Using Electronic Health Records (EHRs) to monitor and improve diabetes care among the urban under-served minority population

Background: Adoption of the EHR system has the potential to improve care quality, reduce medical errors and improve management of patients with chronic conditions. As the EHR system is widely adopted in large academic medical centers across the nation, the policy discussion has been extended to the meaningful EHR use for better patient care and outcomes.

Objective/purpose: To describe how the EHRs have been used to monitor/improve diabetes care to minority Hispanic patients in a community based Family Medicine teaching practice.

Methods: A descriptive study of the improvement of diabetes care quality since the adoption of the EHR system. A diabetes care dashboard was made using the EHR data from 2009 to 2010 to compare the performance and outcome measures of diabetes care with the statewide and national rates on a regular basis. Results: Use of the EHR for quality improvement has been integrated to routine clinical care of patients with chronic conditions. As a result, improvement was observed in a number of areas. HbA1c test done increased from 95% in 2009 to 99% in 2010, and poor HbA1c control rate (value >9 or no HbA1c test) decreased from 23% in 2009 to 20% 2010. While the rates of these quality measures were better, blood pressure control rate (31%) was comparable to the state and the national rates. In addition, the documentation of primary care providers to patients with diabetes in the HER system increased from 65% to 77%. Discussion/conclusions: The implementation of the EHR system allows the practice to track the diabetes care performance measures and outcomes which can be used by clinicians to design QI projects to continuously improve diabetes care. Further efforts are needed to examine the role of EHRs in linking clinical care to community based programs to address health disparities.