Employing the Electronic Health Record to Improve Diabetes Care: A Multifaceted Intervention in an Integrated Delivery System

INTRODUCTION Type 2 diabetes is one of the nation’s most prevalent chronic diseases. Although well-known practice guidelines exist, real-life clinical performance often falls short of benchmarks. AIM Employ an electronic registry derived from a fully integrated electronic health record (EHR) as the...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2008-04, Vol.23 (4), p.379-382
Main Authors: Weber, Valerie, Bloom, Frederick, Pierdon, Steve, Wood, Craig
Format: Article
Language:English
Subjects:
Aged
Ambulatory Care Information Systems
Decision Support Systems, Clinical
Delivery of Health Care, Integrated
Diabetes
Diabetes Complications - prevention & control
Diabetes Mellitus, Type 2 - drug therapy
Electronic health records
Female
Humans
Innovations in Clinical Practice
Integrated delivery systems
Internal Medicine
Male
Medical Order Entry Systems
Medical Records Systems, Computerized - statistics & numerical data
Medicine
Medicine & Public Health
Middle Aged
Outpatient Clinics, Hospital
Patient Compliance
Pennsylvania
Physicians
Practice Patterns, Physicians
Quality Assurance, Health Care
Quality of care
Reminder Systems
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Summary:INTRODUCTION Type 2 diabetes is one of the nation’s most prevalent chronic diseases. Although well-known practice guidelines exist, real-life clinical performance often falls short of benchmarks. AIM Employ an electronic registry derived from a fully integrated electronic health record (EHR) as the cornerstone of an intervention to improve compliance with recommended diabetes performance measures in an integrated practice network. SETTING Geisinger Health System’s network of 38 practice sites providing care to over 20,000 persons with diabetes located in a 40-county region of central and northeastern Pennsylvania. PROGRAM DESCRIPTION A multidisciplinary group of physicians worked to create a “bundle” of best practice measures for diabetes. This measurement tool was then used as part of a multifaceted intervention to improve physician performance in diabetes care, including audit and feedback, computerized reminders, and financial incentives. Changes in performance of individual measures and the total “bundle” were tracked monthly over 1 year. PROGRAM EVALUATION Significant increases were seen in all measures of diabetes care over the 12-month period of the study. Vaccination for pneumococcal disease and influenza improved from 56.5% to 80.8% ( p  
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-007-0439-2