IT helps GPs with diabetes care

Dara Gantly writes that a new automated electronic audit introduced into general practice is helping to improve the care of patients with diabetes.
GP members of the Health Ireland Users Group (HIUG) are spearheading a new automated electronic audit of diabetes care in general practice.

The project, being run in 25 practices, uses the ability of HEALTHone software to capture an agreed data-set from diabetic patients and to export this anonymous data to an Excel file, which can be emailed to a research centre.
h4. Takes only minutes
Capturing the data — including such items as blood pressure, lipids, HbA1c, eGFR, smoking status and BMI — for the whole practice population and forwarding it by email only takes 10 minutes for the average practice.
The doctors and practice nurses utilise a specific diabetic mediform already available in HEALTHone to input the patient data, thus ensuring standardised data collection. The mediform also automatically extracts all the information relevant to the patient’s diabetes from their chart and presents this in a summary page along with the current data. This information is presented in a format similar to the paper-based diabetic flowcharts with which most doctors are familiar. These data are also presented alongside recognised guidelines, so that any abnormalities are clearly flagged on screen for both patient and doctor — greatly enhancing the opportunities for improved patient care and for patient involvement and education.
“Type 2 diabetic patients tend to be complicated as they are often elderly with multiple co-morbidities. The data vital to their diabetic management can be lost to the doctor, as they often generate huge charts where data retrieval is too time-consuming for the already busy staff,” explained Cork GP Dr Frank Hill, who is managing the project on behalf of the HIUG.
The structured use of the diabetic mediform means that all the data is automatically retrieved and presented in a user-friendly format, which should lead to improved patient care, he added.
Conducted in association with Prof Colin Bradley and Prof Ivan Perry of UCC’s Departments of General Practice and Public Health, the research project has been partly funded through a grant from Pfizer.
Dr Hill explained to Irish Medical Times that some technical problems were initially experienced in about half of the practices, but that these issues had been explored and solutions have now been sent to the practices.
He anticipates that they will be resolved within the next few weeks.
It is envisaged that a second audit will be carried out in between six and 12 months’ time to gauge improvements in patient outcomes.
h4. Small percentage
While the technology is available to all HEALTHone users, only a small percentage of GPs are currently using the diabetic mediform in a structured way. “This is a brilliant system, but the main reason it isn’t being used by a lot of GPs is because they just don’t have the time or the manpower to run structured diabetic clinics,” Dr Hill commented.
He expressed concern that if the resources did not follow the patient with diabetes, it was obviously going to be hard to justify the cost of running special diabetes clinics – particularly within the current economic climate.
h4. A learning curve
“The first six months of any new process is a learning curve for practices, but with the diabetic mediform, once you get familiar with it, it probably pays for itself, time wise.”
The Expert Advisory Group on Diabetes has said that comprehensive diabetic care requires ‘adherence to a standard protocol, registration, recall and regular review with protected time’.
“HEALTHone provides the opportunity to do all of the above, apart from providing practices with the protected time needed,” explained Dr Hill.
“We hope that our audit will show how well we can and do care for our patients with diabetes in general practice.”