Agenda

  1. BPA Build Updates
  2. Barriers and Challenges
  3. Data Collection and Sharing (Thematic Analysis)
  4. Next Steps

Participating Center Updates

Grady Update

  • Grady is lagging in build, but moving forward.
  • Ran into a block due to a large EPIC update and IT priorities.
  • Ticket is being reviewed.
  • Parameters have been requested.
  • Expect deployment in August or before September.

 

SUNY Upstate Update

  • Upstate experienced similar blocks with their build.
  • Waiting for final approval from their institutional committee.
  • Epic builder to speak with them today.
  • Expect to go live before August.
  • Approval at the organizational committee level.

 

Nationwide Children’s Update

  • Live since June 23rd.
  • Initial feedback from endocrinology faculty meeting:
  • Some providers not excited about pre-charting display. Some felt it was a useful reminder.
  • Discussion ongoing about whether to keep it in pre-charting.
  • Partners for Kids is working to reach underserved populations.
  • Teaming up to track BPA response in endocrinologist’s note.
  • Text will default in if patient is not on a pump.
  • Working on tweaks due to pre-charting scenarios.

 

Seattle Children’s Updates

  • Went live on Monday the 14th.
  • No live pre-charting due to past negative experiences with other BPAs.
  • Issue: No “snooze button” option.
  • Concern that providers may cancel the alert if it fires before seeing the patient.
  • Report being built to track user interaction.
  • Options: defer, dismiss, override/acknowledgement reason.
  • Defer: suppresses future pop-ups for 90 days.
  • Dismiss: prompts again next time chart is opened.
  • Created an acknowledgement reason without a smart data element attached.
  • Doesn’t cause a lockout action.
  • Minimizes the alert.
  • Lockout on the amount of time between pop-ups.

 

Data Mapping and Outcome Assessment

  • The primary outcome is progression and ADT use during the post-intervention period.
  • The post-intervention period starts on the date the site went live.
  • The study is looking at unique individuals who transitioned from no CGM to CGM or no AID to AID during the post-intervention period.
  • The study compares patient data from the pre-intervention period to the post-intervention period.
  • The study is looking at overall rates, not just the people in whom the BPA fired.

Saturation Point and Future Steps

  • Risa suggests analyzing data after three months to create buckets and then re-evaluating them at six months to identify new buckets.
  • The next step could involve focus groups with patients to address concerns and improve the process.
  • The thematic analysis and coding of the data could be used for a research paper.
  • JHU will work on putting these into subcategories and present their ideas at the next meeting.
  • It might be helpful for all sites to share a small report internally every three months on how things are going.
  • Reports should include data on how many times the BPA fired, and the reasons selected.
  • Hopkins will create a report to post on teams and discuss at a faculty meeting, including actions taken and categorization of reasons.
  • The report will close with the importance of continued adherence and plans for quarterly feedback.