MON-226 Implementation of an Electronic Medical Record Pediatric to Adult Healthcare Transition Planning Tool for Youth with Diabetes Mellitus

Abstract Disclosure: M.K. Douthit: None. K. Cossen: None. Background: Transitioning from pediatric to adult healthcare is associated with worse diabetes-related health outcomes for adolescents and young adults (AYAs) with diabetes mellitus (DM). Pediatric institutions are advised to track and monitor the healthcare transition (HCT) progress, assess patient readiness, and assist in the HCT planning process. Electronic medical record (EMR)-based tools are effective at promoting healthcare provider adherence to clinical guidelines. This study aimed to improve pediatric provider engagement in HCT services for AYAs with DM through implementation of an EMR based HCT tool in a large pediatric healthcare system. Methods: All providers who spent at least 20% of their clinical time caring for patients with DM at a single outpatient pediatric endocrine clinic participated in the study. Initiatives to increase provider engagement with the HCT tool were implemented in five plan-do-study-act (PDSA) cycles: (1) HCT tool release and training, (2) reminders and satisfaction survey, (3) tool revision and training, (4), reminders and feedback on barriers to use, (5) final tool revision and training. The primary outcome was the proportion of established DM clinic encounters for AYAs ≥17 years old in which any HCT tool use occurred. We collected clinical and demographic data via chart review and used run charts and odds ratios to detect differences between cycles. We assessed differences in tool use based on patient characteristics with chi-square analysis. User satisfaction and feedback were elicited. Results: Retrospective baseline data revealed providers documented HCT in only 19% of encounters. A total of 30 providers participated (22 physicians and 8 APPs), and 2196 encounters were reviewed during the 12-month intervention period. HCT tool use increased from 0% to 32% between baseline and cycle 5. Although the odds of using the HCT tool decreased significantly in Cycle 2 compared to Cycle 1 (OR = 0.38, 95% CI: 0.21–0.67), subsequent cycles showed a non-statistical upward trend in tool utilization. Providers were significantly less likely to use the tool for patients that were younger (p=<0.001), publicly insured (p=0.045), or non-English speaking (p=0.019). Providers identified time constraints as the main barrier to tool use. Conclusion: Despite not achieving our aim, we identified important disparities in HCT preparation at our institution. Providers were less likely to engage in HCT services for younger, non-English speaking and publicly insured patients. Future interventions targeting increased tool use with our younger population may improve HCT readiness and lead to safer transitions. Interventions to improve HCT planning for non-English speaking and publicly insured patients are also necessary. Additional interventions and longitudinal studies in this population are needed to improve the transition to adult care process. Presentation: Monday, July 14, 2025