A study of adult diabetes care in the greater Cleveland region shows significantly better adherence to quality of care standards, and resulting better patient outcomes, among providers using electronic health records.

Between July 2009 and June 2010, 50.9 percent of patients at provider sites with an EHR received care that met four standards for quality, compared with 6.6 percent of patients at sites using paper records, according to the study, published August 31 in the New England Journal of Medicine. The care standards were measurement of glycated hemoglobin, kidney management, eye examination and pneumococcal vaccination.

"For diabetes outcomes, 43.7 percent of patients at EHR sites and 15.7 percent of those at paper-based sites had outcomes that met at least four of the five standards, a difference of 28.0 percentage points," according to the study. Achievement was higher for EHR sites on all but one outcome standard (body mass index). These findings were similar but somewhat blunted in analyses that adjusted for insurance type, age, sex, race or ethic group, language preference, estimated household income, and educational level."

In addition to body mass index, other outcomes standards were glycated hemoglobin, blood pressure, LDL cholesterol and nonsmoker. The study examined the care of 27,207 adults with diabetes from 569 primary care providers in 49 practices of 7 care organizations.

Provider participants and study authors are members of Better Health Greater Cleveland, a regional collaborative that receives support from the Robert Wood Johnson Foundation, among other sources.


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