Electronic medical records improve diabetes care in study

Diabetics treated by doctors who use electronic medical records have better quality of care regardless of what type of insurance they have than those whose practitioners use paper records, a recent study showed.

Patients whose doctors used electronic records were 35 percent more likely to receive care that met all standards, including timely measurements of blood sugar, pneumonia vaccinations and management of kidney problems, than those whose doctors used paper records, according to research in the New England Journal of Medicine.

Transitioning U.S. physicians and hospitals to electronic health records is estimated to cost the federal government as much as $27 billion in Medicare and Medicaid incentive payments over the next decade, according to the U.S. Department of Health and Human Services. The study adds to previous research showing that electronic medical records lead to more effective care, said David Blumenthal, a professor of medicine and health care policy at Harvard University Medical School in Boston.

“Electronic health records, when used properly and in a sophisticated way, improve the quality and efficiency of care,” Blumenthal, past national coordinator for Health Information Technology at HHS, said in a telephone interview. He was not an author of the paper.

The study involved more than 500 primary care physicians in 46 practices that are part of a collaborative known as Better Health Greater Cleveland. Researchers looked at data on 27,207 adults with diabetes from July 2009 through June 2010.

They found that 51 percent of patients in practices with electronic medical records received care that met all standards compared with about 7 percent in those with paper-based practices. After adjusting for income, race and other factors, the researchers found that those treated by doctors with electronic records were 35 percent more likely to receive care that met all standards than those in paper-based practices, Randall Cebul, the lead study author, said in a phone interview.

“This is clearly the most dramatic difference that has been demonstrated to date between electronic health records and paper-based records,” said Cebul, a professor of medicine at Case Western Reserve University in Cleveland and director of Better Health Greater Cleveland.

The study also showed that for patient outcomes, including blood pressure and cholesterol control, avoiding smoking and reducing body mass index, those in practices with electronic records were only 15 percent more likely to meet at least four of five outcome standards than those in paper-based practices.

Cebul said those numbers may improve once doctors figure out a way to get patients more engaged in and responsible for their own health care. Electronic health records can’t make a patient exercise or stop smoking, he said.

“It appears to me that the government’s investment in electronic health records is worthwhile,” he said. “The costs of care for people with chronic conditions like diabetes, high blood pressure and heart failure account for over two-thirds or three-quarters of the entire national health spend. This suggests that the improvements in care of those conditions may reduce the cost of care for those conditions.”