The use of information technology to enhance diabetes management in primary care: a literature review.

BACKGROUND Evidence suggests that a more structured approach to diabetes care can lead to better health outcomes. We needed to develop an evidence-based conceptual framework for the Chronic Disease Management Network (CDM-Net) project which aims to use information technology (IT) to optimally support diabetes care in the Barwon region of Victoria, Australia. OBJECTIVE This review aims to demonstrate the benefits of IT in supporting a systematic approach to diabetes management in general practice and to increase our understanding of perceived barriers to and facilitators to the use of IT in this context. METHODS The literature review was based on articles extracted from relevant databases by using search terms related to type 2 diabetes and IT. Eligible papers were those based on original studies which evaluated some form of IT intervention in medical practice and were published after 1996 in the English language. Studies evaluating the use of telemedicine were excluded. FINDINGS IT has been used to provide support to patients, enhance changes in healthcare delivery and provide clinicians with access to expertise and timely, useful data about individual patients and populations. IT use has been associated with a corresponding improvement in measures of diabetes care including HbA1c, blood pressure and lipids, and in the frequency of eye and foot exams. Important barriers to using IT in diabetes care include confidentiality concerns, inadequate funding, workforce shortages, lack of time and anxiety about change. Adequate training and integration into the usual process of care are essential facilitators to implementing IT. CONCLUSIONS IT can be used to improve diabetes care by promoting a productive and informative interaction between the patient and the care team.

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