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A Payer-Provider Partnership for Endocrine Targeted Automatic eConsults: Implementation and Early Impact on Diabetes
Esra Karslioglu French1, Justin Kanter2, Mary E Winger3
1UPMC Division of Endocrinology, Pittsburgh, Pennsylvania, USA.
Population Health Management
|April 24, 2023
Summary
Targeted automatic eConsults (TACos) reduced provider clinical inertia in diabetes care. This technology improved HbA1c levels in patients with uncontrolled diabetes mellitus (DM) and showed potential for cost savings.
Area of Science:
- Health Informatics
- Endocrinology
- Primary Care Medicine
Background:
- Many individuals with diabetes mellitus (DM) do not achieve treatment goals.
- Provider clinical inertia contributes to unfavorable DM outcomes.
- Targeted automatic eConsults (TACos) are a novel intervention to address clinical inertia.
Purpose of the Study:
- To evaluate the impact of TACos on clinical inertia and DM outcomes.
- To assess changes in HbA1c and healthcare costs in adults with uncontrolled DM.
Main Methods:
- An observational, matched design was used with an intention-to-treat (ITT) analysis.
- 196 adults with uncontrolled DM (HbA1c >8%) receiving TACos were matched to 392 controls.
- Clinical inertia was assessed by TACos recommendation implementation rates (65%).
Main Results:
- The ITT group showed a significantly greater median percent change in HbA1c compared to controls (-10.9% vs. -10.2%, P=0.0359).
- Median total costs were 7.9% lower in the ITT group (P=0.0900).
- Per protocol analysis revealed a greater HbA1c reduction in patients with implemented TACos recommendations (-19.5% vs. -10.2%, P<0.0001).
Conclusions:
- TACos interventions are feasible for addressing clinical inertia in primary care.
- TACos demonstrate potential to improve glycemic control (HbA1c) in patients with uncontrolled DM.
- Further research may clarify the cost-effectiveness of TACos in managing DM.
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