A virtual provider training and encouragement increased use of electronic blood glucose flow sheets.

What was the challenge?

The Office of the National Coordinator for Health Information Technology (ONC) has identified patient-generated health data as an important area for advancing provider-patient engagement. Electronic sharing of patient-generated health data between visits is a potentially valuable tool for patients with diabetes performing self-monitoring of blood glucose, who can share their glucose levels with their providers via electronic blood glucose flow sheets.

What was the program change?

ONC, Inova Health System, and OES designed an intervention to encourage physicians to place bulk orders for electronic blood glucose flow sheets for patients with diabetes. Providers were invited to attend a virtual training and offered in-person support, including a template for reaching out to patients.


How did the evaluation work?

The intervention was tested using a cluster randomized controlled trial with 20 primary care practices, totaling 68 physicians and 7,052 patients. Inova, OES, and ONC randomly assigned physicians in ten primary care practices (34 doctors and 3,411 patients) to receive encouragement to place bulk orders for electronic blood glucose flow sheets. The remaining ten primary care practices (34 doctors and 3,641 patients) were assigned to the control condition of business as usual. The team used data from Inova electronic health records to compare (1) provider flow sheet orders, (2) patient flow sheet completion rates, and (3) changes to active medications made following the intervention.


What was the impact?

The intervention yielded large and statistically significant effects across the three outcomes: Patients at practices randomly assigned to the treatment group were more likely to receive an order for electronic flow sheets, more likely to use the flow sheet following the provider training, and less likely to see a change to their active medications in the 14 weeks after the provider trainings.

Allyson Root, Christopher Connolly, Season Majors, Hassan Ahmed, and Mattie Toma. “Electronic blood glucose monitoring impacts on provider and patient behavior.” Journal of the American Medical Informatics Association, ocac069 (2022).

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Project Type

Program Change and Evaluation


Health and Human Services




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