2057-P: Implementation of an Automated Electronic Health Record Program to Support Very Low-Carbohydrate Nutrition Counseling

Introduction and Objective: Very low-carbohydrate diets (VLCDs) support weight loss among overweight and obese individuals, but most general practices lack resources necessary to teach patients VLCDs. We developed and implemented Low Carb Journey (LCJ), a fully automated, EHR-embedded, 16-week program with 20 video modules and online resources. This study evaluates LCJ’s reach, adoption and effectiveness for patients with obesity. Methods: Participants in this retrospective evaluation were (1) primary care providers (PCPs) who practice in clinics affiliated with a large academic health system and (2) patients with obesity referred by PCPs to LCJ. PCPs were informed of LCJ and provided instructions for enrolling eligible patients. Enrolled patients received program content as tasks through their EHR portal, could choose to complete tasks based on their interests, and were asked to self-report weight and carbohydrate intake on a weekly basis. Primary outcomes were program reach (i.e. proportion of eligible patients enrolled, patient uptake rate), adoption (i.e. provider enrollment rate, mean number of patients enrolled), and effectiveness (i.e. patient weight and carb intake change). Results: From 9/27/2024 to 8/26/2025, 26% (92/350) of PCPs enrolled 3.3% (683/21011) of LCJ-eligible patients. On average, PCPs enrolled 7.4 patients (SD 13.8, range 1-87), with 11% (10/92) of PCPs making 59% (400/683) of all enrollments. Of enrolled patients, 69% (474/683) completed ≥ 1 program task and on average completed 18.9 tasks (SD = 25.4, range = 1-136). During the intervention, 18.7% (89/474) of patients completed ≥2 weight and/or carbohydrate intake reports, with -2.7 kg (-2.4%) weight change and -34.4 gram change in reported daily carb intake. Conclusion: LCJ achieved notable reach, adoption, and effectiveness, suggesting its potential as a scalable model for supporting very low carb dietary guidance. Additional evaluation is needed to understand program effectiveness and viable implementation strategies for scale up. Disclosure M. Marras: None. C.D. Turner: None. E.W. Carter: None. J. Lee: Research Support; Current; Lilly. Board Member; Ended; GoodRx. M. Segar: Consultant; Ended; Modify Health - I helped them with behavior change curriculum. R. Hisamatsu: None. D. Griauzde: Other - I received an honorarium for speaking.; Ended; American Diabetes Association. Research Support; Current; National Institute of Diabetes and Digestive and Kidney Diseases.