Impact of a diabetes electronic management system on the care of patients seen in a subspecialty diabetes clinic.
OBJECTIVE
To compare the compliance with diabetes care performance indicators by diabetes specialists using a diabetes electronic management system (DEMS) and by those using the traditional paper medical record.


METHODS
A DEMS has been gradually introduced into our subspecialty practice for diabetes care. To assess the value of this DEMS as a disease management tool, we completed a retrospective review of the medical records of 82 randomly selected patients attending a subspecialty diabetes clinic (DC) during the first quarter of 1996. Eligible patients were defined by the suggested criteria from the American Diabetes Association Provider Recognition Program. During the first quarter of 1996, approximately one half of the providers began using the DEMS for some but not all of their patient encounters. Neither abstractors nor providers were aware of the intent to examine performance in relationship to use of the DEMS.


RESULTS
Several measures were positively influenced when providers used the DEMS. The number of foot examinations, the number of blood pressure readings, and a weighted criterion score were greater (P < 0.01) for providers using the DEMS. There was evidence, although not statistically significant, for lower mean diastolic blood pressures (P = 0.043) in patients and for number of glycated hemoglobins documented (P = 0.018) by users of the DEMS.


CONCLUSIONS
Performance and documentation of the process of care for patients with diabetes in a subspecialty clinic are greater with the use of a DEMS than with the traditional paper record.
Smith
S A
SA
Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota 55905, USA. smith.steven@mayo.edu
Murphy
M E
ME
Huschka
T R
TR
Dinneen
S F
SF
Gorman
C A
CA
Zimmerman
B R
BR
Rizza
R A
RA
Naessens
J M
JM
D000328:Adult; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy; D004219:District of Columbia; D004282:Documentation; D004704:Endocrinology / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D009722:Nurse Practitioners; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D014837:Voluntary Health Agencies