EHRs Bring Improved Treatment for Patients With Diabetes: Study

Electronic health records lead to a boost in health outcomes for patients with diabetes, according to a new study by Kaiser Permanente.

Kaiser Permanente, a health system and plan provider, has released the results of a study showing that electronic health records (EHRs) enable doctors to improve their treatment and monitoring of diabetic patients.

The company published its study results on Oct. 1 in the Annals of Internal Medicine. For the study, called "Outpatient Electronic Records and the Clinical Care and Outcomes of Patients With Diabetes Mellitus," researchers examined EHRs for close to 170,000 patients with diabetes for 17 medical centers in the Kaiser Permanente health system from 2004 to 2009.

When doctors used EHRs, they were able to help patients improve their blood sugar and low-density lipoprotein levels, which when at high levels can cause cholesterol buildup in arteries.

"In our study we found that the use of the EHR helped diabetes patients meet lipid and glycemic control quality goals," Dr. Marc Jaffe, clinical leader for the Kaiser Permanente Northern California Cardiovascular Risk Reduction Program and senior author of the study, told eWEEK in an email. "This is important since people with diabetes have many quality goals to reach, and the EHR may have particular utility in individuals with complex diseases with multiple performance measures."

Use of EHRs helped improve patients' HbA1c levels, which indicate how high a patient's blood glucose rose on average for an 8- to 12-week period, said Jaffe.

Using EHRs allows doctors to intensify drug treatments and monitoring as well as control risk factors. The results of the study highlighted the ability of EHRs to aid a large population of patients, Kaiser Permanente noted.

The results released this month follow those of a similar study published in the journal Health Affairs in 2010 that showed improvement in care for patients with diabetes and hypertension when doctors and patients communicated using secure email.

The increased speed that clinicians could access patients' diabetes data also led to better treatment outcomes, he said.

EHRs allow doctors to make better decisions on drug treatment and testing by accessing the "real-time" clinical messaging when patients visit doctors for non-diabetes issues or came in for overdue tests, said Jaffe.

Order entry for drugs in EHRs also led to improved care, according to Jaffe.

"Increases in order-entry functionality aided clinicians with drug treatment intensification and retesting, likely by making it easier for clinicians to order appropriate tests or treatment using streamlined prompts and keyboard shortcuts," said Jaffe.

Kaiser Permanente implemented the company's HealthConnect EHR software throughout its health system in March 2010. The application is primarily built on Epic Systems' EpicCare EHR platform.

HealthConnect holds patients' records from hospitals, radiologists, laboratories and pharmacies. It also allows doctors to store data on bedside documentation, clinical decision support and bar codes for medication.

In addition to use by doctors, HealthConnect allows patients to access a portion of their records through the company's Web portal.

Following the examination of the role of EHRs on diabetes care, researchers will see how EHR use affects emergency room visits, according to Dr. Mary Reed, a research scientist with the Kaiser Permanente Northern California Division of Research and the lead author of the study.

"Since we have found that glycemic control and lipid levels were better, now we need to better understand if EHR use impacts measurable events like emergency room visits," Reed said in a statement. "This would be an important next step in evaluation of the impact and potential value of electronic health records."

The study notes that benefits for patients with diabetes were seen in EHR applications that were certified. The federal government's Office of the National Coordinator for Health IT has published a list of certified EHR apps.