February 2008

More than 20 million children and adults in the United States have diabetes, a condition in which an individual’s blood glucose level is too high. Late last year, PAMF and its Research Institute received a $1.2 million federal grant from the Agency for Healthcare Research and Quality to conduct a clinical trial on the use of personal health records and remote patient monitoring in managing diabetes – one of the most costly and prevalent chronic health conditions.

Four hundred patients with type 2 diabetes will be enrolled in the trial and randomly split into experimental and control groups. The study’s name, EMPOWER-D, stands for “Engaging and Motivating Patients Online With Enhanced Resources for Diabetes.”

According to Paul Tang, M.D., vice president and chief medical information officer at PAMF and the study’s principal investigator, “EMPOWER-D is designed to evaluate the clinical effectiveness of providing patients with online access to their health data, personalized education and self-management tools, and ongoing feedback from a diabetes care manager.”

One component of the intervention will include home glucose readings. These readings will be automatically uploaded to PAMF through a wireless solution developed by several companies, including iMetrikus, Epic Systems, Palm and Sprint. Currently, diabetic patients have to track their glucose levels on paper logs and share them with their health care providers during office visits. The wireless solution will automatically upload the home readings to the patient’s electronic health record at PAMF, where the patient’s entire health care team will be able to access it, and plan or adjust the patient’s medications and treatment plan as needed.

The study is one of several parts of a larger initiative being developed by PAMF and Sutter Health, of which PAMF is an affiliate, called the Personalized Health Care Program. The goals of the Personalized Health Care Program are to tailor care for chronic diseases to each individual patient and to give them the tools necessary to be an equal partner with their health care team in managing their health conditions. This is important because people are more likely to adopt healthy behaviors and follow their health care team’s treatment plan if they are part of the care process, said Dr. Tang, who was recently elected to the Institute of Medicine.

“Patients’ buy-in and involvement has a tremendous impact on their health behaviors,” he said. “Doctors give advice, but ultimately, it is up to the patient to decide whether to follow a healthy diet, exercise regularly or take their medications. By giving diabetic patients the information and tools they need to take a more active part in managing their own care, we believe we can partner with patients to achieve better outcomes and make care more efficient.

“I believe that empowering patients to be a fully informed member of their health care team will transform the way health care is delivered,” concluded Dr. Tang.