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Use of simple clinical information systems can improve outcomes of patients with diabetes
Use of simple clinical information systems to identify and track patient information can improve the outcomes of primary care patients with diabetes, concludes a new study. These relatively inexpensive systems were particularly useful for improving the outcomes of higher risk diabetic patients with hypertension or heart conditions, notes John Orzano, M.D., M.P.H., of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School.
Dr. Orzano and colleagues surveyed clinicians from 50 primary care practices about their use of clinical information systems for patient identification and tracking. The team also reviewed the medical records of patients with diabetes in the practices to determine achievement of clinical targets. These included control of blood-sugar levels (HbA1c of 8 or less), LDL cholesterol (100 or less), and blood pressure of (130/85 or less).
Use of identification and tracking systems increased by 23 to 32 percent the odds of achieving diabetes care targets. Use of tracking systems increased by 52 percent the odds of hypertension control among patients with diabetes and hypertension, and use of identification systems increased it by 28 percent. Use of electronic health records (EHRs) was not associated with attainment of any clinical targets.
These findings should caution clinicians about the risk of rushing into EHR implementation as an automatic fix for quality-of-care issues. EHR alone is not sufficient for achieving desirable clinical outcomes. Organizational factors also affect successful information use.
The study was supported in part by the Agency for Healthcare Research and Quality (HS14018).
See "Improving outcomes for high-risk diabetics using information systems," by Dr. Orzano, Pamela Ohman Strickland, Ph.D., Alfred T. Tallia, M.D., M.P.H., and others, in the May-June 2007 Journal of the American Board of Family Medicine 20, pp. 245-251.
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