Initial and subsequent therapy for newly diagnosed type 2 diabetes patients treated in primary care using data from a vendor-based electronic health record

2012 ◽  
Vol 21 (9) ◽  
pp. 920-928 ◽  
Author(s):  
Emily S. Brouwer ◽  
Suzanne L. West ◽  
Marianne Kluckman ◽  
Dennis Wallace ◽  
Andrew L. Masica ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Electronic Health Record ◽  
Health Record ◽  
Newly Diagnosed ◽  
Electronic Health ◽  
Using Data ◽  
Diabetes Patients

scholarly journals Real-time surveillance for chronic conditions in Massachusetts using EHR data

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Noelle Cocoros ◽  
John Menchaca ◽  
Michael Klompas
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Electronic Health Record ◽  
Chronic Diseases ◽  
The State ◽  
Community Level ◽  
Health Record ◽  
Surveillance Systems ◽  
Electronic Health

ObjectiveTo assess the feasibility of tracking the prevalence of chronicconditions at the state and community level over time using MDPHnet,a distributed network for querying electronic health record systemsIntroductionPublic health agencies and researchers have traditionally reliedon the Behavioral Risk Factor Surveillance System (BRFSS) andsimilar tools for surveillance of non-reportable conditions. Thesetools are valuable but the data are delayed by more than a year,limited in scope, and based only on participant self-report. Thesecharacteristics limit the utility of traditional surveillance systems forprogram monitoring and impact assessments. Automated surveillanceusing electronic health record (EHR) data has the potential to increasethe efficiency, breadth, accuracy, and timeliness of surveillance. Wesought to assess the feasibility and utility of public health surveillancefor chronic diseases using EHR data using MDPHnet. MDPHnet isa distributed data network that allows the Massachusetts Departmentof Public Health to query participating practices’ EHR data for thepurposes of public health surveillance (www.esphealth.org). Practicesretain the ability to approve queries on a case-by-case basis and thenetwork is updated daily.MethodsWe queried the quarterly prevalence of pediatric asthma, smoking,type 2 diabetes, obesity, overweight, and hypertension statewideand in 9 Massachusetts communities between January 1, 2012 andJuly 1, 2016. We selected these 9 communities because they wereparticipating in a state-funded initiative to decrease the prevalenceof one or more of these conditions. Conditions were defined usingalgorithms based upon vital signs, diagnosis codes, laboratorymeasures, prescriptions, and self-reported smoking status. Eligiblepatients were those with at least 1 encounter of any kind within the2 years preceding the start of each quarter. Results were adjusted forage, sex, and race / ethnicity using the 2010 Massachusetts censusdata.ResultsSurveillance data were available for 1.2 million people overall,approximately 20% of the state population. Coverage varied bycommunity with >28% coverage for 7 of the communities and11% coverage in the eighth. The ninth community had only 2%coverage and was dropped from further analyses. The race / ethnicitydistribution in MDPHnet data was comparable to census datastatewide and in most communities. Queries for all six conditionssuccessfully executed across the network for all time periods ofinterest. The prevalence of asthma among children under 10 yrs rosefrom 12% in January 2012 to 13% in July 2016. Current smoking inadults age≥20 rose from 14% in 2013 to 16% in 2016 (we excludedresults from 2012 due to changes in documentation propelled by theintroduction of meaningful use criteria). This is comparable to the15% rate of smoking per BRFSS in 20141. Obesity among adultsincreased slightly from 22% to 24% during the study period, resultsnearly identical to the most recent BRFSS results for Massachusetts(23% in 2014 and 24% in 2015)2. The prevalence of each conditionvaried widely across the communities under study. For example, forthe third quarter of 2016, the prevalence of asthma among childrenunder 10 ranged from 5% to 23% depending on the community,the prevalence of smoking among adults ranged from 11% to 35%,and the prevalence of type 2 diabetes among adults ranged from7% to 14%. We also examined differences in disease estimates byrace / ethnicity. Substantial racial / ethnic differences were evidentfor type 2 diabetes among adults, with whites having the lowestprevalence at 7% and blacks having the highest at 12% in the thirdquarter of 2016; this trend was consistent over the study period.ConclusionsOur study demonstrates that MDPHnet can provide theMassachusetts Department of Public Health with timely population-level estimates of chronic diseases for numerous conditions at boththe state and community level. MDPHnet surveillance providesprevalence estimates that align well with BRFSS and other traditionalsurveillance sources but is able to make surveillance more timelyand more efficient with more geographical specificity compared totraditional surveillance systems. Our ability to generate real-timetime-series data supports the use of MDPHnet as a source for project/program evaluation.

scholarly journals Establishing an electronic health record–supported approach for outreach to and recruitment of persons at high risk of type 2 diabetes in clinical trials: The vitamin D and type 2 diabetes (D2d) study experience

2019 ◽  
Vol 16 (3) ◽  
pp. 306-315 ◽  
Author(s):  
Vanita R Aroda ◽  
Patricia R Sheehan ◽  
Ellen M Vickery ◽  
Myrlene A Staten ◽  
Erin S LeBlanc ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Clinical Trials ◽  
Electronic Health Record ◽  
System Level ◽  
Health Record ◽  
Recruitment Methods ◽  
Clinical Environments ◽  
Electronic Health

Aims To establish recruitment approaches that leverage electronic health records in multicenter prediabetes/diabetes clinical trials and compare recruitment outcomes between electronic health record–supported and conventional recruitment methods. Methods Observational analysis of recruitment approaches in the vitamin D and type 2 diabetes (D2d) study, a multicenter trial in participants with prediabetes. Outcomes were adoption of electronic health record–supported recruitment approaches by sites, number of participants screened, recruitment performance (proportion screened who were randomized), and characteristics of participants from electronic health record–supported versus non–electronic health record methods. Results In total, 2423 participants were randomized: 1920 from electronic health record (mean age of 60 years, 41% women, 68% White) and 503 from non–electronic health record sources (mean age of 56.9 years, 58% women, 61% White). Electronic health record–supported recruitment was adopted by 21 of 22 sites. Electronic health record–supported recruitment was associated with more participants screened versus non–electronic health record methods (4969 vs 2166 participants screened), higher performance (38.6% vs 22.7%), and more randomizations (1918 vs 505). Participants recruited via electronic health record were older, included fewer women and minorities, and reported higher use of dietary supplements. Electronic health record–supported recruitment was incorporated in diverse clinical environments, engaging clinicians either at the individual or the healthcare system level. Conclusion Establishing electronic health record–supported recruitment approaches across a multicenter prediabetes/diabetes trial is feasible and can be adopted by diverse clinical environments.

scholarly journals Automated Detection and Classification of Type 1 Versus Type 2 Diabetes Using Electronic Health Record Data

Diabetes Care ◽  
2012 ◽  
Vol 36 (4) ◽  
pp. 914-921 ◽  
Author(s):  
M. Klompas ◽  
E. Eggleston ◽  
J. McVetta ◽  
R. Lazarus ◽  
L. Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Electronic Health Record ◽  
Automated Detection ◽  
Health Record ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health

scholarly journals Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
M. van Vugt ◽  
M. de Wit ◽  
F. Sieverink ◽  
Y. Roelofsen ◽  
S. H. Hendriks ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Personal Health Record ◽  
Self Management ◽  
Personal Health ◽  
Health Record ◽  
Management Support ◽  
Emotional Wellbeing ◽  
Diabetes Patients

We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of a personal health record. Patients were followed up for 6 months. Uptake and usage were monitored using log data. Outcomes were self-reported diabetes self-care, diabetes-related distress, and emotional wellbeing. Patients’ health status was collected from their medical chart. 132 patients agreed to participate in the study of which less than half (46.1%) did not return to the personal health record after 1st login. Only 5 patients used the self-management support program within the personal health record, 3 of whom asked a coach for feedback. Low use of the personal health record was registered. No statistical significant differences on any of the outcome measures were found between baseline and 6 month follow-up. This study showed minimal impact of implementing a personal health record including self-management support in primary diabetes care. Successful adoption of web-based platforms, as ongoing patient centered care, is hard to achieve without additional strategies aimed at enhancing patient motivation and engaging professionals.

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