title: Increasing Referrals to a YMCA-Based Diabetes Prevention Program: Effects of Electronic Referral System Modification and Provider Education in Federally Qualified Health Centers.
abstract: BACKGROUND
  The Diabetes Prevention Program has been translated to community settings with varying success. Although primary care referrals are used for identifying and enrolling eligible patients in the Diabetes Prevention Program, little is known about the effects of strategies to facilitate and sustain eligible patient referrals using electronic health record systems.
  
  
  METHODS
  To facilitate and sustain patient referrals, a modification to the electronic health record system was made and combined with provider education in 6 federally qualified health centers in the Bronx, New York. Referral data from April 2012 through November 2014 were analyzed using segmented regression analysis.
  
  
  RESULTS
  Patient referrals increased significantly after the modification of the electronic health record system and implementation of the provider education intervention. Before the electronic system modification, 0 to 2 patients were referred per month. During the following year (September 2013 through August 2014), which included the provider education intervention, referrals increased to 1 to 9 per month and continued to increase to 5 to 11 per month from September through November 2014.
  
  
  CONCLUSIONS
  Modification of an electronic health record system coupled with a provider education intervention shows promise as a strategy to identify and refer eligible patients to community-based Diabetes Prevention Programs. Further refinement of the electronic system for facilitating referrals and follow-up of eligible patients should be explored.
authors.affiliation: 1300 Morris Park Ave, Block 408, Bronx, NY 10461. Telephone: 718-430-3057. Email: earle.chambers@einstein.yu.edu.
authors.forename: Earle C
authors.initials: EC
authors.lastname: Chambers
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Judith
authors.initials: J
authors.lastname: Wylie-Rosett
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Blank
authors.affiliation: YMCA Diabetes Prevention Program, Activate America, New York, New York.
authors.forename: Judy
authors.initials: J
authors.lastname: Ouziel
authors.affiliation: Office Of Community and Population Health, Montefiore Medical Center, Bronx, New York.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hollingsworth
authors.affiliation: Office Of Community and Population Health, Montefiore Medical Center, Bronx, New York.
authors.forename: Rachael W
authors.initials: RW
authors.lastname: Riley
authors.affiliation: Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Selwyn
mesh_terms: D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000517:prevention & control*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D020446:Fitness Centers; D006282:Health Personnel / Q000193:education*; D006801:Humans; D016014:Linear Models; D008297:Male; D009518:New York; D005791:Patient Care / Q000592:standards*; D012017:Referral and Consultation / Q000706:statistics & numerical data*