Electronic health records, patient-centered care needed to revolutionize diabetes management

AADE Annual Meeting and Exhibition

LAS VEGAS — The inclusion of patients on the health care team and the use personalized electronic health records form the foundation for revolutionizing the national health system and delivering better care to patients with diabetes, a speaker said here.

Currently, the United States faces economic issues regarding health care, with costs hovering around $2.8 trillion, according to Paul C. Tang, MD, vice president and chief innovation and technology officer of the Palo Alto Medical Foundation. Costs are two to three times higher compared with the rest of the world, yet the United States lags behind other developed countries in terms of quality, efficiency and access to health care. It is time for a change, he said.

“We don’t need another penny,” Tang said during a presentation. “We need to spend the money more wisely.”

Need for technological advances

Integrating new technologies, such as electronic health records (EHRs), is one way to capitalize on existing funds, Tang said. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act, included in the stimulus package, gave EHRs a $30 billion increase and mandated that the technology be instituted universally by 2014. To advance the process, the act offers financial incentives to those who implement EHRs more quickly; but after 2015, these are replaced by financial penalties. Consequently, concern is growing that Medicare providers will not reach this goal, even as the number of patients available for Medicare soars. HITECH also calls for the “meaningful use” of technology in health care. The criteria for meaningful use include improving the safety, quality and efficiency of health care and the reduction of health care disparities; however, much more is involved, Tang said. Coordinating care and sharing of information in electronic form are essential.

“We need an infrastructure that moves information around electronically that we can have available to patients, their caregivers and us,” he said.

Engaging patients and their families is also important, but providers are sometimes unsure of how to accomplish this task. Tang suggested using technology to address this problem as well.

“Let’s give patients, their families and caregivers access to literally the same information that we have,” he said.

He suggested making information available in electronic form, so it is easily accessible. Technologies such as mobile applications or patient portals on websites may be particularly helpful, but fostering trust and ensuring privacy accompany such practices, Tang said.

Integrating patient-centered care

In addition, health care providers are encouraged to ask patients about their own health goals, which do not often address diabetes specifically, rather than just outlining steps for diabetes care such as losing weight. For instance, a patient may voice wanting to live a long life or spend more time with grandchildren as opposed to lowering blood sugar, Tang said. All patients are at different stages in their lives and have different personal agendas.

“The new definition of patient-centered is not just a word we say; it means bringing the patient onto the health care team,” Tang said. “The more we tailor, the more we personalize what we do, and how we work with them leads to more successful outcomes. … It would be nice if we had that kind of goal in mind.” – by Melissa Foster

For more information:

• Tang PC. GS03. Presented at: the American Association of Diabetes Educators Annual Meeting & Exhibition; Aug. 3-6, 2011; Las Vegas.

Disclosure: Dr. Tang reports no relevant financial disclosures.

Mary M. Austin

I attended Dr. Tang’s presentation in which he discussed utilizing electronic medical records and how to use technology in general to better reach your patients. I found his presentation fascinating. It is definitely what we’ll see in the future.

There are going to be some issues as to how to coordinate and craft services so that you can optimize electronic technology, but the most important thing that he said, which resonated with me, was that you have to put the patient in the mix of providing the service. It’s what the patient wants and how the patient will receive the information. The patient is setting goals that will help you meet his needs, and the use of technology should make things such as feedback time much faster. You are not wasting time unnecessarily going to offices. Instead, you are getting bits and sound bites of information that helps you manage your diabetes at the instant instead of waiting for someone to make a decision 1 week or maybe 2 weeks later.

Electronic technology is something that diabetes educators are going to find very useful in their practices, and I hope that educators become more comfortable with the technology because it is very new for many of us. But, as the health care system is changing and more people are adopting the use of technology, I think educators will have a key role in promoting the patient-and-team relationship in improving their care.

– Mary M. Austin, MA, RD, CDE
Endocrine Today Editorial Board member

Disclosure: Austin reports no relevant financial disclosures.

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