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The Diabetes Dashboard: When Physician Time is Money

November 30, 2011
by Gabriel Perna
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The University of Missouri has found a way to save valuable time for physicians

In healthcare, as in perhaps no other industry, the phrase “time is money” isn’t just a saying, but a reality. Thus, any tool that can help doctors review high volumes of data at a faster rate so they can move onto actual clinical work is typically appreciated. With this in mind, researchers at The University of Missouri, Columbia, have developed a tool that can help doctors fully assess diabetes patients with a few simple clicks.

The Diabetes Dashboard is an intuitive tool that is designed as an add-on to an electronic medical record (EMR). It summarizes a patient’s health problems, vital signs and lab results, which are all specifically geared to diabetes quality measures such as blood pressure control and sugar intake. It also prompts the doctor to consider whether or not the patient is within a satisfactory range with regard to the measures and to make recommendations.

Richelle Koopman, M.D., and associate professor of family and community medicine at University of Missouri School of Medicine, was part of the team that created the dashboard. Koopman says use of the technology to track certain measures of diabetes care can, if successful, eventually reduce the risk of cardiovascular disease.

Richelle Koopman, M.D.

“It’s pretty high stakes stuff for the patient,” Koopman says. “If you can get better care with them or better blood sugar control, you can save life and limb. That’s pretty important. If we can make it easier for patients and physicians to do that, then that’s a win.”

Then and Now
More than anything else, the dashboard is a more convenient tool to figure out critical diabetes information, according to Koopman. The dashboard, which was created by a team of physicians and the school’s EMR vendor Cerner (Kansas City, Mo.), is a huge time-saver, she says.

With paper records, physicians had to flip through sheets of paper to get all of the related diabetes information. Flow-sheets that included diabetes specific information were created, but still hand-entered and thus at risk for human error. Even with an EMR, physicians still must click through various screens to get what they need.

“Collecting all of the data [relevant to diabetes care] to see what needs to be done takes a long time,” Koopman says. “Physicians typically have patients scheduled every 15 minutes and it takes five minutes to find this data in a traditional EMR. You either have to do it beforehand or during your patient’s visit. If you do it during their visit, you are cutting into other things, like treatment adjustments and talking about diet and exercise.”

The dashboard is similar to the flow-sheets, except it’s on an EMR, encompassing all the necessary information for diabetes care on a single screen. In a study done by the University of Missouri, physicians found the Diabetes Dashboard saved them four minutes while paging through the various data. It also reduced the amount of clicks needed by physicians to find the data from 60 to three.

Money and Accuracy
Unlike the old flow-sheets, the diabetes dashboard is less likely to make an error, according to Koopman. In the same study, physicians reported that the data found from the dashboard was accurate 100 percent of the time compared to 94 percent of the time within the traditional EMR.

There’s also an implied cost-savings derived from the dashboard, says Koopman. Even without a cost study analysis, according to the researchers’ calculations, if a physician who makes $180,000 annually in salary and benefits, four minutes saved is equal to $6.59 per patient. Over time, she says, that adds up. In addition, there is cost-savings by having patients avoid taking duplicate tests, which come about because of unclear information.

Next Up
Koopman says that Cerner has provided this technology for their other clients across the country. In addition, she says the dashboard shouldn’t be vendor specific, adding that she would like to see other vendors adopt it as well.

For the actual dashboard, Koopman says improvements will continue to be made. Already, researchers have made it interactive. For instance, if a patient needs something cholesterol levels checked, a test to do just that can be set up directly on the dashboard.

The next step, according to Koopman, is to incorporate all of the conditions a patient might have. Currently, the dashboard can only track single conditions.

“So if your patient has diabetes, high cholesterol, high blood-pressure and asthma, then you wouldn’t have to navigate to those four dashboards because then you’re just navigating again,” Koopman says. “Instead, if the EMR or computer screen says this patient has high cholesterol, high blood-pressure and asthma, here’s everything you need to know about those conditions. What we don’t have yet is a single screen summary that covers all the medical conditions a patient has and the relevant medical information.”

Koopman doesn’t think taking this next step would be that hard. Incorporating recommendations to a multiple condition dataset, she says, would save the most lives.

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