Abstract: FR-PO0548
Development of an Electronic Health Record (EHR)-Based Kidney Care and Prevention Pathway (KCPP) to Improve Evidence-Based Therapy for Patients with Type 2 Diabetes Mellitus (T2DM) and CKD
Session Information
- CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Bansal, Shweta, University Health, San Antonio, Texas, United States
- Conlu, Victoria Marie, University Health, San Antonio, Texas, United States
- Schott, Mysti, University Health, San Antonio, Texas, United States
Background
In patients with T2DM, CKD screening and recognition in primary care remain suboptimal contributing to delayed diagnosis and missed opportunities for timely implementation of therapeutic advances to improve CV and kidney outcomes. EHR-based interventions have been used to improve screening; however, their potential to support therapeutic decision-making remains underutilized.
Methods
We developed KCPP, an EHR-embedded clinical decision support care pathways integrating laboratory, medication, and problem-list data in patients with T2DM. Real-time Best Practice Advisories support: (1) CKD screening and KDIGO risk stratification using eGFR and uACR (Fig); (2) one-click ordering of RAAS and SGLT2 inhibitors and follow-up labs (Fig); and (3) longitudinal monitoring of changes in eGFR and uACR to guide escalation of therapy, including nsMRA, GLP-1RA, nephrology referral, and evaluation of alternative causes of kidney function decline. Before activating KCPP, educational sessions on CKD screening and evidence-based therapy were conducted to improve clinician engagement and acceptance.
Results
The KCPP infrastructure, BPA logic, and workflow integration were developed by team of EHR analysts and nephrologist. Pilot optimization identified challenges involving alert timing, lab identification and medication verification. Baseline evaluation showed major screening gap, in 44,997 annual T2DM encounters, both eGFR and uACR testing was complete in only 60% within the prior 12 months. Clinicians reported favorable acceptance and perceived utility of the KCPP. Longitudinal evaluation of screening and guideline-directed therapy uptake is ongoing.
Conclusion
Implementation of an EHR-integrated KCPP is a feasible and scalable strategy within routine workflows and has the potential to enhance provider awareness, improve early CKD detection and uptake of evidence-based therapies.