Electronic Decision Support for Intervention in Poorly Controlled Type 2 Diabetes

1. Patients of selected St. Elizabeth Physicians Primary Care Physicians without a new intervention related to the management of the patient's diabetes in the last 3 months may be contacted via telephone by research staff.
2. During the telephone call, patients will be offered the opportunity to manage their diabetic medication by following the PATH decision tool, explaining that PATH is a computer program which finds a balance between low cost and high effectiveness. If participation is elected, informed consent will be mailed with a follow up phone call from staff, or an informed consent will be signed at their upcoming primary care office visit. Some patients may be approached during their office visit, without a prior phone call. Patients who do not have an eligible hemoglobin A1c on file, but are expecting to have an eligible hemoglobin A1c value on an upcoming blood test may consent prior to the blood test. If the hemoglobin A1c comes back >=7.0, the patient will continue following protocol. If the hemoglobin A1c comes back <7.0, the patient will be categorized as a screen failure, but will remain eligible for later enrollment. If the patient becomes eligible and is later enrolled, the patient will be assigned a new study ID number.

i) If a patient elects not to participate, the reason for not participating may be recorded in the screening log. As part of the standard of care, patients not selecting the study will be offered an appointment outside the study to address their poorly controlled diabetes.

ii) If a patient elects to participate and a hemoglobin A1c has not been drawn in the last 3 months, one will be ordered through their insurance as part of the standard of care, to be used as the baseline hemoglobin A1c for Path calculations.

3. Patients who agree to participate maybe contacted by telephone by a licensed provider (MD or ARNP) who will enter non identifiable data from the patient's chart into the PATH decision support software. Information will be gathered from the Epic EHR and the questionnaire found on Article #2. This questionnaire may be completed by the patient, or by staff during patient interview. Some patients may complete this process during their scheduled office visit.

i) Study specific items will be recorded as illustrated in Article #4 ii) Time spent populating the data will be recorded, as part of the secondary analysis.