Benefits of information technology-enabled diabetes management

• HIT Description: EHR, Decision support, Telemedicine More info...
  
• Purpose of Study: To determine the financial and clinical benefits of IT disease management systems for diabetes
  
• Years of study: 2007
  
• Study Design: Cost-benefit
  
• Outcomes: Impact on health care effectiveness & quality, Impact of efficiency, utilization, and costs
  

• Settings: Various
• Intervention: Any IT disease management program for diabetes, including decision support, remote monitoring, patient self-management, registries, etc.
• Evaluation Method: A simulation model was created to project the impact on pgrcesses of care, the impact those process changes have on disease progression, the dilution of IT effects from patient movement between health care providers and programs, and the scaling of results to the national level. The primary outcome was medical cost savings.
• Description: Any IT disease management program, including decision support, remote monitoring, patient self-management, registries, etc.
• Interoperability: Clinical decisions support systems (CDSS) compare patient information from electronic medical records against a set of rules and generate alerts to providers. Remote monitoring programs transmit clinical data from patients' homes to providers. New technologies can upload data di
• System Penetration: The model assumes diabetes management is deployed nationally at a rate of 20% per year, until full national implementation in year 5.
• Costs: Varied by system typ, not reported
• Healthcare Utilization: All forms of IT diabetes management result in lower healthcare utilization. Use of important preventive services increased. Electronic registries increased retinopathy screening rates from 14.2 to 61.5% and peripheral neuropathy screening from 45 to 80%. The corresponding screening rates for CDSS were 24 and 68%.
• Quality of Care and Patient Safety Outcome: Electronic registries reduced hemoglobin A1c by .50%, systolic blood pressure by 1.1 mm-Hg and total cholesterol by 31 mg. In contrast, patient-centered programs reduced hemoglobin Aqc by .03%, systolic blood pressure by .56 mm-Hg, and total cholesterol by 2.8 mg for remote monitoring and reduced hemoglobin Aic by .02%, systolic blood pressure by 0 mm-Hg, and total cholesterol by 7.9 mg for self-management
• Changes in healthcare costs: All types of programs showed significant savings estimates. Provider-centered programs showed the greatest potential savings. Diabetes registries would save $14.5 billion over 10 years, while CDSS would save $!0.7 billion
• Time needed to accrue benefit: Study reports results at 10 years