According to the American Diabetes Association, there are 25.8 million people in the United States with diabetes, or 8.3% of the population (11.3% of the adult population). Even more alarming, is the fact that another 79 million American adults (35% of the population) have a condition known as prediabetes, a precursor to diabetes. With nearly half of all adult Americans at risk of developing diabetes complications, it makes perfect sense that this demographic and chronic disease would be a focal point for electronic health record (EHR) implementation, and its effect on the standard of care and patient outcomes across all insurance types, even the uninsured.
Randall Cebul, M.D., of Case Western Reserve University, and colleagues had the same thought, so they conducted a year-long survey comparing medical practices in the Cleveland, Ohio area that use EHRs versus traditional paper records, including safety-net practices. Dr. Cebul’s results were published in The New England Journal of Medicine:
“From July 2009 through June 2010, data were reported for 27,207 adults with diabetes seen at 46 practices; safety-net practices accounted for 38% of patients. After adjustment for covariates, achievement of composite standards for diabetes care was 35.1 percentage points higher at EHR sites than at paper-based sites (P< 0.001), and achievement of composite standards for outcomes was 15.2 percentage points higher (P= 0.005).
EHR sites were associated with higher achievement on eight of nine component standards, including:
- Receipt of glycated hemoglobin (HbA1c) values
- Testing for urinary microalbumin
- Prescribing an ACE inhibitor or an angiotensin receptor blocker (ARB)
- An eye examination for diabetic retinopathy
- Giving a pneumococcal vaccine
Outcomes standards included:
- Achieving an HbA1c below 8%
- Blood pressure below 140/80 mm Hg
- LDL cholesterol below 100 mg/dL or having a statin prescription
- a body mass index (BMI) below 30 kg/m2
- Nonsmoking status
Across all insurance types, EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes care. Results confined to safety-net practices were similar.”
Essentially, the results from Dr. Cebul’s survey indicate, rather definitively, what we at HealthFusion® have always said: the government’s Meaningful Use incentive program for EHR adoption can improve the quality of care for everyone, across all insurance types. These results may conflict with some available studies that claim the implementation and use of electronic health records have little to no quality-related advantages over traditional paper records. However, many of these studies have limited data sets, rely on old data, or simply neglect to include all insurance types, especially the uninsured. And, with one in six Americans now living in poverty, the discrepancy in insurance coverage is sure to increase and become a more vital statistic for Meaningful Use.
If EHR implementation can help patients across all socio-economic levels better manage and even overcome a chronic disease like diabetes, it certainly seems like that really is the definition of Meaningful Use. Give MediTouch EHR® a try, and see what Meaningful Use can mean for your practice and the health of your patients.