New research disputes claims EHRs improve diabetes care

Contrary to previous research, the use of electronic health records failed to improve care for diabetic patients in a study published in the Annals of Family Medicine.

Robert Wood Johnson Medical School at the University of Medicine & Dentistry of New Jersey researchers compared data from 16 practices in the Northeast that used EHRs and 26 practices that did not, assessing the care for 798 patients.

They found, in fact, that patients at clinics using paper records were more likely to meet all of three targets for hemoglobin A1c levels, low-density lipoprotein cholesterol and blood pressure after two years than those in practices that used EHRs.

Having an EHR instead of paper-based records doesn't guarantee better care and suggests that many practices that have adopted EHRs have not made the necessary changes to both work processes and ways of thinking about care that would lead to improvements in chronic illness management, the authors concluded.

"Achieving truly meaningful use of this technology will require more than time and experience: it will require a recognition that until population health is improved, use does not equal success. Practices will need assistance with implementation and achieving successful use to improve care and population health outcomes, especially with regard to redesigning work processes to make the best use of these new technologies by all members of the primary care delivery team."

The findings are in direct contrast to other studies, including three FierceEMR has told you about over the past year.

In one study, type 2 diabetic patients treated by doctors who use EHRs were found to be more likely to receive "optimal care" for their condition. The researchers studied the care of 14,051 adult diabetic patients seen at 34 primary care practices.

Of those, 6,376 patients' physicians used an EHR. Those patients enjoyed better outcomes--including positive improvement in blood pressure, aspirin prescriptions and smoking cessation--than patients whose doctors did not use an EHR, researchers found.

In a 2011 study, Better Health Greater Cleveland--a group that is a member of the Robert Wood Johnson Foundation's "Aligning Forces for Quality" initiative--found that 51 percent of diabetes patients in practices using EHRs received all the care they needed to address their diabetes, compared to only 7 percent in practices with paper records during the 2009-10 period.

Researchers have also claimed success with a "diabetes dashboard" that helps physicians coordinate diabetic care on a single EHR, leading to streamlined and improved care at a lower cost, FierceEMR reported late last year.

To learn more:
- see the Annals of Family Medicine study