Benefits of computerized outcome analysis in diabetes management.
OBJECTIVE
To observe the effects of a computerized relational database designed to measure outcomes and enhance adherence to recommended diabetes management guidelines in a specialty private practice setting.


METHODS
DiaTrends, a software program specifically designed to monitor the processes and outcomes of diabetes care, was introduced in a private endocrinology practice in 1996. Information on all patients with diabetes (N = 1,096) was recorded in the database. Reports ("queries") were developed to monitor the adherence to recommended guidelines and to assess the outcomes of care for patients with diabetes treated with glucose-lowering medications. Glycosylated hemoglobin (HbA(1c)) and lipid control were selected from the many outcomes and processes of care monitored as the basis of this report.


RESULTS
Data were collected on 1,096 patients between 1996 and 1998. We were able to monitor adherence to published diabetes guidelines and to document the outcomes. Parallel trends toward improvement were noted in both HbA(1c) and lipid variables. The average HbA(1c) achieved for the entire patient population was 7.3%.


CONCLUSIONS
Using a computerized database to monitor glycemic control and lipid management is effective in evaluating the outcomes of care and provides a focused approach that enhances diabetes care. These improvements in metabolic outcomes likely reflect a change in the practice patterns of the physicians as a consequence of using this computerized database system.
Gegick
C G
CG
Greensboro Endocrinology and Diabetes, Greensboro, North Carolina, USA.
Altheimer
M D
MD
Kissling
G E
GE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012984:Software; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids