Electronic health records shown to improve type 2 diabetes care

Electronic health records (EHRs) may help doctors provide significantly better care to individuals with type 2 diabetes, according to a new study published in the New England Journal of Medicine.

The researchers showed that when doctors use EHRs, they are significantly more likely to administer recommended tests to their diabetic patients. These screenings can ensure that individuals are properly controlling their blood sugar and avoiding unhealthy lifestyle habits.

For the study, the team examined records from patients being treated at 21 medical offices around the greater Cleveland area. They were looking to see if patients with type 2 diabetes received testing for HbA1c levels, which determine long-term blood sugar control; urinary microalbumin, which can indicate kidney complications; vision to check for signs of retinopathy and cholesterol. Additionally, the team checked to see if a pneumococcal vaccination had been administered.

The results showed that 43.7 percent of patients being treated by doctors using EHRs received four of these five screenings, while only 15.7 percent of those being treated by paper-based physicians received this level of care.

"EHR sites were associated with higher levels of achievement of and improvement in regionally vetted standards for diabetes care and outcomes," the researchers wrote in their report.

However, they admitted that EHR use by physicians did not necessarily lead to better treatment outcomes. While indicators of care quality were better, outcomes were roughly even because type 2 diabetes requires cooperation by the patient when they are away from the doctor's office. If the patient continues to eat an unhealthy diet and live a sedentary lifestyle, better care may not necessarily help.

Still, other studies have shown that using technology similar to EHRs can lead to improvements in medical adherence by type 2 diabetes patients and therefore outcomes.

For example, a recent investigation published earlier this year in the Annals of Family Medicine showed that when physicians use clinical decision support systems in conjunction with EHRs, patients with type 2 diabetes generally experience better blood sugar control and lower blood pressure.

Researchers from the HealthPartners Foundation looked at the medical records of 2,556 patients being treated in this type of system. They found that these individuals improved their blood sugar control by 26 percent and blood pressure levels dropped. However, the technology failed to make any meaningful impact on cholesterol scores.

Still, the HealthPartners team said using EHRs could play an important role in the future of diabetes care.

"EHR-based diabetes clinical decision support significantly improved glucose control and some aspects of blood pressure control in adults with type 2 diabetes," they wrote in their report.

Findings such as these suggest a potential solution to a problem that has plagued diabetes treatment for years. The condition requires individuals to make frequent visits to their doctors, which generate significant amounts of information. However, identifying meaningful data can be tricky. EHRs and other technologies may help physicians make sense of all the information and make better decisions for their patients.
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