Screening for Risk Stratification of Cardiovascular Disease in Type 2 Diabetes

Abstract

An estimated 34 million Americans aged 18 and older have diabetes, with Type 2 Diabetes (T2DM) being the majority diagnosis and at a higher risk for cardiovascular disease. Less than 20% of diabetic patients meet or are below the Centers for Disease Control and Prevention risk levels, including for atherosclerotic cardiovascular disease (ASCVD). Evidence proves that early counseling and interventions in the ambulatory care setting help to reduce modifiable ASCVD risks. Initiating an ASCVD risk screening at primary care visits provides the opportunity for earlier detection, driving quicker and more effective healthcare decisions. Many ambulatory clinics serve lower socioeconomic and health literacy patients with poor self-management skills and miss an opportunity to address the risk of severe illness and death related to unmanaged or undiagnosed ASCVD. By using an embedded electronic medical record (EMR) tool, an ASCVD risk score screening populated into a provider visit note creates a visual reminder for providers to assess the risk level, educate, and engage patients in actively participating in their care. This evidence-based, quality improvement project aimed to increase the number of ASCVD risk score screenings in adult T2DM, ambulatory, EMR provider visit notes and help improve provider’s actions post-screening at the moderate and high-risk levels. The FADE model was used during each project team touchpoint and as needed for ongoing barriers such as EMR technical issues. The project led providers to collaborate with patients to improve their health and increase the number of screenings. An ASCVD risk score screening in a provider visit note is effective in aiding as a visual reminder for providers and will help to decrease the risk or severity of cardiovascular disease in the adult T2DM population.