What Did We Learn About Diabetes in 2011?

Gregory A. Nichols, PhD

Disclosures

November 23, 2011

In This Article

Do EHRs Improve Quality of Diabetes Care?

Cebul and colleagues[30] analyzed data from a retrospective cohort of 46 primary care practices of 7 diverse healthcare organizations that publicly reported achievement of quality standards for adults with diabetes. Of the 46 practices, 33 used electronic health records (EHRs) and 13 used paper-based records. Achievement of composite standards for diabetes care was 35.1 percentage points higher at EHR sites than at paper-based sites (P < .001), and achievement of composite standards for outcomes was 15.2 percentage points higher (P = .005).

Analyses of temporal trends showed that EHR sites were also associated with greater improvement in care (a difference of 10.2 percentage points in annual improvement, P < .001) and outcomes (a difference of 4.1 percentage points in annual improvement, P = .02).

Why Is This a Game Changer?

Current health policy is urging heavy investment in EHRs in the hope that this will lead to a more efficient and less costly healthcare system.[31] That hope, however, is based on surprisingly little empirical data. In fact, limited previous research has not been encouraging.[32] The quality metric differences reported here were quite large, and, perhaps more importantly, they showed a trend in improved outcomes among sites using EHRs. These results can very quickly translate into substantial cost savings, thus justifying investment in EHR systems.

What Does This Mean for the Practitioner?

EHRs may seem daunting to some clinicians. After all, most doctors chose medicine because they wanted to care for patients rather than interface with computers. Furthermore, learning to effectively use EHRs requires time that busy clinicians may feel they just don't have.

However, evidence that EHRs improve patient care may help reticent clinicians invest the time and money to convert their paper-based practices to EHR-based systems. In the end, this investment may save the clinician considerable time and, according to the present study, allow for the provision of better quality of care and healthier patients.

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