Multifaceted support to improve clinical decision making in diabetes care: a randomized controlled trial in general practice

Abstract

Feedback reports with support from facilitators appear to increase rates of foot examination and eye examination in general practice. Alternative interventions should be explored to improve the pursuit of metabolic control by GPs.

Electronic Medical Records and Diabetes Quality of Care: Results From a Sample of Family Medicine Practices

“…For example, by facilitating the management of complex clinical information, EMRs have been shown to improve the coordination of tasks among members of the health care team, 8 to lead to lower rates of missing clinical information, 11 and to support evidence-based clinical decision making. [12][13][14][15] Several recent systematic reviews of EMRs and clinical decision support systems have shown that systems developed in-house over many years lead health care institutions to improve adherence to clinical guidelines. [16][17][18] There is little evidence, however, on whether commercially developed multifunctional health information technology systems, such as EMRs, improve patient care in the primary care settings, where most chronic illness care is delivered.…”

Preventing the Voltage Drop: Keeping Practice-based Research Network (PBRN) Practices Engaged in Studies

“…15,17,18,34,35 While we agree that the ability to send facilitators directly into the practices can be very helpful, in widely dispersed practices, such as those in our national studies, the contact must be continued using distance communication formats such as the telephone, E-mails, and faxes. We also have more recently used video communication with free or low-cost shared services such as Skype.…”

“…15,16 Such activities seem to im- prove practice outcomes [17][18][19] but are not feasible for large, geographically dispersed studies that work to achieve a nationally representative sample of practices.…”

The Vermont Diabetes Information System (VDIS): study design and subject recruitment for a cluster randomized trial of a decision support system in a regional sample of primary care practices

“…There have been reports describing improvements in diabetes clinical process measures in these settings using population-based approaches, but many of these studies suffer from limitations such as a single-institution setting, lack of physiologic outcomes, short duration, or observational design. [53][54][55][56][57][58] Like many of these studies, our quarterly population reports provide a current roster of patients for each PCP, sorted by level of control of A1C, lipids and urinary albumin excretion. This allows the provider to identify patients who may benefit from a more intensive intervention.…”