Welcome and Introductions
  • Dr. Majidi welcomed participants and facilitated introductions.

Assessing the Presence of Psychosocial Support – Dr. Wolf

  • ISPAD guidelines recommend integrating psychological assessment and intervention at diagnosis and throughout routine diabetes care.
  • T1DX-QI projects have contributed to increased psychosocial screening across participating centers.
  • There is currently limited data on how psychology and social work services are integrated into diabetes care, both inpatient and outpatient.
  • A brief survey was developed to assess:
    • Psychology and social work resources available at each clinic.
    • Psychosocial screeners currently being used.
    • How psychosocial support is integrated into diabetes care.
  • Participants were asked to complete the survey using the QR code provided during the meeting.
  • The survey will also be shared during the Diabetes Distress Work Group meeting.
  • Results from the survey could help demonstrate the current landscape and strengthen a future proposal to support and fund psychosocial care within the Collaborative.

Stage 3 Teplizumab Implementation Proposal – Dr. Majidi

  • A funding proposal was submitted to Sanofi to support a 12-month rapid intervention, with a planned start in Q1 2027.
  • The proposed initiative will focus on implementing teplizumab for Stage 3 eligible pediatric populations (ages 8–17).
  • The initial project included six centers, with the goal of expanding participation by an additional 7–10 pediatric centers.

Participating centers would be expected to:

  • Track implementation data and outcomes.
  • Implement an appropriate Epic flowsheet/SmartForm.
  • Engage stakeholders across the practice.
  • Have the ability to refer eligible patients to an infusion center.
  • Have a process for tracking treatment and follow-up results.
  • A Qualtrics survey will be distributed within the next 3–4 weeks to assess center interest and capacity.
  • Participation will be limited to pediatric centers because of the current age requirements for the intervention.
  • The survey will assess whether centers have the infrastructure needed to administer infusions and participate in the project.
  • Center selection criteria and expectations will be clearly outlined in the survey.
  • The long-term vision for the Beta Cell Preservation SmartForm/flowsheet is to support documentation across Stage 1, Stage 2, and Stage 3 T1D.
  • The SmartForm is intended to eventually be available as an Epic Turbocharger package.
  • The Afrezza Turbocharger package is available at no cost to Epic users.
  • Dr. DeSalvo will reach out to his team to determine how the resource can be shared with additional centers.
  • Although the proposed initiative is sponsored by Sanofi, the work will focus more broadly on operationalizing disease-modifying therapies (DMTs) as they receive FDA approval, rather than focusing exclusively on teplizumab.

Data Mapping Changes - Dr. Welch

T1D Exchange is exploring new approaches to data mapping with the goals of:

  • Making the mapping process easier and less time-intensive for centers.
  • Simplifying the process and requirements for future mapping updates.
  • Continue exploring alternative data mapping processes.
  • Identify 3–5 centers to participate in testing a new process.
  • Share a draft of the documentation plan and requirements with PIs by October 1.
  • The group discussed the possibility of completing data mapping directly through Epic.
  • One potential approach would be to pilot this process with centers that have not yet started mapping.
  • How would an Epic-based approach work for centers that have already completed data mapping?
  • Could mapping through a community registry provide advantages for the Collaborative?
  • The group emphasized the importance of getting ahead of potential changes in how data are collected and shared.
  • Only a small number of centers (approximately four) are not currently using Epic.

Clinical Leadership Discussion: Mentorship – Drs. Majidi and Welch

The group discussed how mentorship could become a more formal and integrated component of the QI Collaborative.

A key question was:

How can we create a formal mentorship pathway through the QI Collaborative that supports trainees and early-career clinicians while strengthening the Collaborative's leadership pipeline?

Potential Opportunities

  • Introduce trainees to endocrinology and T1D care early in their careers.
  • Leverage the fact that most medical students and residents already receive some level of required training.
  • Develop a QI training course that is available through the Collaborative.
  • Don Buckingham will facilitate a QI training opportunity this winter, with sessions planned for December and January. CME/CEU opportunities will also be explored.
  • Consider opportunities to recognize fellows and trainees through awards at the Learning Session, such as recognition for abstracts, posters, or other contributions.
  • The Learning Session mentor/mentee session will also be available virtually via Zoom.

The group discussed how these assets can be leveraged to develop, connect, and inspire the next generation of T1D leaders and make the Collaborative a place where trainees and early-career professionals can build their careers.