Meaningful Use in Chronic Care: Improved Diabetes Outcomes Using a Primary Care Extension Center Model

Area of Science:

• Health Services Research
• Primary Care Medicine
• Health Informatics

Background:

• The impact of practice facilitation offering onsite quality improvement (QI) and electronic health record (EHR) coaching on chronic care outcomes requires further investigation.
• This study assesses a program modeled after an agricultural extension center, providing these specific services.

Purpose of the Study:

• To evaluate the effectiveness of practice facilitation incorporating both QI and EHR coaching.
• To determine the impact on chronic care outcomes, specifically diabetes management.

Main Methods:

• The study utilized data from the North Carolina Regional Extension Center (REC) for Health Information Technology, funded by the HITECH Act.
• Fifty primary care practices received onsite technical assistance for achieving meaningful use of certified EHRs and complementary QI advice focused on diabetes care.

Main Results:

• Practices engaging in QI and EHR coaching demonstrated a 19% absolute improvement in patients achieving excellent diabetes control (hemoglobin A1c < 7%) compared to baseline.
• A significant reduction was observed in the percentage of patients with poorly controlled diabetes (hemoglobin A1c > 9%).

Conclusions:

• Practice facilitation providing EHR and QI coaching led to substantial improvements in diabetes outcomes for practices achieving meaningful EHR use.
• This model of support offers a promising strategy for enhancing patient outcomes in small primary care settings.