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When a "planned care" system of healthcare delivery was instituted in three primary-care practices in Wisconsin and Minnesota, it resulted in better care by physicians and in better diabetes control for their patients, according to researchers from the Mayo Health System Diabetes Translation Project.
Planned care includes implementation of guidelines for diabetes care, support for self-management and use of clinical information systems. Healthcare providers in this study also used a diabetes electronic management system (DEMS).
After planned care was implemented, improvements were seen in patients' A1C levels, cholesterol levels and measures of microalbuminuria (an indication of kidney disease) as well as in the number of physicians who counseled against tobacco use.
Physicians who used DEMS were more likely to refer patients for testing in all areas, including microalbuminuria, eye exams, foot exams and self-management support.
The researchers report that while planned care itself resulted in improved metabolic control for patients, there was no further impact on metabolic outcomes when DEMS was used, although the electronic management system did result in increased testing for diabetes-related complications.
-Diabetes Care, November 2002