Recommended Citation
Spencer C, Hackney R, Won M, Wallace Z, Jalan A, Sullivan Vedder L. Improving Continuous Glucose Monitor Prescribing Through EMR Standardization and Resident Education in a Family Medicine Residency Program. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Continuous glucose monitors (CGMs), including Dexcom G7 and FreeStyle Libre 3, improve glycemic control and reduce hypoglycemia in insulin-treated patients with diabetes. Despite strong evidence supporting their use, prescribing CGMs in primary care requires detailed documentation to meet Medicare and commercial insurance criteria. Incomplete documentation and uncertainty regarding eligibility can result in delays, denials, and underutilization. Baseline data within our residency clinics suggested inconsistent prescribing patterns and variability in required documentation. We sought to determine whether implementation of a standardized documentation template combined with resident education would increase CGM prescribing utilization and improve workflow efficiency.
Purpose:
To increase CGM prescribing rates and improve documentation standardization in a large (36-resident) urban family medicine residency program across two clinical sites.
Methods:
We conducted this quality improvement project in a large (36-resident) urban family medicine residency program based across two clinical sites. During the 12-month pre-intervention period (June 1, 2024–June 1, 2025), total outpatient CGM prescriptions were recorded. A standardized smart-phrase was developed within the EMR (Epic), incorporating required documentation elements including insulin administration frequency, most recent hemoglobin A1c (HbA1c), diabetes medications with dosages, confirmation of patient training, insurance verification, and required six-month follow-up language. The intervention also included structured resident education on CGM eligibility and prescribing workflow. Post-intervention prescribing data were collected from June 1, 2025, through February 18, 2026. Prescriptions were normalized by time to compare monthly prescribing rates.
Results:
During the pre-intervention period, 34 CGM prescriptions were generated over 12 months (2.8 prescriptions per month). Following implementation, 41 prescriptions were generated over 8.5 months (4.8 prescriptions per month), representing a 71% increase in monthly CGM prescribing rate. Prescribing distribution among residents became more evenly distributed after intervention, suggesting broader adoption. Providers reported improved clarity regarding documentation requirements and increased confidence in prescribing CGMs.
Conclusion:
Implementation of a standardized EMR (Epic) documentation template combined with resident education was associated with a substantial increase in CGM prescribing.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Improving Continuous Glucose Monitor Prescribing Through EMR Standardization and Resident Education in a Family Medicine Residency Program
Background/Significance:
Continuous glucose monitors (CGMs), including Dexcom G7 and FreeStyle Libre 3, improve glycemic control and reduce hypoglycemia in insulin-treated patients with diabetes. Despite strong evidence supporting their use, prescribing CGMs in primary care requires detailed documentation to meet Medicare and commercial insurance criteria. Incomplete documentation and uncertainty regarding eligibility can result in delays, denials, and underutilization. Baseline data within our residency clinics suggested inconsistent prescribing patterns and variability in required documentation. We sought to determine whether implementation of a standardized documentation template combined with resident education would increase CGM prescribing utilization and improve workflow efficiency.
Purpose:
To increase CGM prescribing rates and improve documentation standardization in a large (36-resident) urban family medicine residency program across two clinical sites.
Methods:
We conducted this quality improvement project in a large (36-resident) urban family medicine residency program based across two clinical sites. During the 12-month pre-intervention period (June 1, 2024–June 1, 2025), total outpatient CGM prescriptions were recorded. A standardized smart-phrase was developed within the EMR (Epic), incorporating required documentation elements including insulin administration frequency, most recent hemoglobin A1c (HbA1c), diabetes medications with dosages, confirmation of patient training, insurance verification, and required six-month follow-up language. The intervention also included structured resident education on CGM eligibility and prescribing workflow. Post-intervention prescribing data were collected from June 1, 2025, through February 18, 2026. Prescriptions were normalized by time to compare monthly prescribing rates.
Results:
During the pre-intervention period, 34 CGM prescriptions were generated over 12 months (2.8 prescriptions per month). Following implementation, 41 prescriptions were generated over 8.5 months (4.8 prescriptions per month), representing a 71% increase in monthly CGM prescribing rate. Prescribing distribution among residents became more evenly distributed after intervention, suggesting broader adoption. Providers reported improved clarity regarding documentation requirements and increased confidence in prescribing CGMs.
Conclusion:
Implementation of a standardized EMR (Epic) documentation template combined with resident education was associated with a substantial increase in CGM prescribing.
Affiliations
Aurora St. Luke's Medical Center, Aurora Sinai Medical Center, Aurora UW Medical Group