What is your practice's configuration?

Private Practice: Solo physician

Does your practice have a care manager that works with type 2 diabetes patients?

Yes

Does your practice have advanced practice providers?

Yes

Estimate the percentage of your type 2 diabetes patients who are on Medicaid.

0-25%

To what extent do you have patients who have type 2 diabetes and do not speak English?

To a very limited extent

What percent of clinic patients are impacted by technological limitations, specifically related to CGM use?

0-10%

What percent of clinic patients are impacted by food insecurity?

0-10%

Please restate the problem that your clinic was trying to solve/improve.

Our clinic did not have a way to help our patients who did not qualify for CGM technology through their insurance.

Describe how your clinic operated before implementing this new change.

Prior to starting MCT 2D program, we really did not prescribe or use CGM technology. Once we started identifying patients who would benefit, there was an unmet need for those who did not have coverage for these technologies but were still very uncontrolled.

Who championed this change and how did they get others on board or involved?

Sister Mary Sarah Macht, FNP championed the change by working with representatives from Abbot to obtain sample sensors on a periodic basis. Abbott also donated a Freestyle 2 reader. We were also able to accept donations from patients of their Freestyle 2 readers. We were able to teach the staff how to identify patients with problems, "lone" readers from the clinic with sample sensors and how to download this information when the patient returned to the clinic.

What changes did you make to improve this process? Tell us in enough detail that another practice could replicate this process in their clinic.

1. When using a reader that had been previously identified with another individual, you have to downloaded into libreview as a one-time report, otherwise the data from the reader can get incorporated into another patient's chart. 2: It is important to have extra yellow cable cords/USB cords from the reader to office computers. 3. When the patient comes into the clinic and needs a reader downloaded, it is important for clinical staff to identify this patient and have this process done before the provider comes to the room.

Which staff take on the primary additional responsibility of this process change?

Primarily this is taken on by the clinical assistants who room the patients. Some of the administrative type issues are dealt with by our administrator.

Were any other tasks taken off their plate to allow for this additional process?

No.

List all the staff whose standard workflow changed with this new process. Please list their role and any new tasks that they completed related to the change.

Marlena, MA, Shauna, MA, Cindy, MA –track loaned readers Download information when patients come to the clinic

Please list any costs to this change, which could include additional patient time, staff time, financial costs, or other.

There is a mild increase in staff time, perhaps, but better patient care.

What advice would you have for other practices looking to implement the process change that you implemented?

It is important to understand that there are limitations in the technology; sometimes the sensors do not work the way we want them to or we can get data downloaded in a timely manner. There is also risk that alone reader will not return back to the clinic when it expected to be alone to another patient. These are things to try to anticipate ahead and avoid if possible.

What challenges did you face implementing these changes?

Proactive awareness of what type of reader device, separate reader versus smart device, the patient is using. Sometimes the patient would be all roomed and ready to go and we would still be waiting to get the data downloaded.

What has your practice learned through making these changes?

It is important that the care team worked together. That is, if someone knows that the reader is going need to be downloaded, that is helpful to make the whole team is aware of that at the beginning of the clinic day.

Are you going to continue this change, adapt it, or discard it?

Continue the change