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Annals of Family Medicine 3:300-306 (2005)
© 2005 Annals of Family Medicine, Inc.
doi: 10.1370/afm.327
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Impact of an Electronic Medical Record on Diabetes Quality of Care

Patrick J. O’Connor, MD, MPH, A. Lauren Crain, PhD, William A. Rush, PhD, JoAnn M. Sperl-Hillen, MD, Jay J. Gutenkauf, MD and Jane E. Duncan, MPH

HealthPartners Medical Group and HealthPartners Research Foundation, Minneapolis Minn

CORRESPONDING AUTHOR: Patrick O’Connor, MD, MPH, HealthPartners Research Foundation, PO Box 1524, Minneapolis MN 55440-1524, patrick.j.oconnor{at}healthpartners.com

PURPOSE This study was designed to evaluate the impact of electronic medical record (EMR) implementation on quality of diabetes care.

METHODS We conducted a 5-year longitudinal study of 122 adults with diabetes mellitus at an intervention (EMR) clinic and a comparison (non-EMR) clinic. Clinics had similarly trained primary care physicians, similar patient populations, and used a common diabetes care guideline that emphasized the importance of glucose control. The EMR provided basic decision support, including prompts and reminders for diabetes care. Preintervention and postintervention frequency of testing for glycated hemoglobin (HbA1c) and low-density lipoprotein (LDL) levels were compared with and without adjustment for patient age, sex, comorbidity, and baseline HbA1c level.

RESULTS Frequency of HbA1c tests increased at the EMR clinic compared with the frequency at the non-EMR clinic (P <.001). HbA1c levels improved in both clinics (P <.05) with no significant differences between clinics 2 years (P = .10) or 4 years (P = .27) after EMR implementation. Similar results were observed for LDL levels.

CONCLUSIONS In this controlled study, EMR use led to an increased number of HbA1c and LDL tests but not to better metabolic control. If EMRs are to fulfill their promise as care improvement tools, improved implementation strategies and more sophisticated clinical decision support may be needed.

Key Words: Medical records systems, computerized • diabetes mellitus • quality of health care • primary health care • diabetic control • disease management • medical decision making, computer-assisted • informatics • endocrinological system/metabolism • practice-based research • electronic medical records




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TRACK Comments:

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Comment on 'Impact of an Electronic Medical Record on Diabetes Quality of Care'
Lawrence S. Phillips, M.D.
Annals of Family Medicine, 27 Jul 2005 [Full text]
Beyond EMR Reminders and Alerts
Jonathan Betz Brown, MPP, PhD
Annals of Family Medicine, 28 Jul 2005 [Full text]
EHR-work in progress
Louis Spikol M.D., et al.
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Comments on O’Connor et al.
Michael M. Engelgau, MD, MS
Annals of Family Medicine, 4 Aug 2005 [Full text]
Comment on 'Impact of an Electronic Medical Record on Diabetes Quality of Care'
Richard W. Grant
Annals of Family Medicine, 4 Aug 2005 [Full text]
ACADEMIC DETAILING
MARY E. ARENBERG
Annals of Family Medicine, 4 Aug 2005 [Full text]
Chronic Care Model
Glenn R. Singer MD
Annals of Family Medicine, 13 Aug 2005 [Full text]
We have a way to go!
Jaan Sidorov
Annals of Family Medicine, 20 Aug 2005 [Full text]
The missing link between diabetes care provided and patient outcomes
Carry M Renders
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