EHRs improve outcomes among patients with diabetes

ST LOUIS (MD Consult) - Implementation of electronic health records (EHRs) is associated with better monitoring and glycemic control among patients with diabetes, finds a study reported in the October 2, 2012, issue of the Annals of Internal Medicine. 

Researchers conducted a quasi-experimental study of sequential outpatient implementation of a commercially available EHR across 17 medical centers of Kaiser Permanente Northern California. Analyses were based on 169,711 patients with diabetes mellitus. 

Results showed that EHR implementation significantly improved the odds of treatment intensification when glycated hemoglobin (HbA1c) values reached 9% or greater (odds ratio, 1.10) or low-density lipoprotein cholesterol (LDL-C) values reached 100 to 129 mg/dL (odds ratio, 1.06) 

It also significantly increased retesting at 1 year for HbA1c and LDL-C levels among all patients, but especially among those having the worst disease control, with HbA1c1c) levels of less than 7% or LDL-C levels of less than 100 mg/dL. 

Finally, EHR implementation led to significant reductions in HbA1c and LDL-C levels, with greatest benefit seen among patients with the worst control. 

The investigators acknowledge that the EHR was i
Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACPmplemented in a health care system that already had good measures of cardiovascular quality of care. 

"Use of a commercially available certified EHR was associated with improved drug treatment intensification, monitoring, and physiologic control among patients with diabetes, with greater improvements among patients with worse control and less testing in patients already meeting guideline-recommended glycemic and lipid targets," they conclude. 

Ann Intern Med. 2012;157:482-489.

From: MD Consult online
Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

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