Computer Health Records May Encourage Better Diabetes Care

Although past studies have found no real relationship between keeping computerized health records and health care standards, a recent study aimed at diabetics has found electronic records seem to improve health care and outcomes.

Many health centers still use paperwork to keep track of patient records, appointments and prescriptions, and there are indications that this traditional system has some benefits over using electronic health records.  Doctors may give more attention to a patient if they are not examining a computer screen, and will spot telltale body language pointers that will aid them in making diagnoses.  Patients may also feel more trust in a doctor who is paying personal attention to them rather than to a monitor, and thus feel reassured and confident in the doctor’s ability to help them.

However, electronic records also have advantages in terms of time allocation, easy access to records, electronic alerts for appointments, sharing of information between healthcare workers and cost-effectiveness.  Although there have been concerns about the privacy issues surrounding electronic records, larger numbers of health centers are adopting them as time passes.

Studies of general health care have found no correlation between better health care and better health outcomes for centers using electronic record keeping.  Nevertheless, a recent study carried out by members of the Better Health Greater Cleveland regional health collaborative found diabetics benefited from the system.

The team studied the health care of 27,207 diabetic patients using 46 health practices inCuyahoga County,Ohio.  The study covered 12 months and monitored both those practices which used electronic records and those still using paperwork systems. They used four care standards, blood sugar level records, tests for protein in the urine, an eye examination for diabetic retinopathy and pneumococcal vaccination.  They also looked at five healthy outcomes, achieving blood sugar levels below 8%, blood pressure below 140/80, cholesterol below 100mg/dl or having a statin prescription, achieving or maintaining body weight below obesity levels and not smoking.

Dr Randall Cebul and his team of researchers found that more health centers in Greater Cleveland met these good standards when they used electronic records instead of paperwork.  Looking at practices that used electronic records, they recorded that in 50.9% of cases, diabetic patients got care that met all four standards, and 43.7% of the patients achieved at least four of the five good health targets.  With practices that used paperwork the outcomes were much less satisfactory, with only 6.6% of patients getting all four care standards and 15.7% achieving their health targets.

The team wrote that the results “support the premise that federal policies encouraging the meaningful use of electronic health records may improve the quality of care across insurance types,” in their report published in the New England Journal of Medicine.  They also reported larger improvements in care and health outcomes every year for the practices using electronic records, with a 10.2% improvement in care and 4.1% in achieving health targets.  They said these trends were observed across all types of health insurance, but were weakest in uninsured patients.  The fact that better improvements were noted for care than for health target achievement they ascribed to fact that the latter needs input from the patient himself and support from his family and environment.

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