What is your practice's configuration?
Private Practice: Group practice, 2-4 physicians
Does your practice have advanced practice providers?
Estimate the percentage of your type 2 diabetes patients who are on Medicaid.
To what extent do you have patients who have type 2 diabetes and do not speak English?
What percent of clinic patients are impacted by technological limitations, specifically related to CGM use?
What percent of clinic patients are impacted by food insecurity?
Please restate the problem that your clinic was trying to solve/improve.
Our Providers were not confident that CGM's were going to get covered and then patient's were upset. We have since sent all orders to ASPN who helps work on figuring out how to get the CGM's covered and what pharmacy to send them to. They are in communication with the patients and now providers order on every patient that says they are interested.
Describe how your clinic operated before implementing this new change.
Prior to the education we received from MCT2D, our office never ordered CGM before MCT2D. Providers had received too many denials, too many forms to fill out.
Who championed this change and how did they get others on board or involved?
I championed the change after meeting with the Dexcom Rep and learning about ASPN and this resource. I am in contact with the providers weekly on where each patient is, step wise, on getting their CGM. I am able to use the ASPN website to track all patients.
What changes did you make to improve this process? Tell us in enough detail that another practice could replicate this process in their clinic.
1) Our office set up an account with ASPN. 2) Office Manager created website login and provider information. 3) Office added ASPN to list of pharmacies to send to electronically. 4) Providers discuss option with patient and send rx directly to ASPN. 5) Providers education patients that ASPN will work with them directly to work on getting the prescription sent to the pharmacy their insurance participates with. 6) Office Manager checks ASPN website weekly to see any the progress for each patient. 7) Office Manager informs
Which staff take on the primary additional responsibility of this process change?
Were any other tasks taken off their plate to allow for this additional process?
List all the staff whose standard workflow changed with this new process. Please list their role and any new tasks that they completed related to the change.
Providers are encouraging patients more to use CGM's. Office Manager is tracking the status of their orders and in better communication with providers.
Please list any costs to this change, which could include additional patient time, staff time, financial costs, or other.
I would not consider there to be any significant cost to our changes.
What advice would you have for other practices looking to implement the process change that you implemented?
My advice would be to use ASPN and their website if an office is having a hard time getting CGM's approved.
What challenges did you face implementing these changes?
We did not face any challenges. It was a simple change in our workflow.
What has your practice learned through making these changes?
Our office has learned that we need to always evaluate why we do or do not do things. We need to take a step back and not get into the same routine over and over. A simple change in sending a rx for a CGM to ASPN vs getting denials from the local pharmacy has created quite a change for our diabetic patients!
Are you going to continue this change, adapt it, or discard it?
Continue the change