Technology Intervention Improves Outcomes in Diabetes Care

Web-based intervention in the treatment of diabetes results in “significantly better” outcomes for patients, new research published in the Canadian Medical Association Journal shows.

The study, conducted at McMaster University in Ontario, Canada—in collaboration with the University of Toronto and Infoclin, a company that helps physicians implement healthcare IT that is also in Toronto—showed that patients in the intervention group showed a process composite score that was much better than patients receiving traditional care (difference 19.1%, P < 0.001). Those who received intervention-based care also showed greater improvement rates related to declines in blood pressure (—3.95mm Hg systolic and –2.38mm Hg diastolic) and glycated hemoglobin (–0.2%). In addition, patients who received the Web-based intervention experienced “greater satisfaction” with their care.

Lead researcher Anne Holbrook, MD, PharmD, director of the Division of Clinical Pharmacology and Therapeutics at McMaster, and her team of investigators placed the focus of the interventional care on a Web-based tracker that accounted for 13 variables related to the “quality of diabetes care” that also interfaced with the physician’s EMR. Intervention also included an automated telephone patient reminder system and a color-coded tracker page that was mailed to patients four times a year and brought to physician appointments.

Study participants included 43 physicians and three nurse practitioners, using five different EMRs. Patients who participated were randomly assigned to either the control or intervention group, and were then seen for follow-up at a mean range of 5.9 months. At the start of the study, a diabetes diagnosis had been given to the patients at a median time of “5.9 (in-terquartile range 10.2) years,” and 16.8% of patients were using insulin at the beginning of the investigation.

“A shared electronic decision-support system to support the primary care of diabetes improved the process of care and some clinical markers of the quality of diabetes care,” the researchers wrote. “Key elements of our intervention included its simultaneous focus on both providers and patients, multiple communication approaches (electronic, telephone and paper) and point-of-care multifactorial computerized monitoring and decision support.”