white and are not Black or Hispanic. For example, there is a large Somali population in Columbus, OH
o “non-English preferred language” could be helpful in matching
o Medicaid coverage for CGM can be huge influencing factor and cause
differences in uptake
• Next meeting in September

BPA Project Kickoff Slides