Diabetes Electronic Prompt for Improved Care Coordination and Treatment in the ED
Diabetes Electronic Prompt for Improved Care Coordination and Treatment (DEPICCT) in the ED
Rutgers, The State University of New Jersey
200 participants
Mar 30, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to improve the processes of Type 2 Diabetes (T2D) care coordination and treatment in the emergency department (ED) by utilizing clinical decision support mechanisms in the electronic health record (EHR). The main question is whether electronic prompts triggered by hyperglycemia and elevated A1c results in providers providing earlier treatments and faster time to subsequent primary care appointment and greater reduction in hemoglobin A1c (HA1c). ED clinicians will receive alerts called Our Practice Advisories (OPA's) through the EPIC EHR. The 1st OPA triggers when a random point-of-care (POC) glucose is ≥250 mg/dL, prompting a suggested additional HA1c order. A 2nd OPA triggers if the resulting HA1c is ≥10%, prompting consideration of further care coordination in the Observation Unit. Investigators will compare the outcomes post-intervention compared to pre-intervention.
Eligibility
Inclusion Criteria4
- Moderate hyperglycemia, (glucose ≥250 mg/dL)
- Patients who arrive in the emergency department
- Not pregnant or peri-partum
- Not SARS-COV-2 PCR positive in past 7 days
Exclusion Criteria4
- Diabetic ketoacidosis (pH \< 7.20, HCO3 \< 15, AG \> 25)
- Diabetic foot ulcer or skin complications
- Hyperglycemic hyperosmolar state with neurologic impairment
- Patients who leave against medical advice (AMA), elope from the ED, or are transferred to another facility
Interventions
Prompt to order A1c
Electronic prompt nudging ED provider to consider admitting patient to the Observation Unit for care coordination and more aggressive glycemic control
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06899191