CITL Publishes Latest Research: IT-Enabled Diabetes Management Can Save Hundreds Of Thousands Of Lives

Main Category: Diabetes
Also Included In: IT / Internet / E-mail
Article Date: 10 Jul 2007 - 1:00 PDT

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The Center for Information Technology Leadership (CITL), a nonprofit research center based at Partners HealthCare System in Boston, has announced the publication of its research findings on the benefits, costs, and effectiveness of information technology-enabled diabetes management (ITDM) for patients with Type-2 diabetes. The research for the report, The Value of Information Technology-Enabled Diabetes Management - funded through a Robert Wood Johnson Foundation (http://www.rwjf.org) grant and supported by the Healthcare Information and Management Systems Society (HIMSS) - concludes that ITDM can improve care processes, delay Type-2 diabetes complications, and save healthcare dollars.

Of existing technologies, electronic diabetes registries used by providers, followed by clinical decision support systems (CDSS) for providers, showed the greatest improvement in clinical outcomes, according to the study. While CITL found that all forms of ITDM improved the health of patients with diabetes and reduced healthcare expenditures, during a 10-year period, electronic diabetes registries saved the most- $14.5 billion. Other technologies had varying degrees of savings, from hundreds of thousands to several billion dollars; however, national adoption was found to cost more than it saves.

An implication of CITL's report is that payers, especially Medicare, stand to benefit the most from ITDM since they bear the most financial risk. CITL reports that "misaligned incentives," such as episodePage based payment systems for providers, may cause the market to underutilize provider-based forms of ITDM, though these ironically may be the most cost-beneficial approaches of all.

The full report is available on CITL's website (http://www.citl.org) for download, and a soft-bound report will be available at www.himss.org. Core findings are also published in peer-reviewed journals, with a paper in Diabetes Care focusing on the benefits of this technology, and a paper in Disease Managementreviewing the associated costs.

Fighting a Growing Epidemic Diabetes-a condition in which the body has lost its ability to produce insulin or utilize it correctly-is the fifth-leading cause of death by disease in the United States. The Centers for Disease Control estimated in 2005 that more than 20.8 million Americans have diabetes at a cost, according to the American Diabetes Association, of more than $132 billion. Advances in medicine have resulted in widely cited compliance guidelines for providers, and it is clear that compliance can be critical in saving lives and reducing healthcare costs. Yet patients often do not receive the recommended care because the healthcare system is generally more oriented toward treating patients' acute rather than chronic conditions.

CITL's analysis shows that ITDM can improve compliance with standards of care, from the current rate of less than 50% to as high as 80%. As a result, millions of cases of diabetes complications, such as kidney failure, stroke, heart attacks, and blindness, can be avoided, and hundreds of thousands of lives can be saved.

"Our research suggests that all forms of ITDM, whether used by payers, providers, or patients, can improve care for patients with Type 2 diabetes-and improved care results in improved quality of life," says Douglas Johnston, Executive Director of CITL. "With diabetes reaching epidemic proportions, ITDM tools, particularly those used by providers, have the greatest potential to provide a solution. By setting up diabetes registries in their offices, providers can move from acute, episodic care to true diabetes management across a population."

CITL approached its ITDM research by developing a computer-based model that virtually simulates the outcomes for Type-2 diabetes patients in a diabetes management program over 10 years. Researchers examined currently available ITDM technologies used by payers, providers, and patients; how these technologies may affect and improve processes of care over time; and whether or not changes in processes of care result in improved clinical and economic outcomes. CITL's findings are based on model projections and informed by literature reviews, expert assessments, and market research. To supplement published studies, CITL relies on the informed judgment of its Expert Panel, as well as interviews with IT users, developers, and vendors.

"At the national level, electronic diabetes registries are the only form of ITDM we found to be cost beneficial when adopted for all patients with Type 2 diabetes," says Blackford Middleton, MD, Chairman of CITL.

"Adoption of ITDM is in its early stages, and the evidence of impact in this space is starting to be realized," he adds. "At this point, our research suggests that diabetes registries are a clear win for patients, and they give providers the groundwork for expanded use of IT in their practices. Our research also suggests that costs are a major factor in realizing value from ITDM, and that we need to find the means to lower the costs of these IT-enabled interventions. Ultimately, getting the most value from ITDM will require the coordination of provider, payer, and patient-based initiatives… and alignment of financial incentives will be key in this equation."

Dr. Middleton acknowledged the "vital support" of the Robert Wood Johnson Foundation and HIMSS for making this study possible.

"Identifying new technologies that improve care processes and save healthcare dollars is a fundamental step toward providing effective and efficient care," says Anne F. Weiss, M.P.P., senior program officer and leader of the Quality/Equality Health Care Team at the Robert Wood Johnson Foundation. "CITL's research underscores the importance of incorporating health IT into treatment options for chronic conditions such as diabetes."

CITL has previously published reports on the value of computerized provider order entry (CPOE) in ambulatory care and the value of standardized national healthcare information exchange and interoperability (HIEI).

About the Center for Information Technology Leadership (CITL)

Chartered in 2002 by Boston-based, nonprofit Partners HealthCare System, CITL assesses the value that information technology (IT) brings to healthcare. Using a rigorous approach, CITL performs research, disseminates findings, and provides additional services designed to help healthcare providers and other stakeholders improve quality and reduce cost using IT. CITL has previously published reports on the value of computerized provider order entry (CPOE) in ambulatory care and the value of standardized national healthcare information exchange and interoperability (HIEI).

http://www.citl.org.