Developing and Evaluating SEE-Diabetes: A Patient-Centered Educational Decision Support System for Diabetes Care.

OBJECTIVES

This feasibility study evaluated the effectiveness of Support-Engage-Empower-Diabetes (SEE-Diabetes), a patient-centered educational tool designed to promote shared decision-making of diabetes management in older adults. We aimed to assess SEE-Diabetes's ability to facilitate patient engagement and collaborative goal setting, as measured by the Observational Patient Involvement (OPTION) scale and Shared Decision-Making Questionnaire (SDM-Q-Doc). We hypothesized that these instruments would effectively differentiate between healthcare providers who actively leveraged SEE-Diabetes to guide patient-centric conversations and set goals compared to those who did not.

METHODS

SEE-Diabetes, developed through a 4-year user-centered design process, was employed in simulated clinical encounters at the University of Missouri Health Care. We conducted an analysis of 12 clinical encounters using video recordings. This analysis involved three simulated patients and four providers, two internals and two externals, utilizing a mixed-methods approach. We assessed the decision-making process using SEE-Diabetes by SDM-Q-Doc, OPTION scale, and conversation analysis.

RESULTS

The average scores for the SDM-Q-Doc and the OPTION scale, out of a possible 100, were 52.6 and 75.9, respectively. Our findings revealed that active provider engagement with SEE-Diabetes during patient interactions served as an effective medium to facilitate shared decision-making and to set patient-centered goals. Providers who actively utilized SEE-Diabetes to guide conversations, ask open-ended questions, and incorporate patient input into goal setting demonstrated significantly higher OPTION and SDM-Q-Doc scores compared to those who used the tool less frequently or primarily for documentation purposes. Providers expressed positive feedback, highlighting its conciseness, patient-centricity, and optimism about integrating SEE-Diabetes into their future practices.

CONCLUSION

SEE-Diabetes showed considerable promise in improving interactions between patients and providers, presenting an innovative approach to diabetes management for older adults. This tool has the potential to not only close communication gaps but also enable patients to take a more active role in their healthcare decisions.