Benefits of information technology-enabled diabetes management.
OBJECTIVE
To determine the financial and clinical benefits of implementing information technology (IT)-enabled disease management systems.


METHODS
A computer model was created to project the impact of IT-enabled disease management on care processes, clinical outcomes, and medical costs for patients with type 2 diabetes aged >25 years in the U.S. Several ITs were modeled (e.g., diabetes registries, computerized decision support, remote monitoring, patient self-management systems, and payer-based systems). Estimates of care process improvements were derived from published literature. Simulations projected outcomes for both payer and provider organizations, scaled to the national level. The primary outcome was medical cost savings, in 2004 U.S. dollars discounted at 5%. Secondary measures include reduction of cardiovascular, cerebrovascular, neuropathy, nephropathy, and retinopathy clinical outcomes.


RESULTS
All forms of IT-enabled disease management improved the health of patients with diabetes and reduced health care expenditures. Over 10 years, diabetes registries saved $14.5 billion, computerized decision support saved $10.7 billion, payer-centered technologies saved $7.10 billion, remote monitoring saved $326 million, self-management saved $285 million, and integrated provider-patient systems saved $16.9 billion.


CONCLUSIONS
IT-enabled diabetes management has the potential to improve care processes, delay diabetes complications, and save health care dollars. Of existing systems, provider-centered technologies such as diabetes registries currently show the most potential for benefit. Fully integrated provider-patient systems would have even greater potential for benefit. These benefits must be weighed against the implementation costs.
Bu
Davis
D
Center for Information Technology Leadership, Partners HealthCare System, Wellesley, MA, USA.
Pan
Eric
E
Walker
Janice
J
Adler-Milstein
Julia
J
Kendrick
David
D
Hook
Julie M
JM
Cusack
Caitlin M
CM
Bates
David W
DW
Middleton
Blackford
B
D000328:Adult; D003198:Computer Simulation; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000628:therapy*; D001330:Electronic Data Processing / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D013678:Technology, Pharmaceutical / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome