Clinical informatics to improve quality of care: a population-based system for patients with diabetes mellitus

Inform Prim Care. 2009;17(2):95-102. doi: 10.14236/jhi.v17i2.721.

Abstract

Background: The prevalence of diabetes mellitus is increasing in the USA. However, control of intermediate outcome measures remains substandard. Recently, significant emphasis has been placed on the value of electronic medical records and informatics systems to improve the delivery of health care.

Objective: To determine whether a clinical informatics system improves care of patients with diabetes mellitus.

Methods: In this quality improvement pilot initiative, we identified 48 patients with diabetes mellitus who were due for their annual haemoglobin A1c (HbA1c), low-density lipoprotein (LDL) and microalbumin tests. Through our newly developed clinical informatics initiative, patients were reminded to schedule tests and a physician appointment. Seventy-five patients without reminders served as controls.

Results: A significant improvement in LDL control was achieved in the intervention group (35.4% vs 13.3%; P=0.004). The intervention group had a greater percentage of patients who underwent the three tests, and members of this group also showed greater control of haemoglobin A1c, but these differences were not statistically significant.

Conclusions: A clinical informatics system, used to deliver proactive, co-ordinated care to a population of patients with diabetes mellitus, can improve process and also quality outcome measures. Larger studies are needed to confirm these early findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Albuminuria / urine
  • Appointments and Schedules
  • Cholesterol, LDL / blood
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / therapy*
  • Diabetes Mellitus / urine
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Preventive Health Services / methods
  • Primary Health Care / methods*
  • Quality Assurance, Health Care
  • Reminder Systems*
  • Young Adult

Substances

  • Cholesterol, LDL
  • Glycated Hemoglobin A