ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-PO068

EMR-Based CKD Patient Education and Decision Support in Primary Care Improves Patient Satisfaction

Session Information

  • Educational Research
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 1000 Educational Research

Authors

  • Wright Nunes, Julie A., University of Michigan, Ann Arbor, Michigan, United States
  • Ojo, Akinlolu, University of Kansas School of Medicine, Kansas City, Kansas, United States
  • Powell, Corey C., University of Michigan, Ann Arbor, Michigan, United States
  • Fan, Audrey, University of Michigan, Ann Arbor, Michigan, United States
  • Devine, Anita M., University of Michigan, Ann Arbor, Michigan, United States
  • Ellies, Tammy, University of Michigan, Ann Arbor, Michigan, United States
  • Grzyb, Katie, University of Michigan, Ann Arbor, Michigan, United States
  • Garcia-Guzman, Luis M., University of Michigan, Ann Arbor, Michigan, United States
  • Oliverio, Andrea L., University of Michigan, Ann Arbor, Michigan, United States
  • Chen, Emily P., University of Michigan, Ann Arbor, Michigan, United States
  • Fagerlin, Angela, University of Utah Health, Salt Lake City, Utah, United States
Background

We pilot-tested an EMR-based CKD patient education and decision support tool in primary care. Systems engineering optimized seamless integration into clinical workflow.

Methods

With input from patients and providers we developed an EMR-based patient education and decision support tool called an Encounter Decision Intervention (EDI). The EDI was designed to be used during primary care encounters when patients and providers discussed a CKD diagnosis and decided on management steps. Patients were enrolled into an intervention (received EDI) or control group (did not receive the EDI) using a prospective, cross-sectional design. Measurement of outcomes occurred after patient visits via validated surveys of patient perceived and objective kidney disease knowledge, CKD-specific stress, and satisfaction. Chi-square tests, t-tests, and Kruskal-Wallis were used to detect associations between outcomes and measured characteristics, as appropriate.

Results

Seventy-four patients completed the pilot study (37 per group). There were no statistically significant differences in patient characteristics between groups, nor were there statistically significant differences in overall kidney objective knowledge (mean (SD) of 67 % correct (15)), perceived knowledge (mean (SD) out of 4 total, 3.0 (2.1)) or CKD-specific stress (1.9 (0.7)). Satisfaction scores with provider communication, care, and providers themselves were all significantly higher in the intervention group: The proportion of participants rating satisfaction with provider communication as all 5’s (scale 1-5), showed n= 16 (43%) in usual care and 30 (81%) in the EDI group, p=0.0016. For satisfaction with care, 26 (70%) in usual care and 35 (95%) in the intervention group rated all 5’s, p=0.012. The proportion of patients rating all 5’s for satisfaction of providers themselves were 29 (78%) in the usual care group and 36 (97%) in the EDI group, p = 0.028. All three satisfaction scores remained statistically significant in multivariate analysis. Patients rated use of the EDI high (4.1 (out of 5) CI 3.8-4.4).

Conclusion

The EDI was seamless to care delivery and associated with more patients who were very satisfied with provider communication, overall care, and the primary care providers themselves.

Funding

  • NIDDK Support