Electronic Health Records Bolster Diabetes Outcomes

When Kaiser Permanente Northern California rolled out a new electronic health record (EHR) system for outpatients a few years back, a team of researchers considered it a golden opportunity to evaluate how such systems affect care and outcomes.

The staggered implementation of the EHR system at 17 KP-owned medical centers from 2004 to 2009 allowed researchers to “examine the association between use of a commercially available certified EHR and clinical care processes and disease control in patients with diabetes,” says the study “Outpatient Electronic Health Records and the Clinical Care and Outcomes of Patients With Diabetes Mellitus” in the Oct. 12 issue of Annals of Internal Medicine.

Mary Reed, DrPH, the lead author, tells Managed Care that “patients’ diabetes and cholesterol control were actually significantly better when their physicians used an EHR compared to when they didn’t. We found that the patients who needed the most care, meaning their lab values were furthest out of control, were most helped by using the EHR.”

The study included nearly 170,000 patients and found that use of EHRs led to better control of diabetes and dyslipidemia.

The report says that when an EHR was used, patients with the greatest needs got increased testing, treatment, and physiologic improvement, and people already meeting glycemic and lipid targets had “decreased testing and treatment intensification.”

There’s a lot at stake, the study points out. Federal incentives for “meaningful use” of certified EHRs total about $29 billion, as much as $44,000 per doctor, and financial penalties for lack of certified EHR begin in 2015.

“The outpatient EHR completely replaced the paper-based medical record and a limited patchwork of pre-existing nonintegrated health IT tools” at the 17 medical centers,” says the study. “Use of those early health IT tools was limited because paper-based alternatives were still in use.”

It’s good to know that the investment will be worth it because “even with federal incentive payments … implementing a complete EHR system requires a large up-front investment in money and time, with careful coordination....”