Journal article
Harnessing the electronic health record to identify and enroll people with epilepsy into a self-management program: Implementation and scalability in a clinical setting
Epilepsy & behavior, Vol.170, 110461
09/01/2025
DOI: 10.1016/j.yebeh.2025.110461
PMID: 40383001
Abstract
•Epilepsy Self-Management (ESM) programs, such as SMART, improve patient outcomes.•Electronic health record tools identify optimal ESM candidates in epilepsy clinics.•Over 5000 Best Practice Advisory alerts led to 360 SMART referrals over 5 months.•These practical health record tools improved access to ESM in clinical settings.
“Self-management for people with epilepsy and a history of negative health events” (SMART) is an 8-week, remotely delivered, Epilepsy Self-Management (ESM) program. The ongoing EXPANDing self-management support in healthcare networks (EXPAND) initiative leveraged the Electronic Health Record (EHR) to identify SMART candidates, simplify recruitment, and reduce staff workload.
This is an ongoing implementation effort at two Level 4 Epilepsy Centers (Iowa and Cincinnati) using the Epic EHR which follows 9326 People With Epilepsy (PWE). The EHR uses pre-visit screening to identify PWE with a recent seizure; barriers to medication adherence; depression symptoms; age 18–25; or residence in rural regions. At outpatient visits, Epic generated a Best Practice Advisory (BPA). The clinician clicked the BPA to forward a referral or to signal either the patient declined or was not a candidate. The program aims to enroll 560 PWE.
11 Nurse and Peer Educators received training. Within the first 5 months of BPA activation over 5000 clinician alerts were sent, 360 PWE were referred to SMART. Among 42 PWE who attended at least 1 SMART session, mean age was 35.0 (12.0), 57.5 % (N = 23) women. Mean past 30-day seizure count was 4.3 (10.0).
The EXPAND initiative, conducted in 2 Midwest U.S. epilepsy centers, is being successfully implemented to provide ESM to PWE. A widely available EHR has facilitated the referral process and remote delivery format allows for reach among diverse communities. This practical approach is amenable to scale-up and may be a model for expanding ESM access to PWE.
Details
- Title: Subtitle
- Harnessing the electronic health record to identify and enroll people with epilepsy into a self-management program: Implementation and scalability in a clinical setting
- Creators
- Gena R. Ghearing - Department of Neurology, Carver College of Medicine and Iowa Health Care, Iowa City, IA, USAMichael Privitera - University of CincinnatiMaegan Tyrrell - Department of Neurology, Carver College of Medicine and Iowa Health Care, Iowa City, IA, USALucy Mendoza - University of CincinnatiDavid Ficker - University of CincinnatiDana LoTempio - Department of Neurology, Carver College of Medicine and Iowa Health Care, Iowa City, IA, USAMark Granner - Department of Neurology, Carver College of Medicine and Iowa Health Care, Iowa City, IA, USAClara Adeniyi - Case Western Reserve UniversityRichard Barigye - Case Western Reserve UniversityJessica Black - University Hospitals of ClevelandFarren Briggs - University of MiamiNicole Fiorelli - Case Western Reserve UniversityCarrie Rogers - Case Western Reserve UniversityMartha Sajatovic - University Hospitals of Cleveland
- Resource Type
- Journal article
- Publication Details
- Epilepsy & behavior, Vol.170, 110461
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.yebeh.2025.110461
- PMID
- 40383001
- ISSN
- 1525-5050
- eISSN
- 1525-5069
- Grant note
- Centers for Disease Control and Prevention (CDC): NU58DP007544
This publication is a product of Cooperative Agreement Number NU58DP007544 from the Centers for Disease Control and Prevention (CDC). The findings and conclusion in the report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
- Language
- English
- Date published
- 09/01/2025
- Academic Unit
- Neurology; Neurosurgery
- Record Identifier
- 9984824297002771
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