Impact of Health Information Technology Implementation on Diabetes Process and Outcome Measures (Texas)
Diabetes is an increasingly common chronic disease that requires long-term management. Currently, the health care provided to patients with diabetes falls short of the "best care" practices established in evidence-based clinical guidelines. The primary objective of this observational study is to quantify the effects of a commercially-available ambulatory electronic health record (EHR) on quality of diabetes care, as measured by compliance with recommended processes of care and patient outcome measures. The EHR includes diabetes care prompts and a diabetes management form (DMF), a condition specific documentation tool that integrates data review, real time evidence based clinical decision support, order entry, and patient education.
The study will be conducted in the Baylor Health Care System HealthTexas Provider Network, which implemented the EHR in staggered practices between 2006 and 2008. The primary aim is to test the impact of the EHR on the care of diabetes patients using retrospective chart audit data as measured using the Health Partners "Optimal Diabetes Care" composite measure. This composite measure includes hemoglobin A1c (HbA1c), cholesterol, blood pressure, patient age, and smoking status. Secondary aims will include testing the impact of the EHR on patient outcomes and compliance with recommended processes of diabetes care, estimate the prevalence of voluntary physician use of the DMF embedded within the EHR, and the effect of DMF use on patient outcomes.
This study will provide important information about the potential for an EHR to improve quality of diabetes care, including insight regarding the potential of and need for disease-specific EHR components to effect improvement.