579-P: ADA Diabetes Medical Management Plan Implementation—Barriers and Opportunities

Introduction 100% of providers and 92% of nurses agreed that the DMMP was comprehensive and 60% felt it was the right length. The DMMP was usually completed on a computer by providers (82%), though only 31% could share the form electronically with schools. Common barriers reported by school nurses included delays in receiving the DMMP (57%) including updates (64%) and alternative forms from providers (41%); for providers, barriers included lack of health record integration (72%) and time required to complete the DMMP (50%). Both groups endorsed difficulty with parent engagement with DMMP completion (37% nurses, 44% providers). Over 750 comments suggested modifications to enhance usability; themes included fostering parent and provider input for all sections, streamlining references to accommodations, and providing more flexible formats to customize based on local practices. Conclusion: Barriers at the health system level interfere with uptake of the DMMP. Multi-stakeholder input can co-create medical orders and school resources which can be customized to meet the needs of local centers. Electronic systems for bidirectional information transfer between schools and diabetes centers would facilitate adoption. Disclosure C. March: None. J. McManemin: None. M. Pellizzari: None. J. Rodriguez: None. H. Rodriguez: Consultant; Provention Bio, Inc. Speaker's Bureau; Sanofi. Other Relationship; Merck Boehringer-Ingelheim, Dexcom, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk, Tandem, Teva. K. Harriman: None. C. Woodward: None.