Web-Based Collaborative Care for Type 2 Diabetes

Abstract

OBJECTIVE—To test Web-based care management of glycemic control using a shared electronic medical record with patients who have type 2 diabetes. RESEARCH DESIGN AND METHODS—We conducted a trial of 83 adults with type 2 diabetes randomized to receive usual care plus Web-based care management or usual care alone between August 2002 and May 2004. All patients had GHb ≥7.0%, had Web access from home, and could use a computer with English language–based programs. Intervention patients received 12 months of Web-based care management. The Web-based program included patient access to electronic medical records, secure e-mail with providers, feedback on blood glucose readings, an educational Web site, and an interactive online diary for entering information about exercise, diet, and medication. The primary outcome was change in GHb. RESULTS—GHb levels declined by 0.7% (95% CI 0.2−1.3) on average among intervention patients compared with usual-care patients. Systolic blood pressure, diastolic blood pressure, total cholesterol levels, and use of in-person health care services did not differ between the two groups. CONCLUSIONS—Care management delivered through secure patient Web communications improved glycemic control in type 2 diabetes.

The Association Between Personal Health Record Use and Diabetes Quality Measures

“…Three prospective randomized trials evaluated the use of PHRs in the management of type 2 diabetes mellitus (DM) [4][5][6] . These studies demonstrated modest but inconsistent improvements in diabetes quality measures when comparing PHR users to non-users.…”

“…These studies demonstrated modest but inconsistent improvements in diabetes quality measures when comparing PHR users to non-users. However, because all three studies included additional interventions, such as regular contact with a diabetes care manager, 6 the independent effect of PHR use cannot be determined. Further, small sample sizes in these trials may have limited the ability to detect clinically meaningful differences between study groups.…”

Access, Interest, and Attitudes Toward Electronic Communication for Health Care Among Patients in the Medical Safety Net

“…[1][2][3][4][5][6] Recent studies have shown that communication between patients and their health care teams via email or a patient portal with secure web messaging can increase patient satisfaction, enhance provider productivity, and improve health care quality. [5][6][7][8] Health and Human Services' inclusion of patient portals as part of 'meaningful use' standards for electronic health records 9 and the federally legislated financial incentives in the Health Information Technology for Economic and Clinical Health (HITECH) Act 10 are making access to these web-based tools for patient-provider communication the standard of care. Despite this, implementation of technologies for health-related electronic communication has lagged, particularly in community health centers.…”

Podcast vs. Pamphlet; Which One Is More Effective in Self-care Training Program of Diabetic Patients?

“…In their study, the education was based on patients' needs and telephone counseling provided by nurses, but in the present study, a preprepared educational content in audio file format was provided to the subjects. It should also be noted that in most of the studies conducted in European countries on diabetes education in recent years, all the capabilities of e-learning and multimedia are used to enrich the learning process (20,21). However, due to bandwidth constraints and given that access to a computer connected to broadband in the current situation in Iran is not provided for all patients, replacing traditional methods with simple and yet effective methods could help to provide educational content to patients effectively, since "Education" is principally the basis of diabetes therapy and influences the adherence to diet therapy.…”