Glycemic control associated with secure patient-provider messaging within a shared electronic medical record: a longitudinal analysis

Published: April 29, 2013
Category: Bibliography > Papers
Authors: Haneuse SJ, Harris LT, Koepsell TD, Martin DP, Ralston JD
Countries: United States
Language: null
Types: Care Management
Settings: Academic, Hospital

Diabetes Care 36:2726-2733.

University of Washington School of Public Health, Seattle, WA, USA; Harvard School of Public Health, Boston, MA, USA; Group Health Research Institute, Seattle, WA, USA

OBJECTIVE: To study differences in glycemic control and HbA1c testing associated with use of secure electronic patient-provider messaging. We hypothesized that messaging use would be associated with better glycemic control and a higher rate of adherence to HbA1c testing recommendations.

RESEARCH DESIGN AND METHODS: Retrospective observational study of secure messaging at Group Health, a large nonprofit health care system. Our analysis included adults with diabetes who had registered for access to a shared electronic medical record (SMR) between 2003 and 2006. We fit log-linear regression models, using generalized estimating equations, to estimate the adjusted rate ratio of meeting three indicators of glycemic control (HbA1c <7%, HbA1c 9%) and HbA1c testing adherence by level of previous messaging use. Multiple imputation and inverse probability weights were used to account for missing data.

RESULTS: During the study period, 6,301 adults with diabetes registered for access to the SMR. Of these individuals, 74% used messaging at least once during that time. Frequent use of messaging during the previous calendar quarter was associated with a higher rate of good glycemic control (HbA1c <7%: rate ratio, 1.26 [95% CI, 1.15-1.37]) and a higher rate testing adherence (1.20 [1.15-1.25]).

CONCLUSIONS: Among SMR users, recent and frequent messaging use was associated with better glycemic control and a higher rate of HbA1c testing adherence. These results suggest that secure messaging may facilitate important processes of care and help some patients to achieve or maintain adequate glycemic control.

PMID: 23628618

High-Impact Chronic Conditions,Practice Patterns Comparison,United States,Adult,Aged,Diabetes Mellitus,Gender,Middle Aged,Primary Health Care,Retrospective Studies

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