Electronic Medical Records and Diabetes Care Improvement

Abstract

We have been waiting for electronic medical records (EMRs) to improve chronic disease care for a long time (1). Availability of sophisticated EMR systems has enticed an increasing number of health plans and medical groups to invest resources in such systems. Many EMR systems are able to improve documentation of care, communication of clinical information across sites, and measurement of productivity and variation in care (2). Inpatient EMR systems have led to improvements in care in some clinical domains (3). However, the potential impact of outpatient EMR use on quality of chronic disease care has not been fully realized. In this issue of Diabetes Care , Meigs et al. (4) report on a randomized trial designed to assess the impact of a web-based EMR system on quality of diabetes care at an outpatient teaching practice. Physicians using the EMR ordered significantly more A1C and LDL cholesterol tests in patients with diabetes. However, increased test frequency did not translate into better A1C or LDL levels in the patients of physicians with access to the EMRs compared with patients of physicians without access to the EMRs. The authors conclude that EMR use leads to better quality of diabetes care, because more A1C and LDL tests were ordered. While it is encouraging that EMR use led to increased frequency of testing, it is disappointing that key care outcomes such as A1C …

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