Initiating a Prediabetes Patient Registry

Henry Ford Macomb Hospital https://www.henryford.com in partnership with the AMA is piloting a patient registry that could become a national model for enrolling patients with prediabetes into evidence-based diabetes prevention programs.

Henry Ford Macomb, a part of the Henry Ford Health System is currently evaluating the registry for effectiveness for screening, testing, and referring patients diagnosed with prediabetes to a diabetes prevention program. The hospital developed specific clinical protocols before creating the registry using tools available in their EPIC EMR.

The AMA www.ama-assn.org approached Henry Ford Macomb located in Clinton Township Michigan which is about 25 miles northeast of Detroit to collaborate on the pilot project. The project is based on the documentation and reporting system used by their diabetes prevention program partner Henry Ford Macomb “Faith Community Nursing Network” (FCNN).

This system allows providers to view their patients’ progress after enrolling in a diabetes prevention program which includes attending classes on weight loss, blood pressure, and activity levels.

The goal is to help the providers using the system to have the tools they need to effectively identify and screen patients at risk for prediabetes and then refer them to proven diabetes prevention programs.

The AMA and Henry Ford Macomb have worked with Epic to develop and implement additional features into a registry based on evidence-based best practices and clinical guidelines that are needed to use for patient screening and referrals to diabetes prevention programs.

The registry being pilot tested by Henry Ford Macomb is of value to health systems both large and small because of its integration into the EMR”, reports Gina Aquino, R.N, a Clinical Quality Nurse Facilitator at Henry Ford Macomb and Co-Leader of the registry project.

The data provided by the registry will help providers, hospitals and other healthcare professionals compile, view, and share data that will include diabetes risk assessments, diagnoses, medications, patient instructions, referrals to a diabetes prevention program plus a report on the patient’s progress.

After the test pilot ends in June 2018, the AMA will assess the registry’s effectiveness as a potential national model that could be used to help other health systems across the country increase patient participation in the diabetes prevention program.