Quality of Outpatient Care for Diabetes Mellitus in a National Electronic Health Record Network

Abstract

This retrospective cohort study examined quality of care for diabetes ina largenationalnetwork of electronic health record users. Of 10572 patients with diabetes included in the study, 55% had at least 2 hemoglobin A1c (HbA1c) tests, 95% had at least 1 systolic and diastolic blood pressure test, and 52% had at least 1 low-density lipoprotein (LDL) cholesterol test over a 1-year period. Of those tested, 41% had an HbA1c <7.0, 28% had a blood pressure <130/80mmHg, and 44% had an LDLcholesterol level <100mg/dL. Of those not adequately controlled, 99% were prescribed hypoglycemic medications, 85% were prescribed antihypertensive medications, and 71% were prescribed lipidlowering medications. These results suggest that there is significant room for improvement in testing and control of risk factors for persons with diabetes and that the electronic health record has a significant potential for conducting practice-based quality-ofcare studies across large numbers of outpatient practices.

Keywords

quality of care diabetes mellitus primary care electronic medical records practice-based research

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