An Electronic Health Record Type 2 Diabetes Management Program Implementation and Outcomes in a Rural Practice

Abstract

Type 2 diabetes mellitus is a chronic disease affecting 26 million people in the United States or 8.3% of the population. The prevalence of diabetes is rapidly increasing and increases with age. Treatment guidelines for Type 2 diabetes mellitus have been developed by the American Diabetes Association (2015) to decrease mortality and morbidity in patients with the disease. Utilization of current guidelines is a major component of providing evidence-based care. With the advent and widespread usage of electronic health records (EHR), a vehicle for point-of-care inclusion of accepted standardized guidelines exists. Including a reminder alert system within an existing EHR triggers providers to comply with current guidelines. Implementation of such a reminder system within a rural family medicine practice increased compliance with established guidelines. The guidelines measured in this study were blood pressure measurement at last visit, measurement of glycosylated hemoglobin within the last six months, and prescribed statin pharmacologic therapy. Glycosylated hemoglobin measurement increased by 16%, blood pressure measurement improved by 13%, and treatment with statin therapy increased by 16%. Implications for practice are inclusion of other Type 2 diabetes mellitus guidelines into the reminder alert system. Expansion of this system to iv include other chronic diseases with accepted evidence based guidelines may be designed and implemented based on this project