Digital record no better in diabetes
Electronic health records are seen as one way to improve health care in the US. Researchers have now assessed how the introduction of electronic health records has influenced the management of diabetes in primary care.
Data came from 42 practices in New Jersey and Pennsylvania. These practices were trying to implement national guidelines for diabetes care.
Sixteen practices had used electronic health records for three years. The other 26 used paper records.
Every year there was an audit of approximately 20 patient records in each practice. They were assessed for their process of care, treatment and achievement of outcomes.
After two years of follow up, the quality of care had improved in all practices. The type of records used in the practice made little difference.
For some outcomes the practices with paper records had significantly better outcomes. The patients were more likely to have achieved their targets for HbA1c, lipids and blood pressure.
Although the practices involved in the study were participants in a quality improvement program, more than 40% of the patients were still receiving sub-optimal care by the end of the study. Less than 20% met their outcome targets.
How patient information was recorded did not appear to have a major effect on the quality of care. Changing to electronic records will not fix low quality care.
Obtaining the potential benefits of electronic records may require greater use of decision support programs.
More training on how to get the best out of electronic systems will also be needed.
Dr John Dowden
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