An Electronic Medical Record Tool for Prediabetes Screening: Educational Program for Primary Care Healthcare Professionals
Abstract
ABSTRACT
Background: Electronic medical records (EMRs) are one example of technology that enhance healthcare due to efficacy and quality of data. Incorporation of a screening tool into the EMR can be used for assessment purposes.Problem: The growing need for early diabetes mellitus diagnosis may benefit from EMR-based screening tools.Methods: The American Diabetes Association Risk Tool (ADART) was incorporated into an EMR-ready format, staff were educated on the use, and validity and reliability testing of the use of the tool was performed. Comparisons were made on de-identified retrospective chart data of the ADART tool versus HgbA1C results, and case studies, using Chi-Square analysis. Inter-rater reliability of the use of the tool was determined by 2 reviewers and by staff who reviewed a case study. Pre-and post-educational scores were analyzed.Results: For tool use during review of 15 charts, a sensitivity of 80% and specificity of 40% was calculated. The positive predictive value was 72.7% and negative predictive value was 50%. The inter-rater reliability score by the ARNP and CMA when assessing the same 5 patient charts had a perfect correlation through the Cohen’s Kappa value (κ=1.0). All 17 participants who did complete the case study had the same score calculated. Post-educational testing scores were significantly improved over pre-testing scores.Conclusion: Through this quality improvement intervention we have found that the ADART is a feasible tool to assess a patient’s risk of prediabetes or DMII.
Background: Electronic medical records (EMRs) are one example of technology that enhance healthcare due to efficacy and quality of data. Incorporation of a screening tool into the EMR can be used for assessment purposes.Problem: The growing need for early diabetes mellitus diagnosis may benefit from EMR-based screening tools.Methods: The American Diabetes Association Risk Tool (ADART) was incorporated into an EMR-ready format, staff were educated on the use, and validity and reliability testing of the use of the tool was performed. Comparisons were made on de-identified retrospective chart data of the ADART tool versus HgbA1C results, and case studies, using Chi-Square analysis. Inter-rater reliability of the use of the tool was determined by 2 reviewers and by staff who reviewed a case study. Pre-and post-educational scores were analyzed.Results: For tool use during review of 15 charts, a sensitivity of 80% and specificity of 40% was calculated. The positive predictive value was 72.7% and negative predictive value was 50%. The inter-rater reliability score by the ARNP and CMA when assessing the same 5 patient charts had a perfect correlation through the Cohen’s Kappa value (κ=1.0). All 17 participants who did complete the case study had the same score calculated. Post-educational testing scores were significantly improved over pre-testing scores.Conclusion: Through this quality improvement intervention we have found that the ADART is a feasible tool to assess a patient’s risk of prediabetes or DMII.