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EHRs and the worsening diabetes epidemic

By sbrooks99@verizon.net

- A recent study published in the journal Pediatrics showed that rates of diabetes and prediabetes among teens tripled during the course of the last decade. This represents one of the most pressing issues facing the healthcare industry, but more specifically, it should be viewed as a top priority for health IT vendors and users of technology.


Diabetes is a notoriously difficult condition to treat. It requires a great deal of coordination between multiple physicians and a high degree of engagement from the patient. We often hear about how EHRs lead to improvements in these areas, so it stands to reason that the technology should improve diabetes care. All that’s left is for the benefits to be proven.


There is mixed evidence regarding the use of technology in diabetes management. A frequently cited study published last year in the New England Journal of Medicine indicated that practices using EHRs delivered significantly better care to diabetics. By combining a number of different measures, the researchers determined that patients of EHR-wielding doctors experienced 35 percent better care than those not being treated with the help of technology.


However, a more recent investigation countered these claims. Researchers reported in the latest issue of the Annals of Family Medicine that there was no difference in the quality of care received by diabetics regardless of whether their doctors used EHRs.


Taken together, these findings neither indicate that EHRs are a silver bullet for improving diabetes care, nor is the technology useless in managing this chronic disease. What the collective findings should suggest to technology vendors and physicians alike is that there is a strong basis for using EHRs in diabetes care, but there is significant room for progress.


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EHR systems aren’t designed specifically for treating diabetics, but maybe they should be. The Pediatrics report indicated that one-fourth of all young people today have the metabolic condition or are at risk. It is very unlikely that those who currently have diabetes will resolve their condition as they reach adulthood, but it is likely that many of those with prediabetes will develop the full-blown condition. Therefore, we could be looking at a future in which one-third of adults are diabetic.


Given the economic cost of treating diabetes and the devastation it can cause in a person’s life, every effort should be made to help at-risk individuals avert the condition and improve the ability of those who are diabetic to manage the disease. EHRs are the prime candidate.


There is little doubt that team-based care improves treatment outcomes for diabetics. This has been demonstrated many times. EHRs can play an important role in coordinating the services of many different healthcare players.


For example, a patient’s primary care physician can administer and HbA1c test during a well visit and then make these results immediately available to the patient’s endocrinologist, who can look at the results as part of a larger trend and make recommendations as necessary. Furthermore, patients can upload daily glucose measures to their personal health records and share the results with physicians’ EHRs, which are able to monitor the readings for potential signs of worsening health.


All of this can improve blood sugar management and help individuals avoid future health complications, such as heart disease and neuropathy. These health problems are some of the main drivers of the high costs associated with treating diabetes and the poor quality of life of some diabetics.


EHRs may not be a magical cure-all for improving diabetes treatment. But the technology is well-positioned to make meaningful gains in disease management. To fulfill this potential technology vendors will have to understand what doctors need to improve diabetes care, and physicians will need to use technological tools in intelligent, targeted ways.


If this happens it may be possible to divert the approaching tidal wave of diabetes that is threatening the country.

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