Electronic Health Records and Quality of Diabetes Care

Primary care practices that use electronic health records are more likely than paper-based ones to adhere to quality standards for care for people with diabetes.

Medical practices are being encouraged to adopt “meaningful use” of electronic health records (EHRs), which means not just to use EHRs, which are computer-based records, but to use them to improve quality or save money.

The Better Heath Greater Cleveland collaborative, one of 16 sites of the Robert Wood Johnson Foundation's national program Aligning Forces for Quality: The Regional Market Project, provided researchers with the opportunity to study data from both paper-based and EHR-based primary-care providers. The collaborative’s practices care for the majority of people with chronic illnesses in the metropolitan area and include large nonprofit health care organizations, a large public hospital system, a university hospital practice, and all three of the county’s qualified health centers.

Researchers studied data on 27,207 adults with diabetes, 38 percent of whom received care from safety-net practices. Better Health’s Clinical Advisory Committee approved nine quality standards for diabetes, including four standards of care and five standards of intermediate outcomes.

The adjusted difference in achieving composite standards was 35 percentage points higher for EHR-based sites than paper-based sites; 30 percentage points higher at safety-net sites. As found in other studies, the association was stronger for care than for outcomes, which depend on support and patient compliance at home.

This research concluded that federal policies which encourage "meaningful use" of EHRs may improve the quality of care across insurance types.