Electronic Health Records associated with decreased medical visits among diabetics

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1. Use of electronic health records was associated with statistically significantly lower rates of ED visits, hospitalizations, and ambulatory care-sensitive conditions in diabetic patients. 

Evidence Rating Level: 2 (Excellent) 

Study Rundown: While the Health Information Technology for Economic and Clinical Health Act promoted up to 27 million USD for the meaningful use of electronic health records (EHRs), rigorous evidence on the effects that EHRs may have on health outcomes or clinical events is limited. This study examined the association between the use of EHR and ED visits, hospitalizations, and office visits among diabetic patients within a large integrated health care delivery system. Implementation of EHR was associated with modest but statistically significant decreased ED visits, hospitalizations for any condition, non-elective hospitalizations, and hospitalizations for ambulatory care-sensitive conditions in diabetic patients. A further, more thorough analysis of EHR utility in different systems and practices would be beneficial in better understanding benefits as well as barriers to further implementation.

Click to read the study, published today in JAMA

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In-Depth [observational study]: Between 2004 and 2009, a total of 169,711 patients within the Kaiser Permanente Northern California clinical diabetes registry were linked to the medical facilities where care was received and a commercially available complete outpatient EHR was implemented. The change in the mean number of ED visits, hospitalizations, and office visits per patient was recorded monthly before and after the implementation of EHR. Among statistically significant results, use of the EHR was associated with statistically significantly decreased rate of ED visits (28.80 fewer ED visits per 1000 patients; 5.54% difference), decreased overall rate of hospitalizations (13.10 fewer hospitalizations per 1000 patients; 5.21% difference), 10.92 fewer non-elective hospitalizations per 1000 patients (6.14% difference),  and 7.08 fewer ambulatory care-sensitive conditions (10.50% difference). There were no statistically significant differences in office visit rates.

By Elizabeth Park and Rif Rahman

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