The Impact of Guideline Integration into Electronic Medical Records on Outcomes for Patients with Diabetes: A Systematic Review

被引：7

作者：

Shah, Sapna ^{[1
,2
]}

Yeheskel, Ariel ^{[1
,2
]}

Hossain, Abrar ^{[3
]}

Kerr, Jenessa ^{[4
]}

Young, Kelsey ^{[5
]}

Shakik, Sharara ^{[6
]}

Nichols, Jennica ^{[7
]}

Yu, Catherine ^{[1
,2
,8
]}

机构：

[1] Univ Toronto, Dept Med, Toronto, ON, Canada

[2] Univ Toronto, Fac Med, Toronto, ON, Canada

[3] Univ British Columbia, Dept Pediat, Vancouver, BC, Canada

[4] Univ Calgary, Dept Pediat, Calgary, AB, Canada

[5] Diabet Canada, Toronto, ON, Canada

[6] Canc Care Ontario, Toronto, ON, Canada

[7] Univ British Columbia, Fac Grad & Postdoctoral Studies, Vancouver, BC, Canada

[8] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

来源：

AMERICAN JOURNAL OF MEDICINE | 2021年 / 134卷 / 08期

关键词：

Clinical practice guidelines; Diabetes; Electronic medical record; Systematic review; CLINICAL DECISION-SUPPORT; HEALTH RECORD; PRIMARY-CARE; MANAGEMENT; IMPLEMENTATION; INTERVENTION; ACHIEVEMENT; PERFORMANCE; PREVENTION; STRATEGIES;

D O I：

10.1016/j.amjmed.2021.03.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Optimal strategies for integration of clinical practice guidelines into electronic medical records and its impact on processes of care and clinical outcomes in diabetic patients are not well understood. A systematic review of CINAHL, MEDLINE, PubMed, and Cochrane Library databases in August 2016, November 2017, and June 2020 was conducted. Studies investigating integration of diabetes guidelines into ambulatory care electronic medical records reporting quantitative results were included. After screening 15,783 records, 21 articles were included. Lipid and blood pressure control consistently improved with guideline integration, but A1c control remained equivocal. Electronic guideline integration improved microvascular complication screening, vaccination, and documentation of cardiovascular risk factors, while medication prescription and blood pressure, lipid, and A1c documentation did not improve. Studies employing a combination of electronic record intervention strategies were associated with improvement in monitoring and attainment of guideline and screening targets. Thus, strategies employing combinations of interventions to incorporate guidelines into electronic records may improve processes of care and some clinical outcomes. (C) 2021 Elsevier Inc. All rights reserved.

引用

页码：952 / +

页数：15

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