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Diabetes clinic improves outcomes across patient population

Diabetes is an epidemic. Millions of Americans suffer from this disease.  The American Diabetes Association recently estimated the disease cost $245 billion in 2012.  While our healthcare system is adept at treating acute illness, patients and clinicians are often ill-equipped to manage chronic illnesses that require frequent communication between them.

study released by the Center for Disease Control notes that health IT is an essential component of chronic care models. Health IT can improve care coordination, advance self-management skills, and promote decision support.

The UMass Memorial Health Care system serves about 33,000 patients with diabetes. To help improve patient outcomes, and integrate care across our health care system, we’ve been using MyCareTeam™ Diabetes Management for Allscripts Enterprise EHR™.

We believe the system can help connect diabetic patients with their health care teams, can help engage patients in their own care, and can facilitate communication among healthcare team members (e.g., primary care providers, educators and specialists).

Achieving better clinical outcomes for diabetic patients

Use of MyCareTeam Diabetes Management for Allscripts Enterprise EHR has improved outcomes, demonstrated in peer-reviewed, randomized clinical trials*.For example the solution helped lower hemoglobin scores (HbA1c) by an average of 2 points in one published trial. Patients also had significantly lower blood pressure, weight and cholesterol.

We started using MyCareTeam at UMass about a year ago, and now around 5,000 patients in our specialty clinic are using the solution. Most patients simply use MyCareTeam to upload their meters when they come to clinic with less than 10% uploading their meters from home.

We are now pushing to get more and more patients viewing their blood glucose readings from home.  We’re getting great results. For example, we’ve improved:

  • Patient engagement – Better options to upload and review their own health data
  • Provider access to data – Patient glucose levels/patterns, exercise log and diet are at providers’ finger tips
  • Efficiency with office visits – Because MyCareTeam is compatible with most patients’ blood glucose meters, it helps the check-in and meter upload process, saving staff up to 15 minutes per patient

We believe MyCareTeam integrated with Enterprise EHR is the answer to be able to deliver improved care across this population.

Equipping patients to better manage diabetes

In this country approximately 25 million individuals have diabetes, but we only have 3,000 endocrinologists. If all the endocrinologists saw patients with diabetes during all their working hours, and did nothing else, non-stop, they could spend only about 15 minutes per year per patient. It’s clear we must expand the number of people involved with care, especially the patients themselves.

And yet, many patients liken the demands of managing diabetes to another full-time job – one they never wanted. It’s a complex, emotionally charged task and quite unforgiving. Many know little about managing the disease, and suddenly they’re expected to process complex numbers, rules and systems.

The MyCareTeam solution helps patients take an active role in their own diabetes care. It gives patients the opportunity to upload or review data from any device, anytime and anywhere. The solution supports almost all glucose meters, and it automatically transfers the data into the EHR.

Making it easier to review health information

MyCareTeam charts help patients and providers identify blood glucose patterns, and address issues. Consider the example below:

It’s easier for diabetes patients and caregivers to spot trends in a MyCareTeam solution chart, versus the old paper-based methods of tracking glucose levels, or worse, trying to scroll through numbers in a blood glucose meter.

We encourage our patients to upload glucose readings frequently. This capability has been particularly useful with young diabetes patients allowing our pediatric colleagues to coordinate care with school nurses. Now the school nurse can upload the meter readings and discuss them with the pediatrician.

Delivering efficient care also has financial rewards

Modern health care is vexed by many problems. The system is being asked to deliver care across the population in a cost-effective way in an era of shrinking resources. Our approach has been to focus first on what is best for the patient.  Only after we’ve determined that, do we worry about making it work financially.   That recipe has worked for us, and kept us true to the ideals that first attracted out staff to the health care professions.

Diabetes patient numbers and the profit/loss for our clinic have done well, due in part to the MyCareTeam solution. We are more efficient, see more new patients, and visits go much more quickly. Nurse practitioners or certified diabetes educators can review patient data in between official visits to identify which patients our physicians need to see before problems arise.

As caregivers, it’s our job to help develop systems that help patients achieve better outcomes– when they are in front of us, and when they are not. I think MyCareTeam integrated with Allscripts Enterprise EHR helps us do that very well.

* Outcomes obtained from several clinical trials, including: Boston VA Randomized Clinical TrialGeorgetown Clinical TrialCommunication Plays a Critical Role in Web-Based MonitoringChanges in Diabetes Distress and Native American Randomized Clinical Trial.

Editor’s Note: This blog post was based on a recent webinar conducted by Dr. Harlan. If you’d like more information about MyCareTeam Diabetes Management for Enterprise EHR, you can listen to this webinar, watch this video or contact


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