Using Patient Notification Reminders to Increase Diabetic Patient Participation in Follow up Hemoglobin A1CTesting

Abstract

In 2014, the global estimate of those with diabetes was 422 million (World Health Organization [WHO], 2018). The costs associated with the complications of diabetes can be detrimental to individuals and whole healthcare systems. Therefore, achieving glycemic control in diabetic patients is essential to improve patient outcomes and reduce complications. Glycemic control is assessed by testing hemoglobin A1C (HbA1C). Diabetic patients are tested anywhere from twice a year to quarterly, depending on HbA1C goals. Patient reminders and general education provided through text messages, short message services (SMS), and secure messages through patient portals have demonstrated improvements in HbA1C. Patient reminders and education varies. It includes anything from reminding the patient to take their medications to proper insulin injection techniques. Project purpose: increase diabetic patient follow up testing for HbA1C testing utilizing patient reminders sent through the patient portal. The project was developed with assistance from the Banner University South Campus Quality Improvement team in Tucson, Arizona. The nurse practitioners in this clinic identified five patients each. Patients were between the ages of 18 to 75 years old with an HbA1C of 9% or greater and due for testing. The patients received a reminder message through the patient portal system to return for follow up testing. A survey was provided to the nurse practitioners to assess their perceived usefulness of the patient portal. Descriptive statistics were used to analyze the findings. This quality improvement project will help determine if patient notification reminders help improve follow up testing in diabetic patients and ultimately improve patient outcomes. Results: Twelve patients received a reminder, and two made follow up appointments. Survey findings suggest a somewhat favorable approach to the use of the patient portal reminders.