Electronic Health Records Linked to Improved Care for Patients With Diabetes
Study part of Kaiser Permanente’s ongoing work to better understand how EHRs affect clinical care
The use of electronic health records in clinical settings was associated with a decrease in emergency room visits and hospitalizations for patients with diabetes, according to a study published today in the Journal of the American Medical Association.
Researchers examined the medical records of 169,711 diabetic patients over 1 year of age in the Kaiser Permanente diabetes clinical registry before and after the implementation of Kaiser Permanente HealthConnect®, the organization’s comprehensive EHR system. They found that patients visited the emergency room 29 fewer times per 1,000 patients and were hospitalized 13 fewer times per 1,000 patients annually after the implementation.
“Using the electronic health record in the outpatient setting improved the quality of care in ways that cumulatively resulted in fewer negative events,” said Mary Reed, DrPH, staff scientist with the Kaiser Permanente Division of Research in Oakland, Calif. and the study’s lead author. “A reduction in the number of emergency department visits represents not just improvements in diabetes care, but the cumulative effect of the EHR across many different care pathways and conditions.”
Researchers found that annual emergency room visits declined 5.5 percent, from 519 visits per 1,000 diabetes patients before electronic health records to 490 visits per 1,000 diabetes patients afterward. Annual hospitalizations declined 5.2 percent, from 239 per 1,000 diabetes patients before electronic health records to 252 per 1,000 diabetes patients afterward. The researchers did not find any significant change in the number of office visits for patients with diabetes before and after electronic health records were implemented.
“This study demonstrates that when doctors and patients use an EHR, good things happen,” said Marc G. Jaffe, MD, a study co-author and Kaiser Permanente endocrinologist in South San Francisco. “The current study adds to our understanding by describing how an EHR like KP HealthConnect can help doctors keep patients healthy when used as part of an integrated care delivery system.”
This study is part of Kaiser Permanente’s ongoing work to better understand how EHRs affect clinical care. In October of last year, Kaiser Permanente researchers found that use of the electronic health records was associated with improved drug-treatment intensification, monitoring and risk-factor control among patients with diabetes.
In addition to Reed, co-authors of the study were Jie Huang, PhD, Ilana Graetz, PhD, Romain Neugebauer, PhD, and Bruce Fireman, MA, of the Kaiser Permanente Division of Research; Richard Brand, PhD, of the Department of Epidemiology and Biostatistics, University of California, San Francisco; Marc Jaffe, MD, Department of Medicine and Endocrinology, The Permanente Medical Group, South San Francisco; Dustin W. Ballard, MD, MBE, Department of Emergency Medicine, The Permanente Medical Group, San Rafael, Calif.; and John Hsu, Massachusetts General Hospital, Harvard Medical School, Boston.
The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the Agency for Healthcare Research and Quality.