Tonic For Diabetes Clinical Intake
The Seattle Children’s Diabetes clinic uses a form for intake data called the “pink sheet” on all patients. This data can be collected prior to the appointment to maximize the provider’s response to the patient’s concerns and compare outcomes to previous appointments. In an iPad format (using technology by Tonic Health), we designed online intake surveys to collect relevant clinical data prior to the patient visit. The digital survey questionnaire enables patients to self-report their glucose and insulin levels as well as set goals for their routine diabetes management on iPads, while checking in for appointments. This information is vital to the visit, but can be cumbersome to complete in clinic before seeing their provider.
Proactively serving up the questionnaire pre-appointment allows patients additional time to complete the survey from home in a convenient platform. Their answers can be confirmed at the visit and more rapidly reviewed by the care team, which improved clinic flow as well. Families can also opt-in to learn about research opportunities.
Pilot Goals
- Improve patient and family experience completing standard paperwork.
- Improve clinic flow by decreasing wait time prior to visit to complete form and allow providers access to data ahead of visit.
- Create a sense of being “known” by provider/clinic because information is already cued up for them.
- Develop comprehensive database for intake results.
Findings & Reach
| Measured: |
Result: |
Conclusion/Comments: |
|---|---|---|
| Duration of “Pilot” |
2/2016 to Present |
No longer considered pilot as it has been fully integrated into the workflow and is considered standard care. |
| # of surveys taken |
>18.5K runs as of March 2019 |
Outpatient surveys only – additional surveys completed by transition clinic ~500. |
| # of locations implemented |
Main Campus |
Pink Sheet, PHQ-9, Consent and other Transition Clinic forms have been implemented at multiple sites. |
| Average completion rate prior to clinic visit |
40% |
Initially interpreted as low but per Tonic team this completion rate is higher than average in the nation. |
Conclusions
- The only solution in digital health that has been integrated into the EPIC scheduling which is a key factor in optimizing workflow and standardizing care.
- The ability to pull through patient demographic information and prior answers improves patient and family experience and improves patient-provider communication.
- Initially was an adjustment for providers not to get the pink sheet. Needed to optimize flow for MAs by emailing completed survey to group inbox. Integration of this information back into the EHR could be desired (current workflow is for MAs to email/print report for physicians) as structured data to improve outcomes and reduce further inefficiencies.
