Diabetes Care and Management Using Electronic Medical Records: A Systematic Review

Abstract

BACKGROUND: Diabetes treatment and management provide a unique opportunity for examination of the effectiveness of electronic health records (EHRs) on patient health outcomes, continuity of care, and areas for further development. This systematic literature review was designed to identify the strengths and limitations of EHR and opportunities for improvement proposed in original research and recent rigorous systematic reviews. METHODS: This review utilized methodology adapted from PRISMA. Inclusion criteria for original research were published between March 2003 and November 2017; included randomized controlled trial design with participants ≥18 years of age with diabetes diagnosis ≥1 year; measured outcomes included HbA1c, blood pressure, and LDL cholesterol levels. Criteria for systematic reviews included research focused on EHR outcomes, improvement of care for patients with diabetes, prevention of adverse outcomes, web-based communication, and limitations of EHR regarding chronic disease management. Thirteen articles qualified for inclusion. RESULTS: Meta-synthesis of articles suggests that chronic disease patients benefit most by decision support tools that alert physicians of drug interactions, communication tools that keep them informed and engaged in their treatment regimens and detailed reporting and tracking designed to inform progress. Collective results suggest that EHR technology is advancing rapidly; however, patient outcomes documented via EHR systems remain largely unknown. CONCLUSION: A fertile area for inquiry designed to enhance patient outcomes in diabetes and chronic disease management is determining how EHR systems can be utilized for new drug and treatment options in addition to enhancing the quality, cost-effectiveness, and continuity of care.

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