Early Win: Closing a Technology Access Gap
Assessments powered by these new tools enabled Cincinnati Children’s to nearly close the gap in access to diabetes technology among certain patient populations.
The dashboards highlighted a significant disparity in continuous glucose monitor (CGM) use between publicly and privately insured patients.
"Over the past couple of years, across the entire population, access to CGM is greater than 90%,” Corathers says. “We've closed a gap of about a 20% difference between our public and privately insured individuals to within 2%."
Automated insulin delivery systems (a combination of CGM and insulin pump) have dramatically improved glycemic outcomes across all patient groups, reducing disparities between publicly and privately insured patients.
Facilitating Actionable Change
Data segmentation and analysis are key features of the dashboard. Originally designed to streamline the division’s responses to the U.S. News & World Report survey, the project facilitates actionable change by providing access to detailed patient information. This, in turn, helps guide decision making.
The endocrinology team also developed a second data visualization tool through a ConnecT1D innovation grant from the Helmsley Charitable Trust. By offering a comprehensive view of the entire patient population, these tools advance analysis and intervention planning, says Amanda Howell, MPH, the data analyst who helped design and build them.
The dashboards:
- Provide a functional and efficient reporting structure for 118 visualizations, 15 measures, and more than 20,000 data points spanning 2,488 patients over 3.5 years
- Are HIPAA compliant and accessible to relevant end users through shareable links, subscription and Microsoft Teams
All of those data points are building core measures where we can zoom in, apply different lenses and acquire insights,” Howell says. “We employed statistical process controls that harness analytical power across the center population and various subgroups like race or insurance.
The interactive dashboards let the endocrinology team track performance in real time throughout the year, letting care teams “maintain a relevant, continuous feedback loop and refine insights and interventions to improve patient outcomes,” Howell says.
Engaging in this work means the team is not surprised by responses on external benchmarking surveys, Corathers says, “because they're items that we've been actively monitoring, intervening in and, if necessary, mitigating throughout the entire course of the year.
The dashboard's straightforward visualization lets clinicians easily and quickly assess performances on any specific measure, including:
- Duration of diabetes diagnosis
- Ethnicity
- Insurance type
- Language other than English
- Race
- Social determinants of health
"We can filter based on age, diabetes type or other demographic features," Corathers says. "Then we can get an actionable patient list, which we can use to design care interventions."
Ongoing Refinement
In the future, the endocrinology team will continue to refine and expand the dashboards. The goal is to make them as efficient and reliable as possible so that clinicians can focus on other important areas of their work.
For example, as new factors emerge, the tools can track them and provide additional transparency. This will allow for data analysis and quick identification of areas that need attention—providing opportunities to create improved or new interventions.
