The goal of this pragmatic randomized clinical trial is to determine whether an Epic-based clinician notification increases initiation of guideline-directed cardio-kidney-metabolic (CKM) therapies in adults with type 2 diabetes and confirmed albuminuria.
The main question it aims to answer is:
• Does an Epic clinician notification improve initiation of guideline-directed CKM therapies compared with usual care?
Researchers will compare an Epic in-basket clinician notification strategy with usual care.
In the intervention arm, the treating clinician will receive an Epic notification identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing electronic health record (EHR) data. Participants in the usual care arm will receive standard clinical care without notification.
Adults aged ≥18 years
Diagnosis of type 2 diabetes mellitus
Receiving outpatient care within Baylor Scott & White Health
At least 1 outpatient encounter within the preceding 12 months
Type 1 diabetes mellitus
Contraindication or documented intolerance to all eligible guideline-directed CKM therapies
Advanced kidney dysfunction below recommended initiation thresholds for SGLT2i or finerenone
Hyperkalemia or elevated baseline serum potassium precluding safe therapy initiation