JMIR Publications

ABSTRACT

Background:

Older adults with diabetes often access their electronic health record (EHR) notes but report difficulty understanding medical jargon and vague instructions. To address this gap, our team developed SEE-Diabetes (Support–Engage–Empower Diabetes), a patient-centered educational tool designed to embed tailored diabetes self-management education and support (DSMES) into the Assessment and Plan section of clinical notes.

Objective:

This study aimed to validate the clarity, relevance, and alignment of SEE-Diabetes content with the Association of Diabetes Care & Education Specialists 7 Self-Care Behaviors™ (ADCES7) framework from the perspectives of older adults and clinicians in primary care.

Methods:

An interdisciplinary team conducted expert reviews and qualitative interviews with 11 patients and eight clinicians at a Midwestern academic health center. Patients evaluated readability and relevance, while clinicians assessed sufficiency, clarity, and potential for clinical use. Descriptive and thematic analyses were applied.

Results:

Patients (mean age 72 years, mean diabetes duration 26 years) reported that the statements were clear, relevant, and written in plain language. Clinicians (mean 13 years of diabetes care experience) considered SEE-Diabetes concise, sufficient, and aligned with patient self-care goals. Both groups recognized its potential to improve engagement and communication, although some concerns were raised regarding generic language and clarity of medication-related content.

Conclusions:

SEE-Diabetes was validated as a practical, patient-centered digital health tool for embedding DSMES into EHR notes. Findings support its integration into routine primary care to improve communication, reinforce self-care, and align education with patient-specific needs.