Alonso, T, Rioles, N, Ebekozien, O, Noor, N, Carlson, E, Sonabend, R, Indyk, J, Weinstock, R, Lee, J, Prahalad, P, Lorincz, I, Polsky, S, Clements, M

A multidisciplinary group designed the T1DX-QI to improve type 1 diabetes (T1D) care by sharing QI tools and expertise among pediatric and adult diabetes clinics and by comparing real-world data from clinics’ entire T1D populations. The QI Collaborative has implemented standardized processes, including common data definitions and a central database.

To participate, clinics must dedicate time from clinic leaders and IT support staff, obtain IRB exemption clearance, map clinical data to the standard, and receive QI coaching. The data standard contains 135 discrete fields between two sections. Fields specific to the care of people with T1D (insulin regimen and doses, blood glucose monitoring parameters, severe hypoglycemia and diabetic ketoacidosis events) are captured in the diabetes section. The core section contains general fields such as demographics, medical history, laboratory results, medications, and depression screening results. The coordinating center validates data quality and incorporates data into the production database after receiving data files transmitted via a secure connection every 1–4 weeks.

Thirty-four clinics are in 1 of 5 phases of onboarding (Figure). Eight clinics have transmitted data accounting for >26,000 individuals with T1D, seven of which have validated clinical data for population health analysis and portal use. The QI Portal provides population health reports, including run charts, case management tools, and business intelligence tools.

Clinics’ entire T1D populations are included. Data standards allow clinics to benchmark outcomes, identify variation, and share best practices for QI interventions quickly. Future enhancements will include outcomes predictions, population health management, self-management device data, and creation of a de-identified research repository.

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