Use of a Large Diabetes Electronic Medical Record System in India: Clinical and Research Applications

Abstract

Background: The diabetes electronic medical record (DEMR) has emerged as an effective information management tool with the potential to improve diabetes care and research. This study reports on the usefulness of the DEMR system at Dr. Mohan's Diabetes Specialities Centre (DMDSC), Chennai, India, for clinical and research purposes. Methods: The DEMR, set up in 1996 at DMDSC, connects data of nine centers/clinics in different geographical areas in Southern India. The present data analysis is based on a total of 226,228 patients registered in the DEMR system at DMDSC between the years 1991 and 2010. Results: The DEMR included data of 139,906 male and 86,322 female patients, of whom 92.6% had type 2 diabetes mellitus (T2DM), 1.4% had type 1 diabetes mellitus (T1DM), and the rest had other types. Patients with T2DM had higher prevalence rates of neuropathy (33.1% vs 13.0%, p < .001), microalbuminuria (25.5% vs 20.0%, p < .001), coronary artery disease (17.5% vs 9.2%, p < .001) and peripheral vascular disease (3.9% vs 2.8%, p = .017) compared with T1DM patients, while prevalence of diabetic retinopathy was similar (37.9% vs 35.7%, p = .06). Prevalence of microvascular and macrovascular complications of diabetes increased with increasing glycated hemoglobin levels ( p for trend < .001) and increasing diabetes duration ( p for trend < .001). Conclusions: The DEMR helps track diabetes care and is a valuable tool for research.

Morbidity Profile and Causes of Mortality in Type 2 Diabetes Patients: Data from a Tertiary Teaching Hospital from Eastern India

“…On the contrary, few other studies reported higher prevalences i.e. 32.5% [14] and 37.9% [15] respectively, probably due to clinic based studies.…”

“…19.5% [19]. The prevalence of neuropathy in earlier studies from India are 15.3% [01], 26.8% [14], and 33.1% [15] respectively. This variation may be due to glycemic control, genetic susceptibility to develop neuropathy and environmental factors.…”

International Models of Care that Address the Growing Diabetes Prevalence in Developing Countries

“…To streamline the process of patient referral systems and improve communication, coordination, and data sharing between physicians and other providers, a patient-centered electronic information system is needed [78,79]. The local governments can allocate regional responsibilities to specific tertiary and secondary care centers to ensure that all metropolitan and regional primary health care providers have ready access to specialist multidisciplinary teams for advice, shared care, outreach, and mobile health services.…”

Technology in the management of diabetes mellitus

“…In addition to improving processes and ensuring the quality of patient care, the DEMR also facilitates data mining for clinic-based research. [40] However, such a system is expensive to set up and maintain and is prone to bugs like any other software. Occasionally, use of computerised patient records may detract from the doctor-patient interaction, when the clinician spends more time looking at the computer screen than talking to the patient.…”