September 20, 2011

EHRs May Help People With Diabetes

I don't know whether to laugh at this one or have some other thoughts. I realize that some medical health insurance companies are now covering dental, vision, and hearing as part of the same policy. With many companies, it is still necessary to get each covered through different individual companies at outrageous prices.

How is it then that people are claiming that electronic health records improve care and the outcomes for patients with diabetes. If they have have an insurance policy that covers everything and all (the dentist, eye doctor, hearing doctor, medical doctors are all on the same network) communicate with each other, then what the study findings show may be possible. This does require a stretch to believe that this is happening on a nationwide basis.

Even the authors admit there are some performance gaps, the study does not use the prospective approach, and is is not a randomized controlled trial. Even admitting the a randomized controlled trial will never happen for this type of study does make sense, but when doing look back studies, more care does need to be practiced which is not evident from the press releases and I do not have access to the full study.

At least one blogger has his doubts and expresses them here. Even HealthDay News was cautious in their headline by using the term might boost diabetes care. From the article in Medscape, it appears that everything is positive until near the end of the article.

I think there are dreams in the eyes of the authors of the article published in the New England Journal of Medicine. Yes, I think once all forms of the medical profession that I mentioned above are on the same EHR system or interact with different EHR systems to track patients, we may see improvements in diabetes care over the paper chart systems, but many improvements will need to be in place and communications will have to greatly improve between the different professions.

Indeed a lofty ideal that needs to be a goal, but doubt it will happen in the near future.  Some additional agruments have been raised in the comments to this blog and we need to be aware of them.

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