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This study will develop a new electronic health record module to improve guideline-compliant care of older adults with diabetes. The module will incorporate effective behavioral economics (BE) principles to improve the degree to which care of older adults is compliant with Choosing Wisely guidelines; this generally involves less aggressive targets for HbA1c, and reductions of medications other than metformin.
The implementation of the module will ultimately be triggered by medication prescribing in EPIC. The BE principles include suggesting alternatives to medications, requiring justification, setting of appropriate default order sets, and incorporation of anchoring and checklists to guide behavior. The study will involve provider workflow analysis based on observation, module user testing, and live usability testing with direct observation and semi-structure interviews.
The primary objective of this study is to develop a scalable, EHR customization toolkit that applies BE insights to promote appropriate diabetes care in older adults based on the American Geriatric Society's Choosing Wisely Guideline, as to assess the acceptability of the resulting module.
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| Measure | Description | Time Frame |
|---|---|---|
| Compliance with Choosing Wisely guidelines measured by number of reductions of medications | The implementation of the module will ultimately be triggered by medication prescribing in EPIC. | 60 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Usability measured by module user testing with direct observation and semi structured interviews | 60 Months |
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Inclusion Criteria:
Exclusion Criteria:
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Providers in NYU outpatient primary care, geriatrics, or endocrine clinics at NYU who care for older adults with diabetes
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| Name | Affiliation | Role |
|---|---|---|
| Andrea Troxel, MD | NYU Langone Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New York University School of Medicine | New York | New York | 10016 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32885374 | Derived | Belli HM, Chokshi SK, Hegde R, Troxel AB, Blecker S, Testa PA, Anderman J, Wong C, Mann DM. Implementation of a Behavioral Economics Electronic Health Record (BE-EHR) Module to Reduce Overtreatment of Diabetes in Older Adults. J Gen Intern Med. 2020 Nov;35(11):3254-3261. doi: 10.1007/s11606-020-06119-z. Epub 2020 Sep 3. |
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| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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