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Increasing Diabetes Self-Management Education and Support Referrals with an Electronic Best Practice Advisory.
Laura A Young1,2, Jacqueline R Halladay2,3, Ping Chen4
1Division of Endocrinology, Department of Medicine, School of Medicine University of North Carolina at Chapel Hill.
Journal of the American Board of Family Medicine : JABFM
|April 28, 2026
Summary
Best Practice Advisories (BPAs) integrated into electronic health records (EHRs) significantly increased diabetes self-management education and support (DSMES) referral rates in primary care. This EHR intervention improved patient identification and simplified referrals.
Area of Science:
- Health Informatics
- Clinical Decision Support
- Diabetes Management
Background:
- Diabetes self-management education and support (DSMES) services are underutilized, often due to low clinician referral rates.
- Effective strategies are needed to increase patient engagement in DSMES programs.
- Electronic health record (EHR) systems offer potential for improving healthcare processes.
Purpose of the Study:
- To evaluate the impact of a Best Practice Advisory (BPA) integrated into an EHR on DSMES referral rates.
- To determine if EHR-based prompts can overcome barriers to DSMES utilization for patients with type 2 diabetes (T2D).
Main Methods:
- A BPA was developed within the Epic EHR for eligible T2D patients.
- The BPA was implemented in four primary care practices (intervention group).
- Two primary care practices served as controls; data analyzed using multilevel logistic regression.
Main Results:
- A total of 2,526 BPAs were deployed in intervention clinics.
- The DSMES referral rate in intervention clinics was 12.9%.
- Control clinics had a significantly lower referral rate of 1.2% (p<0.001).
Conclusions:
- Integrating EHR-based BPAs significantly increases DSMES referral rates.
- This intervention effectively identifies eligible patients and streamlines the referral process.
- BPAs show promise in addressing barriers to DSMES utilization.
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