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Am J Med Qual. 2015 Jan-Feb;30(1):14-22. doi: 10.1177/1062860613516991. Epub 2014 Jan 7.

Impact of an EHR-based diabetes management form on quality and outcomes of diabetes care in primary care practices.

Author information

1
Health Research & Educational Trust, Chicago, IL Yale University, New Haven, CT.
2
Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, TX.
3
HealthTexas Provider Network, Baylor Health Care System, Dallas, TX.
4
Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, TX dj.ballard@baylorhealth.edu.

Abstract

Health information technology shows promise for improving chronic disease care. This study assessed the impact of a diabetes management form (DMF), accessible within an electronic health record. From 2007 to 2009, 2108 diabetes patients were seen in 20 primary care practices; 1103 visits involved use of the DMF in 2008. The primary outcome was "optimal care": HbA1c ≤8%, low-density lipoprotein (LDL) cholesterol <100 mg/dL, blood pressure <130/80 mm Hg, not smoking, and aspirin prescription in patients ≥40 years. After adjusting for number of visits, age, sex, and insulin use, DMF-exposed patients showed less improvement in attaining "optimal care" (estimated difference-in-difference [DID] = -2.06 percentage points; P < .001), LDL cholesterol (DID = -2.30; P = .023), blood pressure (DID = -3.05; P < .001), and total cholesterol (DID = -0.47; P = .004) targets. Documented microalbumin tests, aspirin prescription, and eye and foot exams increased more. Thus, DMF use was associated with smaller gains in achieving evidence-based targets, but greater improvement in documented delivery of care.

KEYWORDS:

diabetes; electronic health records

PMID:
24399633
DOI:
10.1177/1062860613516991
[Indexed for MEDLINE]

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