Objective of Section
To show how information systems can help the health care system become more efficient and effective at improving patient outcomes. This section will review use of information system tools to prevent diabetes complications within the structure of the Chronic Care Model (CCM).1
- Information systems may be used to improve the health of individual patients and to identify gaps in care for the broader diabetes population.
- Information systems can provide within-care workflow clinical decision support to improve medical decisions at the point of care.
- Information systems can be leveraged to help empower patients and increase their self-management capabilities.
- Information systems can help engage patients and prepare health care teams for productive visits, while supporting the delivery of care even when patients are not present in the office.
Information technology is evolving at a rapid pace and revealing new possibilities to improve the quality and safety of care. Health care practices’ increased use of electronic health records (EHRs) allows for the creation of structured data, new workflows, and new possibilities for influencing care at the point of the provider/patient encounter. In addition, EHRs allow health care practices to gather knowledge about patient needs between visits, which may reveal gaps in care.
This section reviews how this transition is occurring and guides practices on their journeys. It is increasingly necessary for provider workflows to take advantage of information technology’s ability to provide just-in-time clinical reminders and decision support as well as patient-specific education that can help patients become more empowered in their partnership with providers, with an ultimate goal of optimal self-management. More patients are being provided a window into their care through patient portals as well as programs such as “Open Notes,” which allows direct access to their records. In this journey, patients and providers are increasingly partnering on what information is shared in the electronic record as well as redesigning care to provide novel types of data to guide decision making (e.g., data obtained through wearable technologies). Information technology influences the success of additional elements of the chronic care model, including patient self-management, practice redesign, and clinical decision support. The goal of this model and the use of information systems is to empower patients and health care professionals to have productive encounters, allow their relationships to continue even when the patient is not present in the office, and ultimately lead to improved outcomes.