Health InsuranceImprovement In Diabetes Patient Care With Electronic Tracking System
A recent study published in the Canadian Medical Association Journal (CMAJ) reports that diabetes care and clinical outcomes are improved by an electronic system with personalized patient information shared by diabetes patients and their primary care providers.
A total of 511 patients and 46 family physicians and nurse-practitioners were involved in the study. Web-based tools integrated with five different types of electronic health records were on hand, as well as an automated telephone reminder system and a mailing of color-coded materials to half the study sample. There was improvement for 62 percent of the patients compared to 42.6 percent in the control group. Intervention patients reported greater satisfaction with their diabetes care.
About 23 million people are affected by diabetes, which represents approximately 7 percent of the populations of Canada and the US. There are $105 billion in direct annual healthcare costs. The majority of diabetes care is community-based, and is largely managed by primary care physicians.
This research is one of the first randomized trials to break new ground in community-based primary care. It is the first trial of its kind in Canada.
Dr. Anne Marie Holbrook of McMaster University and coauthors write: "Despite the technical challenges for both patients and physicians, we have demonstrated that the care of a complex chronic disease can be improved with electronic tracking and decision support shared by family physician and patient."
In an associated comment, Dr. Richard Grant and Dr. Blackford Middleton of Harvard Medical School say the results of the study "provide strong evidence that complex research interventions can and should be implemented in community-based practices." Further development will focus on creating patient-centered rather than disease-focused systems. The aim is to address a wide range of patient concerns and help clinical management of complex diseases outside of a visit to a doctor or nurse.
"Individualized electronic decision support and reminders to improve diabetes care in the community: COMPETE II randomized trial"
Anne Holbrook, MD PharmD, Lehana Thabane, PhD, Karim Keshavjee, MD MBA, Lisa Dolovich, PharmD MSc, Bob Bernstein, PhD MDCM, David Chan, MD MSc, Sue Troyan, Gary Foster, PhD, Hertzel Gerstein, MD MSc for the COMPETE II Investigators
CMAJ ò€¢ July 7, 2009; 181 (1-2). doi:10.1503/cmaj.081272
"Improving primary care for patients with complex chronic diseases: Can health information technology play a role?"
Richard W. Grant and Blackford Middleton
Can. Med. Assoc. J. 2009 181: 17-18.
cmaj
Written by Stephanie Brunner (B.A.)
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