5069 Utilizing The Electronic Health Record To Improve Transitions Of Care From Pediatric To Adult Endocrinology For Patients With Type 1 Diabetes

Abstract Disclosure: L.C. McHan: None. J.N. Tich: None. M. Augustine: None. During late adolescence and emerging adulthood, patients are becoming more independent and assuming more responsibility for their care. The transition from pediatric to adult healthcare providers is a particularly vulnerable time for patients with diabetes since disruptions in care can lead to poor health outcomes such as poor glycemic control, increased healthcare utilization, and increased occurrence of complications related to diabetes. In a preliminary chart review, 36% of pediatric patients at our institution with type 1 diabetes (T1DM) referred to adult endocrinology in the year 2022 have not yet established care with an adult endocrinologist. Of these patients, 67% had a first appointment scheduled with adult endocrinology. For patients who have established care with adult endocrinology, the average time between their last pediatric visit and first adult visit was 10 months. To address these gaps in care during the transition process, we created a multidisciplinary team, including representatives from pediatric and adult endocrinology with the goal of utilizing the electronic health record (EHR) to improve transitions of care for adolescents and young adults with T1DM at our institution. Our team consists of physicians, advanced practice providers (APPs), a social worker, and representatives from our information systems division. Because buy-in from providers is a cornerstone of successful transition planning, we surveyed the pediatric endocrinology providers to assess attitudes regarding transitions of care and received 4 physician and 4 APP responses. Fifty percent of providers felt it was extremely important to discuss transition to adult care with their patients, and all providers reported feeling comfortable discussing transition. The age at which providers initiate discussion about transition with their patients varies significantly; half of providers reported waiting until patients are 18 years or older, and only one provider starts discussing transition at the recommended age of 12-13 years old. One provider reported discussing transition with their patients at every visit, while 25% discuss transition every 6 months and 50% discuss transition yearly. When asked what tools would help providers address transition to adult care with patients, 100% selected a reminder in the diabetes note template. We are actively working to incorporate reminders to discuss transition into the diabetes note template. Additionally, we have partnered with the Endocrine Society to incorporate a T1DM skills checklist into the EHR. While the long-term health benefits of discussing transition to adult care may not be evident for years, our hope is that these tools encourage providers to engage in earlier and more frequent discussions about independent disease management and transition to adult care. Presentation: 6/2/2024