The Need for Data Standards and Implementation Policies to Integrate CGM Data into the Electronic Health Record

Abstract

The current lack of continuous glucose monitor (CGM) data integration into the electronic health record (EHR) is holding back the use of this wearable technology for patient-generated health data (PGHD). This failure to integrate with other healthcare data inside the EHR disrupts workflows, removes the data from critical patient context, and overall makes the CGM data less useful than it might otherwise be. Many healthcare organizations (HCOs) are either struggling with or delaying designing and implementing CGM data integrations. In this article, the current status of CGM integration is reviewed, goals for integration are proposed, and a consensus plan to engage key stakeholders to facilitate integration is presented.

The Need for Data Standards and Implementation Policies to Integrate Insulin Delivery Data Into the Electronic Health Record

“…The iCoDE Project (Figure 12) began in January of 2022, and over the course of the next ten months, more than 130 individuals from over 30 organizations met regularly in both large-format and small working group meetings to establish consensus on both the technical and operational aspects of CGM-EHR data integration. 3 The final output of this project was the publication of the 2022 iCoDE Report: CGM-EHR Integration Standards and Recommendations on November 7, 2022. 1 This 108-page report contains extensive documentation of data standards, interoperability standards, clinical implementation recommendations, and practical project management guidance.…”

Diabetes Technology Meeting 2021

“…An in-depth Diabetes Technology Integration Framework (Figure 8) shows the key considerations that need to be addressed from beginning (data sourcing) to middle (data exchange and storage) to end (governance). 47…”

“…An in-depth Diabetes Technology Integration Framework (Figure 8) shows the key considerations that need to be addressed from beginning (data sourcing) to middle (data exchange and storage) to end (governance). 47 Although the session included distinct perspectives on the topic of diabetes software and digital therapeutics, the overall message was clear. To succeed, diabetes software must provide clinical outcomes, develop a strong business case, and integrate seamlessly with EHRs.…”

“…Abbreviations: CGM, continuous glucose monitor; EHR, electronic health record; FHIR, Fast Healthcare Interoperability Resources; IRB, Institutional Review Board; IT, information technology; SMART, Substitutable Medical Applications, Reusable Technologies. Source: Figure reprinted from Espinoza et al47…”

The Launch of the iCoDE Standard Project

“…The Integration of Continuous Glucose Monitor Data into the Electronic Health Record (iCoDE) project is a program intended to develop data standards and implementation policies to integrate continuous glucose monitor (CGM) data into the electronic health record (EHR). 1 The CGM data pipeline from patient to clinician is complex, but there are a number of opportunities along the way to adopt, adapt, or develop standards and define best practices that can significantly improve data access and drive adoption (Figure 1). Different sensors are currently being used for physiologic monitoring of cardiac, neurologic, gastrointestinal, pulmonary, orthopedic, and other conditions.…”