Use of a shared medical record with secure messaging by older patients with diabetes

Published: August 25, 2010
Category: Bibliography > Papers
Authors: Grothaus LC, Jordan L, Koepsell TD, Larson EB, Ralston JD, Reid RJ, Weppner WG
Countries: United States
Language: null
Types: Care Management
Settings: Academic

Diabetes Care 33:2314-2319.

Department of Medicine, University of Washington, Seattle, WA, USA

OBJECTIVE: Evaluate use of a web-based shared medical record (SMR) between older patients with diabetes and providers.

RESEARCH DESIGN AND METHODS:  This was a retrospective cohort study. Health records and SMR use patterns of 6,185 enrollees aged ≥65 years with diabetes were analyzed from implementation of a SMR in August 2003 through December 2007. We analyzed baseline predictors of age, sex, distance from clinic, socioeconomic status, insulin use, morbidity, and associated primary care provider’s (PCP) secure messaging use on patients’ initial and subsequent use of the SMR. Changes in morbidity, PCP, or diabetes treatment were evaluated for impact on outcomes.

RESULTS: A total of 32.2% of enrollees used the SMR; median rate was 1.02 user-days/month. Numbers of users and rate of use continued to increase. In adjusted analyses, likelihood of SMR use was associated with younger age, male sex, and higher socioeconomic status neighborhood, as well as clinical characteristics of overall morbidity and assigned PCP’s use of secure messaging. Initial SMR use was more likely within 3 months of an increase in morbidity (hazard ratio 1.61, 95% CI 1.28-2.01) and within 1 month of changing to a PCP with higher use (3.02, 1.66-5.51).

CONCLUSIONS: Four years after implementation, one-third of older individuals with diabetes had used the web-based SMR. Higher morbidity predicted initial and continued use of SMR services. Providers’ use of the communication feature was associated with higher likelihood of SMR engagement by their patients. Web-based SMRs may be an effective form of non-visit-based health care for older individuals with diabetes.

PMID: 20739686
PMCID: PMC2963486

High-Impact Chronic Conditions,Population Markers,Outcome Measures,United States,Aged,80 and over,Gender,Physicians,Primary Care

Please log in/register to access.

Log in/Register

LinkedIn Facebook Twitter

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System.
All rights reserved. Terms of Use Privacy Statement

Back to top