The landmark Diabetes Prevention Program demonstrated that comprehensive lifestyle change can definitively prevent diabetes over the short and long-term. Recently, internet based adaptations of the DPP have been successfully implemented to help disseminate the core elements of the DPP to a wider patient population. To date, this web version of the DPP called GOALS has functioned autonomously of the primary care provider. Participants of GOALS cited integration of the program with their primary care provider as a key motivator to involvement and success with the program. The lack of communication between GOALS and the primary care team limits the potential synergies in diabetes prevention efforts between primary care and internet based interventions. The objective of this project is to develop a novel interface between GOALS and a widely used commercial electronic medical record platform. Building on the experience and expertise of the study team, the specific aims of the proposal are: (1) To determine the type, amount, frequency and location of lifestyle change data that primary care providers prefer from patients enrolled in a web-based diabetes prevention program;(2) To develop an interface between GOALS, an evidence-based internet DPP based lifestyle intervention, and the primary care electronic medical record (EMR) workflow;and (3) To test the usability, workflow integration and technical feasibility of an interface between a web-based diabetes prevention program and the primary care EMR. To achieve these aims, we propose a two year study in which we will 1) Interview and observe providers, patients and online coaches using the system and eliciting preferences for communication between GOALS and the EMR;2) Develop a prototype interface that shares data on patient progress with GOALS with the provider through a EMR interface;and 3) Usability test and optimize workflow integration of the prototype to create a fully functional interface. The study leverages innovative approaches such as "near-live" usability testing, a focus on real-time workflow integration, and embedding in the most widely used commercial EHR system in the US today (providing enormous dissemination potential). It also draws on unique expertise in usability testing, primary care decision support tool development, health services research and collaboration with DPP investigators and the developers of the GOALS system. These innovations make the proposed interface development study uniquely positioned to achieve its aims and provide an exciting new mode of communication between patients and providers and help encourage more successful diabetes prevention behaviors.
This study seeks to build a novel interface between an evidence-based internet diabetes prevention program and a widely used primary care electronic health record. Using novel development techniques including near- live usability prototyping, the investigators will determine how to optimally share patient behavior change data between the two systems so that the primary care providers can motivate and facilitate achievement of the patient diabetes prevention behavior change goals.