MINNEAPOLIS–Patients with diabetes and their physicians will soon have access to a new decision support tool that will reliably support a highly customized and state-of-the-art treatment plan in HealthPartners clinics.
Because diabetes is not a one-size-fits-all disease and each patient is different, HealthPartners researchers and physicians have developed a new personalized tool called “Diabetes Wizard,” believed to be the first application that uses electronic medical records to customize individual care.
The Diabetes Wizard helps physicians engage patients in a discussion of the best medications and lifestyle improvements that will lower their chances of diabetes complications.
Building on already strong results for helping patients achieve control of their diabetes, the HealthPartners Diabetes Wizard will tailor a treatment plan for each patient based on the best medical evidence, including medications recommended for better blood pressure, blood sugar and cholesterol control
The physician and patient will see whether the patient’s current blood sugar, cholesterol and blood pressure test results are not at goal and then provide a list of medications and treatments for the physician and patient to consider. The Wizard will provide benefits and risks of the medications, recommended doses and clinic visit intervals. The Wizard also suggests if seeing a diabetes educator or pharmacist might be helpful to provide additional support for nutrition, medication counseling or self-management.
Developed by the HealthPartners Research Foundation in collaboration with the HealthPartners Medical Group, the Diabetes Wizard was studied from October 2006 to May 2007. Eleven clinics, 40 primary care physicians and more than 2,500 patients with type 2 diabetes were part of the study. The results, which were published in the Annals of Family Medicine found patients to have improved blood sugar and blood pressure control.
The Wizard takes much more patient detail into account than previously available in “prompts,” or reminders, in the electronic health record, including data on patient age, current medications, smoking status, kidney function, history of heart disease or congestive heart failure. It can also identify gaps in care, such as the need for a screening test for kidney disease.
“The Diabetes Wizard is really designed to help solve a problem for patients with diabetes,” said JoAnn Sperl-Hillen, MD, senior research investigator with HealthPartners Research Foundation. “The treatment of diabetes is complex for patients and physicians because treatment involves a combination of lifestyle behaviors and many possible medications. The best approach to caring for diabetes is customized and personalized.”
The Wizard also improves care in part because of the support it provides for primary care physicians. While many patients with other diseases may receive care from specialists, nearly all patients with diabetes are treated by primary care physicians. Those doctors often treat patients for a wide spectrum of conditions each day.
“Because much diabetes care is provided in primary care settings, electronic medical records truly have the potential to meaningfully improve the health of patients with diabetes,” said Patrick O’Connor, MD, MPH, assistant medical director and senior clinical research investigator, HealthPartners Research Foundation. “The electronic medical record can present personalized patient information in a single screen to the physician and patient in an instant. This allows physicians and patients to have complete information at the office visit when they are making choices about their care.”
HealthPartners clinics will expand the use of the Diabetes Wizard in all HealthPartners clinics this summer.
“HealthPartners is already one of the national leaders in the quality of diabetes care,” said Beth Averbeck, MD, associate medical director for primary care of HealthPartners Medical Group. “This will give us another new way for physicians to partner with our patients to continue to improve outcomes.
“An estimated one-third of Medicare costs come from diabetes or diabetes-related complications, including heart disease and stroke, so there’s no question that new tools are needed to better manage the disease,” Averbeck added.
Beginning in fall 2011, HealthPartners will study an expanded use of Wizard in primary care clinics to assess cardiovascular risk, under a grant from the National Institutes of Health. These tools can ultimately be made available to other health care organizations.
HealthPartners is a leader in electronic medical records and online patient care. HealthPartners began implementing early versions of electronic medical records in 1997. By 2004, all HealthPartners Clinics were paperless as their medical records became electronic.