To assess the impact of electronic health record () implementation on primary care diabetes care.
Charts were abstracted semi‐annually for 14,051 diabetes patients seen in 34 primary care practices in a large, fee‐for‐service network from anuary 1, 2005 to ecember 31, 2010. The study sample was limited to patients aged 40 years or older.
A naturalistic experiment in which was rolled out over a staggered 3‐year schedule.
Chart audits were conducted using the /hysician onsortium dult iabetes easure set. The primary outcome was the ealthartners’ “optimal care” measure: ≤ 8 percent; cholesterol < 100 mg/dl; blood pressure < 130/80 mmHg; not smoking; and documented aspirin use in patients ≥40 years of age.
After adjusting for patient age, sex, and insulin use, patients exposed to the were significantly more likely to receive “optimal care” when compared with unexposed patients ( < .001), with an estimated difference of 9.20 percent (95% : 6.08, 12.33) in the final year between exposed patients and patients never exposed. Components of the optimal care bundle showing positive improvement after adjustment were systolic blood pressure <80 mmHg, diastolic blood pressure <130 mmHg, aspirin prescription, and smoking cessation. Among patients exposed to , all process and outcome measures except and lipid control showed significant improvement.
Implementation of a commercially available in primary care practice may improve diabetes care and clinical outcomes.
