title: Use of technology to track program outcomes in a diabetes self-management program.
abstract: The Diabetes Self-Management Education Program at MetroHealth Medical Center in Cleveland, OH, uses widely available technology to facilitate outcomes tracking and market the diabetes program. Baseline assessment data are entered directly into an Access database form (Microsoft, Inc, Seattle, WA). Quarterly, updated weight and lab data are downloaded into the database from the Epicare electronic medical record (Epic Systems Corp, Madison, WI). This system has enabled staff to track outcomes of program participants on an ongoing basis. To date, 438 patients have been entered into the program database, though complete clinical data are not available for all patients. Mean (+/-standard deviation) baseline body mass index of program participants was 35.8+/-9.1 (range 18.0 to 70.0, n=261). Mean (+/-standard deviation) baseline hemoglobin A1c (HbA1c) for all patients was 9.5%+/-2.5%, range 4.5% to 18.3% (n=332). Median baseline HbA1c was 9.1%, and the median last available postprogram HbA1c was 7.5% (P<.001, n=216; patients ranged from 90 days to more than 3 years postprogram entry). Weight change was not significant. In patients 1-year postprogram (n=72), mean baseline HbA1c was 9.9%+/-2.9% and the mean 1-year HbA1c value was 7.4%+/-1.7%, P<.001. At 1 year, 75% of patients had HbA1c < or = 8%. In response to these outcomes, an alert was implemented in the outpatient charting system triggered by an HbA1c > 8.5% and recommending referral to the Diabetes Self-Management Education Program. Since implementation of the prompt, referrals to the program have increased 40%.
authors.affiliation: Department of Family and Consumer Sciences, University of Akron, OH 44325-6103, USA. csc19@uakron.edu
authors.forename: Cinda S
authors.initials: CS
authors.lastname: Chima
authors.forename: Nancy
authors.initials: N
authors.lastname: Farmer-Dziak
authors.forename: Pat
authors.initials: P
authors.lastname: Cardwell
authors.forename: Sara
authors.initials: S
authors.lastname: Snow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring; D015992:Body Mass Index; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007256:Information Systems; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D009820:Ohio; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D014481:United States
chemical_list: D006442:Glycated Hemoglobin