Glycemic Control Associated with Secure Patient-Provider Messaging Within a Shared Electronic Medical Record: A Longitudinal Analysis

Details

• Personal Author:
  Haneuse SJ ; Harris LT ; Koepsell TD ; Martin DP ; Ralston JD
• Description:
  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 <8%, and 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. [Description provided by NIOSH]
• Subjects:
  Blood Communication Delivery Of Health Care Health Promotion Hematologic Diseases Occupational Health Safety
• Keywords:
  Blood Sugar Disorders Communication Research Electronic Health Records Health Communications Medical Care
• ISSN:
  0149-5992
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1 ; OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  36
• Issue:
  9
• NIOSHTIC Number:
  nn:20056634
• Citation:
  Diabetes Care 2013 Sep; 36(9):2726-2733
• Contact Point Address:
  Lynne T. Harris, PHD, Department of Health Services, University of Washington School of Public Health, Seattle, Washington
• Email:
  lynneharris@outlook.com
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Diabetes Care
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fc34c81c9782b002b73ed762f9c7d26c4b0544f83e73c4f4c9e373a25ee623b70a938f90565e3c436fc779d624c4554b7f4055db464c26ea4863adf56dca6be1
• Download URL:
  https://stacks.cdc.gov/view/cdc/214197/cdc_214197_DS1.pdf
• File Type:
  [PDF - 137.51 KB ]