# A Technology-Driven Intervention to Improve Identification and Management of Chronic Kidney Disease in Primary Care

> **NIH NIH R18** · HEALTHPARTNERS INSTITUTE · 2020 · $485,836

## Abstract

Project Summary
Chronic kidney disease (CKD) is a common and serious chronic disease that often leads to end-stage renal
disease and major cardiovascular events. Although evidence-based CKD care can slow disease progression
and avert complications, less than 10% of CKD patients currently receive major elements of CKD care in a
timely fashion. The objective of this project is to develop, implement, and evaluate a technology-driven and
team-based intervention to improve quality of care and clinical outcomes for patients with stage 3-4 CKD. The
proposed intervention uses a sophisticated Web-based clinical decision support (CDS) system that is
seamlessly integrated within the electronic health record (EHR) to: (a) identify adults with CKD at primary care
encounters; (b) suggest personalized evidence-based treatment options to increase the appropriate use of
renoprotective antihypertensive medications, improve blood pressure control, and improve glycemic
management in patients with diabetes; and (c) suggest to patients and providers when collaboration and
consultation with nephrologists may be advisable. We rigorously test the impact of the intervention by randomly
assigning 30 primary care clinics with approximately 120 primary care physicians and 6100 adults with
evidence of stage 3-4 CKD to the CDS intervention versus usual care and assess intervention impact on 5 key
evidence-based elements of care for patients with CKD: (i.) recognition and diagnosis of CKD in patients who
meet diagnostic criteria; (ii.) adequate blood pressure control; (iii.) optimal angiotensin converting enzyme
inhibitor or angiotensin receptor blocker use; (iv.) adequate glucose control; and (v.) nephrology consultation
when appropriate. The intervention, referred to as CKD-CDS, provides patient-specific and stage-specific CKD
treatment options in high- and low-literacy formats to the primary care provider (PCP) and patients at each
primary care encounter to facilitate shared decision making. This CKD-CDS will be implemented using
previously successful methods that in previous CDS studies have achieved very high use rates with patients
(>75% of targeted patient encounters) for diabetes and high cardiovascular risk. Scalability of this NIH-
developed, non-commercialized intervention strategy is supported by its current use (without the CKD
identification or specific recommendations) in 4 large medical groups that provide care to 2,000,000 patients in
rural and urban areas in 4 Midwestern states, with research contracts to extend use to more than 60 safety net
clinics in an additional 14 states in 2018. If the addition of CKD-CDS to this tool is effective, the intervention is
immediately scalable and could (a) improve quality of care for large numbers of CKD patients, thereby slowing
progression of CKD and improving quality of life, (b) maximize the clinical return on massive public and private
investments now being made in sophisticated outpatient EHR systems, and (c) provide ...

## Key facts

- **NIH application ID:** 10004030
- **Project number:** 5R18DK118463-03
- **Recipient organization:** HEALTHPARTNERS INSTITUTE
- **Principal Investigator:** JOANN M SPERL-HILLEN
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $485,836
- **Award type:** 5
- **Project period:** 2018-09-06 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10004030

## Citation

> US National Institutes of Health, RePORTER application 10004030, A Technology-Driven Intervention to Improve Identification and Management of Chronic Kidney Disease in Primary Care (5R18DK118463-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10004030. Licensed CC0.

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