Using a Registry to Coordinate Diabetes Care
Hello, My name is Judith Cook, and I’d like to welcome you to our podcast on diabetes registries. Today I’ll be talking about what registries are, how they are used by patients and service providers to improve care and outcomes, and the research supporting their use and effectiveness.
If you’re a person with diabetes, or you work with or care about people with diabetes, this podcast is for you. This is because diabetes registries are a new way to promote better care and positive medical outcomes for people with diabetes. A disease registry is an electronic database containing information from patients’ medical records. It focuses on patients with a specific type of medical condition such as diabetes, asthma, or heart disease. Registries are used by care providers, patients, and administrators to improve the delivery of health care and support the use of evidence-based medicine.
A registry allows you to identify and track patients with a specific chronic condition. It lets care providers engage in individual disease management by alerting them to a patient’s abnormal test results, missed appointments, and needed medical procedures. Registries also promote the use of evidence-based care by keeping clinicians and patients aware of when a test should be performed or whether a test result needs to be followed up with a medical procedure or another test. Registries also allow managers to monitor patient outcomes at the individual, clinic, and regional levels. Finally, registries help patients track their progress and let them know when they need to take action in some way.
So far, I’ve explained that a diabetes registry is an electronic data base containing medical information. You may be wondering what kind of information is included in a diabetes registry. Generally, the information is similar to what is found in a patient’s medical record. This includes patient demographic information like age and gender. It also includes all diabetes test results like a person’s blood sugar values or their A1C levels. It contains risk factors related to diabetes, like being overweight or smoking, along with other co-occurring conditions such as the presence of kidney disease or heart disease. It typically includes information about medical appointments that have been scheduled, whether they were kept, and what appointments still need to be scheduled. It also has information on other medical services that are related to diabetes, like a dental exam or a dilated eye exam. The confidentiality of this sensitive medical information must be protected, just like a medical record. No one should have access to information in a registry without the patient’s knowledge and permission.
Patients can benefit from a diabetes registry in several ways. Registries allow patients to see all their test results in one place, and can even let patients compare their test results and health outcomes other peoples.’ Registries can help patients share their health information with other providers for better care coordination. For example, our Center is leading a project where medical and mental health care providers share information about their patients with diabetes through a diabetes registry. We also use the registry to create patient report cards, so that patients can see their test results over time and track improvement in values like their blood glucose or cholesterol levels. Through the diabetes registry, we also help patients by generating appointment reminders, and notifying them that it’s time to make an appointment.
There are two major structures for electronic disease registries. One is a spreadsheet structure like you use when you work in Excel, if you’re familiar with that computer program. The other is a relational database structure, like you use when you work with a program such as Microsoft ACCESS or Oracle. Each registry structure has its advantages and disadvantages, and I’m not going to go into these today. But the simplest to use is a spreadsheet format. Later, I’ll tell you about a free diabetes registry template that uses an Excel spreadsheet format. With this, you can create your own diabetes registry.
If you are a diabetes health service provider, you’ll be interested to know that registries can make your work much easier. Research shows that using a registry can lead to better patient outcomes, more efficient disease management, and greater adherence to American Diabetes Association care standards. While you can spend a lot of money purchasing diabetes registry software and having it programmed, most medical practices, especially small ones, can’t afford this. But you probably already have computers that staff use for word processing and billing. These computers can use the free diabetes tracking spreadsheet I’ll tell you about in a moment.
If you work in a mental health center or belong to a peer-run program, you may wonder how you could use a diabetes registry. Let’s say you’re a case manager working in a community mental health program. You might create and use a small registry to keep track of your clients with diabetes, their latest test results, and which ones need to schedule medical tests and procedures. Or, maybe you belong to a peer-run program. If so, you might develop a registry so that your members with diabetes can keep track of their test results and follow their progress over time. You might also use your registry to remind members when it’s time to schedule an eye or foot exam. With a little creativity, you can use a registry to meet many needs of different actors in medical and mental health care settings.
Earlier, I told you that a free diabetes registry template is available in Microsoft Excel. You can download this template from the Internet at a website sponsored by the American Academy of Family Physicians at www.aafp.org/fpm/2006/0400/p47.html. This spreadsheet was created by Dr. David Ortiz and it comes with an article that explains how to download and use it. Another place to get more information about diabetes registries is at the website of our Center, the University of Illinois at Chicago’s Center on Psychiatric Disability and Co-Occurring Medical Conditions. Our website address is www.cmhsrp.uic.edu/health/. If you go there, and look under the heading “Learn About Wellness and Mental Health,” you can click on a presentation called “Using a Diabetes Registry” that has more in-depth information on everything I’ve talked about in this pod cast. Also, under the heading “News and Features,” you can click on a new interactive Diabetes Toolkit for people with diabetes and their care providers. This Toolkit has educational materials that are cross-walked with American Diabetes Association standards of care for managing diabetes. I encourage you to explore these and other resources on our website related to diabetes. Thank you for listening today. I wish you luck in managing your diabetes and in helping others to do the same.