Search of EHRs uncovers undiagnosed diabetes

Researchers combed data from the EHRs of 11.5 million patients from more than 9,000 primary care clinics across the United States. By comparing diabetes coding in the records to biochemical data that measured the quality of care, the team of researchers found that 5.4 percent of the 1,174,018 individuals had lab values or other clinical indicators of diabetes, yet their records did not contain the medical code for diabetes.

They also noted that the use of electronic diabetes registers—used more in England than in the United States—could further reduce the number of undiagnosed cases. "Patients with a coded diagnosis of diabetes had a higher quality of care than those with uncoded diabetes," the researchers wrote. "Organizational context may determine the potential for using primary care records to identify undiagnosed diabetes and to monitor quality of diabetes care. But wherever electronic diabetes registers are used to support the provision of care, and where blood glucose levels, HbA1c and quality-of-care data are recorded in the same system, it should be possible to identify readily (and at low cost) individuals at risk of their diabetes going undetected and those receiving suboptimal care."