In a paper urging the use of electronic diabetes registries, researchers illustrated that analysis of coding in electronic health records and the use of algorithms to sort through biochemical data can flag a significant number of people with undiagnosed diabetes.
In the study, published at CMAJ Open, researchers analyzed 11.5 million primary care electronic records from at more than 9,000 primary care clinics across the United States. Of the 1,174,018 patients with diabetes found in that database, it had gone undetected in 63,620--5.4 percent of them.
The Oxford University researchers found higher proportions of the population with undiagnosed diabetes in certain areas in Arizona, North Dakota, Minnesota, South Carolina and Indiana.
Then, looking at an array of quality measures, they determined that patients with coded diagnoses in their records and those in disease registries received better care. Electronic disease registries are more established in the U.K. than in the U.S.
"Wherever electronic diabetes registers are used to support the provision of care, and where blood glucose levels, HbA1c and quality-of-care data are recorded in the same system, it should be possible to identify readily [and at low cost] individuals at risk of their diabetes going undetected and those receiving suboptimal care," the authors wrote.
A case study from the Western New York Beacon Community describes its efforts to develop a diabetes registry involving 98 primary care practices serving more than 50,000 diabetic adults.
The Utah Beacon Community, meanwhile, examined ways to improve diabetic care at small clinics that lack experience with using electronic data for quality improvement initiatives.
And patient-centered medical homes in New York that used EHRs improved patient care more than those that still used paper or clinics that used EHRs, but were not part of a medical home, a recent study in the Annals of Internal Medicine found.
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