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OBJECTIVE - To test Web-based care management of glycemic control using a shared electronic medical record with patients who have type 2 diabetes.
RESEARCH DESIGN AND METHODS - We conducted a trial of 83 adults with type 2 diabetes randomized to receive usual care plus Web-based care management or usual care alone between August 2002 and May 2004. All patients had GHb ≥7.0%, had Web access from home, and could use a computer with English language-based programs. Intervention patients received 12 months of Web-based care management. The Web-based program included patient access to electronic medical records, secure e-mail with providers, feedback on blood glucose readings, an educational Web site, and an interactive online diary for entering information about exercise, diet, and medication. The primary outcome was change in GHb.
RESULTS - GHb levels declined by 0.7% (95% CI 0.2-1.3) on average among intervention patients compared with usual-care patients. Systolic blood pressure, diastolic blood pressure, total cholesterol levels, and use of in-person health care services did not differ between the two groups.
CONCLUSIONS - Care management delivered through secure patient Web communications improved glycemic control in type 2 diabetes.
Diabetes Care 32:234-239, 2009
Health care limited to clinic visits does not meet the needs of many patients with diabetes. Care systems that use Web-based communication provide an opportunity to shift the focus in health care away from the office and toward patients' daily lives at home. Patient interaction with online care plans and electronic medical records may further enhance the effectiveness of chronic care (1,2). Little is known, however, about the impact of using Web communications and shared electronic medical records in the primary care of patients with diabetes.
We present the results of a randomized trial examining a Web-based diabetes support program that aimed to improve glycemic control for patients with type 2 diabetes. The program consisted of access from home to the electronic medical record, secure electronic communications between patients and providers, and interactive disease management tools. We hypothesized that glycemic control would improve in the group receiving the intervention.
RESEARCH DESIGN AND METHODS - Between August 2002 and May 2004, we enrolled participants in a 12-month open, randomized, singlecenter, controlled trial with a parallel group design. Patients with type 2 diabetes were...