Improving Diabetes Outcomes Using a Web‐Based Registry and Interactive Education: A Multisite Collaborative Approach1. Issue 2 (17th June 2013)

• Record Type: Journal Article
• Authors: Morrow, Robert W.; Fletcher, Jason; Kelly, Kim F.; Shea, Laura A.; Spence, Maureen M.; Sullivan, Janet N.; Cerniglia, Joan R.; Yang, YoonJung
• Is Part Of: Journal of continuing education in the health professions. Volume 33:Issue 2(2014:Spring)
• Page Start: 136
• Page End: 144
• Publication Date: 2013-06-17
• Subjects: Medicine -- Study and teaching (Continuing education) -- Periodicals; Paramedical education -- Periodicals; Medical education -- Periodicals; 610.7
• DOI: 10.1002/chp.21170
• Languages: English
• ISSNs: 0894-1912

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Introduction:</title> <p>To support the adoption of guideline concordant care by primary care practices, the New York Diabetes Coalition (NYDC) promoted use of an electronic diabetes registry and developed an interactive educational module on using the registry and improving patient communication. The NYDC hypothesized that use of a registry with immediate feedback would achieve measurable and clinically meaningful improvement in the proportion of patients at goal for diabetes health metrics.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Research Design and Methods:</title> <p>In 2006–2007, the NYDC recruited 7 small to midsized primary care practices to implement the registry and to receive education and coaching on registry use, practice work flow, and patient engagement. The patient cohort included those with 2 or more visits with a diagnosis of diabetes within a 12‐month period. Each patient's health measure status (at goal, above goal, not recorded) was assessed quarterly for hemoglobin A<sub>1C</sub>, low‐density lipoprotein (LDL), and blood pressure (BP), and most recent A<sub>1C</sub> value was noted. A cohort analysis was performed using random effects regression models to assess the impact of the registry over time for each diabetes health metric.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Results:</title> <p>After controlling for variability between sites, with each subsequent quarter during the registry period patients were 1.4 times more likely to have A<sub>1C</sub> ≤ 9, almost twice (OR = 1.8) as likely to have LDL < 100, and 1.3 times more likely to have BP < 140/90. These improvements in compliance were statistically significant. Average A<sub>1C</sub> also improved over time, though this did not reach statistical significance.</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Discussion:</title> <p>Utilizing a Web‐based registry and interactive education, the project demonstrated improved patient outcomes, as well as the feasibility of collecting aggregate data from unrelated, independent practices.</p> </sec> </abstract>