Benefits of Information Technology–Enabled Diabetes Management

  1. Davis Bu, MD, MA123,
  2. Eric Pan, MD123,
  3. Janice Walker, RN, MBA13,
  4. Julia Adler-Milstein, BA4,
  5. David Kendrick, MD, MPH13,
  6. Julie M. Hook, MA, MPH1,
  7. Caitlin M. Cusack, MD, MPH13,
  8. David W. Bates, MD, MSC123 and
  9. Blackford Middleton, MD, MPH, MSC123
  1. 1Center for Information Technology Leadership, Partners HealthCare System, Wellesley, Massachusetts
  2. 2Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts
  3. 3Department of Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts
  4. 4Department of Health Policy and Management, Harvard University, Boston, Massachusetts
  1. Address correspondence and reprint requests to Eric Pan, MD, MSc, Center for Information Technology Leadership, Partners Health Care, One Constitution Center, 2nd Floor West, Charlestown, MA 02129. E-mail: epan{at}citl.org

Abstract

OBJECTIVE—To determine the financial and clinical benefits of implementing information technology (IT)-enabled disease management systems.

RESEARCH DESIGN AND METHODS—A computer model was created to project the impact of IT-enabled disease management on care processes, clinical outcomes, and medical costs for patients with type 2 diabetes aged >25 years in the U.S. Several ITs were modeled (e.g., diabetes registries, computerized decision support, remote monitoring, patient self-management systems, and payer-based systems). Estimates of care process improvements were derived from published literature. Simulations projected outcomes for both payer and provider organizations, scaled to the national level. The primary outcome was medical cost savings, in 2004 U.S. dollars discounted at 5%. Secondary measures include reduction of cardiovascular, cerebrovascular, neuropathy, nephropathy, and retinopathy clinical outcomes.

RESULTS—All forms of IT-enabled disease management improved the health of patients with diabetes and reduced health care expenditures. Over 10 years, diabetes registries saved $14.5 billion, computerized decision support saved $10.7 billion, payer-centered technologies saved $7.10 billion, remote monitoring saved $326 million, self-management saved $285 million, and integrated provider-patient systems saved $16.9 billion.

CONCLUSIONS—IT-enabled diabetes management has the potential to improve care processes, delay diabetes complications, and save health care dollars. Of existing systems, provider-centered technologies such as diabetes registries currently show the most potential for benefit. Fully integrated provider-patient systems would have even greater potential for benefit. These benefits must be weighed against the implementation costs.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 23 February 2007. DOI: 10.2337/dc06-2101.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted February 8, 2007.
    • Received October 11, 2006.
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  1. Diabetes Care vol. 30 no. 5 1137-1142
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