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Research ArticleOriginal Research

Impact of an Electronic Medical Record on Diabetes Quality of Care

Patrick J. O’Connor, A. Lauren Crain, William A. Rush, JoAnn M. Sperl-Hillen, Jay J. Gutenkauf and Jane E. Duncan
The Annals of Family Medicine July 2005, 3 (4) 300-306; DOI: https://doi.org/10.1370/afm.327
Patrick J. O’Connor
MD, MPH
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A. Lauren Crain
PhD
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William A. Rush
PhD
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JoAnn M. Sperl-Hillen
MD
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Jay J. Gutenkauf
MD
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Jane E. Duncan
MPH
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    Figure 1.

    Observed HBA1c improvement with time in EMR and non-EMR clinics, Minnesota, 1996–2000.

    Note: Differences in mean HbA1c levels between clinics were not significant at any time (P >.05 for all comparisons).

    HbA1c = glycated hemoglobin; EMR = electronic medical record.

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    Table 1.

    Characteristics of Study Patients at the EMR and Comparison Clinics

    Patient CharacteristicEMR Clinic n = 57Comparison Clinic n = 65P Value
    EMR = electronic medical record.
    * Charlson Comorbidity Score. See text for definition and measurement.
    Age, mean (SE) years60.6 (1.62)59.4 (1.72).34
    Male, %54.458.5.65
    Charlson* <2, %73.775.4.97
    Charlson = 2, %15.815.4
    Charlson >2, %10.59.2
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    Table 2.

    Adjusted Number of HbA1c and LDL Tests Performed on Patients in the EMR and Comparison Clinics in a 12-Month Period

    TestEMR n = 57Comparison n = 65Time by EMR P Value
    HbA1c = glycated hemoglobin; LDL = low-density lipoprotein cholesterol; EMR = electronic medical record.
    HbA1c tests, No.
        19961.671.75
        19982.201.83.04
        20002.461.63.001
    LDL tests, No.
        1996.54.49
        1998.87.59.33
        20001.45.92.19
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    Table 3.

    Percentage of Patients Having at Least 2 HbA1c Tests, 1 LDL Test, or 2 HbA1c and 1 LDL Tests per Year in the EMR and Comparison Clinics

    TestEMR n = 57Comparison n = 65Time by EMR P Value
    HbA1c = glycated hemoglobin; LDL = low-density lipoprotein cholesterol; EMR = electronic medical record.
    ≥ 2 HbA1c tests
        199647.455.4
        199873.763.1.09
        200078.953.9.002
    ≥ 1 LDL test
        199642.146.2
        199868.455.4.12
        200084.272.3.12
    ≥ 2 HbA1c and 1 LDL test
        199629.830.8
        199857.946.2.27
        200070.246.2.03
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    Table 4.

    Predicted Least Squares Mean HbA1c Test Values in Clinics With Time, Adjusted for Patient Age, Sex, and Charlson Comorbidity Score

    YearEMR n = 46Comparison n = 50Time by EMR P Value
    HbA1c = glycated hemoglobin; EMR = electronic medical record.
    1996 HbA1c value7.807.35
    1998 HbA1c value7.907.26.10
    2000 HbA1c value7.717.11.27

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    Background: It is widely believed that electronic medical records (EMRs) can help manage medical information and improve care of diseases, such as diabetes. EMRs can identify patients with diabetes, determine whether they are due for tests or procedures, and identify whether they have high blood sugar, high blood pressure, and other related conditions. This study looked at whether use of an EMR improved the quality of care of patients with diabetes.
    What This Study Found: The use of EMRs improved the process of caring for patients with diabetes, but it did not lead to better health results for diabetes patients. Patients in a clinic using EMRs received more tests for long-term blood sugar control and bad cholesterol levels than patients in a clinic that did not use EMRs. However, diabetes patients in the EMR clinic did not have better control of their blood sugars compared with other patients.
    Implications:
    � EMRs need more capabilities to help doctors make decisions about diabetes care and to help educate and activate patients.
    � At this time, other methods, which are less expensive and less disruptive, may be as effective as EMRs in improving the care of patients with chronic diseases.

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The Annals of Family Medicine: 3 (4)
The Annals of Family Medicine: 3 (4)
Vol. 3, Issue 4
1 Jul 2005
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Impact of an Electronic Medical Record on Diabetes Quality of Care
Patrick J. O’Connor, A. Lauren Crain, William A. Rush, JoAnn M. Sperl-Hillen, Jay J. Gutenkauf, Jane E. Duncan
The Annals of Family Medicine Jul 2005, 3 (4) 300-306; DOI: 10.1370/afm.327

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Impact of an Electronic Medical Record on Diabetes Quality of Care
Patrick J. O’Connor, A. Lauren Crain, William A. Rush, JoAnn M. Sperl-Hillen, Jay J. Gutenkauf, Jane E. Duncan
The Annals of Family Medicine Jul 2005, 3 (4) 300-306; DOI: 10.1370/afm.327
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