Byline: Mark Taylor
Last week's announcement that Cerner Corp. would spend at least $25 million to provide personal health records for up to 1.3 million patients with juvenile diabetes was hailed by children's hospitals and pediatricians.
The 10-year project-first reported Oct. 11 in Modern Healthcare's Daily Dose electronic newsletter-allows patients with Type 1, or juvenile, diabetes under the age of 18 to transmit updated test data and other health information through a secure Web site where their physicians can access their personal health records. Officials at Cerner, Kansas City, Mo., and some of the 17 children's hospitals that are participating in the first phase of the program said the project has the potential to reduce physician office and emergency room visits and hospital admissions, improve patients' quality of life and health outcomes, and cut the costs of caring for a vulnerable population.
Cerner Chairman and Chief Executive Officer Neal Patterson said the healthcare technology company would let physicians, pediatric endocrinologists and caregivers enroll their juvenile diabetes patients through the partner hospitals, which include Children's Hospital Boston, Childrens Hospital Los Angeles and Children's Mercy Hospitals and Clinics, Kansas City, Mo.
Patterson said physicians already using a Cerner system would integrate the program into their daily workflow and those not using a Cerner program would connect through the Web site to access the health records. Patterson said eventually a national call center could alert physicians when life-threatening abnormal test results are detected.
He said most Type 1 patients are scheduled to see their doctors every three months. 'We think it's a realistic goal to reduce that to three times a year from four visits, and with better management we expect to see meaningful reductions in hospitals admissions, too.''
A personal health record, which incorporates information found in an electronic medical record, is under the control of the patient while accessible by caregivers.
Physician Daniel Nigrin, chief information officer for Children's Hospital Boston and an assistant professor of pediatrics with Harvard Medical School, said improved communication tools offer a huge advantage to pediatric endocrinologists. 'There is so much data that needs to be communicated back and forth between patients, nurses and nurse practitioners and doctors and right now it happens in clunky ways, such as by phone,'' Nigrin said. 'It's inconvenient and inefficient.''
He said doctors need to know the readings from insulin pumps and glucometers, the number of doses and types of insulin injected, amount of food consumed and the kind of exercise performed. That information is now reported by telephone or recorded in a paper log. Nigrin said that when patients are sick or newly diagnosed, that information becomes more crucial and needs to be transmitted daily. He said the Cerner project creates a faster and more effective transmission of information.
'This is the first time something like this has been done gratis and on such a large scale,'' Nigrin said. 'The idea is not revolutionary in itself, but the push to extend this to all comers, whether Cerner clients or not, is pretty significant.''
Nigrin said the short-term impact may be hard to assess. 'But if you don't monitor these patients carefully, the long-term risks can be costly and devastating. They're at higher risk of blindness, amputation of limbs, heart disease, stroke and kidney failure,'' said Nigrin, who has Type 1 diabetes himself. 'It pays to be diligent to ensure they have the best care now, and investing in diabetes control early can exert a potentially huge impact on outcomes and cost later.''
The American Diabetes Association estimates that 13,000 children are diagnosed with Type 1 diabetes annually in the U.S. and that caring for diabetes patients costs $132 billion per year.
The president of a Grand Rapids, Mich., hospital that implemented the Cerner health record nearly two years ago applauded the national kickoff. 'I continue to believe that this will be a strategy for delivering the highest quality of care,'' said David Alexander, who leads DeVos Children's Hospital, owned by Grand Rapids-based Spectrum Health. 'Electronic personal health records create a level of transparency we can't get with paper records.''
CAPTION(S):
Nigrin, left, and Alexander agree that personal health records will increase efficiency.
