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Cost of an informatics-based diabetes management program

Published online by Cambridge University Press:  28 March 2006

Bonnie B. Blanchfield ,
Richard W. Grant ,
Greg A. Estey ,
Henry C. Chueh ,
G. Scott Gazelle  and
James B. Meigs
Bonnie B. Blanchfield
Affiliation:
Massachusetts General Hospital
Richard W. Grant
Affiliation:
Harvard Medical School and Massachusetts General Hospital
Greg A. Estey
Affiliation:
Massachusetts General Hospital
Henry C. Chueh
Affiliation:
Harvard Medical School and Massachusetts General Hospital
G. Scott Gazelle
Affiliation:
Harvard Medical School and Massachusetts General Hospital
James B. Meigs
Affiliation:
Harvard Medical School and Massachusetts General Hospital
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Abstract

Objectives: The relatively high cost of information technology systems may be a barrier to hospitals thinking of adopting this technology. The experiences of early adopters may facilitate decision making for hospitals less able to risk their limited resources. This study identifies the costs to design, develop, implement, and operate an innovative informatics-based registry and disease management system (POPMAN) to manage type 2 diabetes in a primary care setting.

Methods: The various cost components of POPMAN were systematically identified and collected.

Results: POPMAN cost $450,000 to develop and operate over 3.5 years (1999–2003). Approximately $250,000 of these costs are one-time expenditures or sunk costs. Annual operating costs are expected to range from $90,000 to $110,000 translating to approximately $90 per patient for a 1,200 patient registry.

Conclusions: The cost of POPMAN is comparable to the costs of other quality-improving interventions for patients with diabetes. Modifications to POPMAN for adaptation to other chronic diseases or to interface with new electronic medical record systems will require additional investment but should not be as high as initial development costs. POPMAN provides a means of tracking progress against negotiated quality targets, allowing hospitals to negotiate pay for performance incentives with insurers that may exceed the annual operating cost of POPMAN. As a result, the quality of care of patients with diabetes through use of POPMAN could be improved at a minimal net cost to hospitals.

Keywords

CostsDisease managementQuality
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 2 , April 2006 , pp. 249 - 254
Copyright
© 2006 Cambridge University Press

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References

Beckles GL, Engelgau MM, Narayan KM, et al. 1998 Population-based assessment of the level of care among adults with diabetes in the U.S. Diabetes Care. 21: 1432– 1438.Google Scholar
Bodenheimer T, Wagner EH, Grumbach K. 2002 Improving primary care for patients with chronic illness. JAMA. 288: 1775– 1779.Google Scholar
Eddy DM. 2002 Evidence-based medicine: What it is, why to use it, and how to incorporate it into decision-making. Formulary. 37: 525– 530.Google Scholar
Grant RW, Cagliero E, Murphy-Sheehy P, et al. 2002 Comparison of hyperglycemia, hypertension, and hypercholesterolemia management in patients with type 2 diabetes. Am J Med. 112: 603– 609.Google Scholar
Grant RW, Cagliero E, Sullivan CM, et al. 2004 A controlled trial of population management: Diabetes mellitus: Putting evidence into practice. Diabetes Care. 27: 2299– 2305.Google Scholar
Grant RW, Hamrick HE, Sullivan CM, Cagliero E, Meigs JB. 2003 Impact of population management with direct physician feedback on care of patients with Type 2 diabetes. Diabetes Care. 26: 2275– 2280.Google Scholar
Grant RW, Meigs JB. 2002 The use of computers in population-based diabetes management. J Clin Outcomes Manag. 9: 390– 396.Google Scholar
Health Care Financing Management Association. Financing the future. Report 1. Available at: www.financingthefuture.org.
Information for Health. 2001 A Strategy for building the national health information infrastructure: Report and recommendations from the National Committee on Vital and Health Statistics. Washington, DC: NCVHS; November.
Institute of Medicine. 2001. Crossing the quality chasm: A new health system for the 21st century. Washington DC: National Academy Press;
Institute of Medicine. 2003. Patient safety: Achieving a new standard for care. Washington DC: National Academy Press;
Institute of Medicine Priority Areas for National Action. 2003 Transforming health care quality. Washington DC: National Academy Press; January.
Mehler PS, Esler A, Estacio RO, et al. 2003 Lack of improvement in the treatment of hyperlipidemia among patients with type 2 diabetes. Am J Med. 114: 377– 382.Google Scholar
Meigs JB, Stafford RS. 2000 Cardiovascular disease prevention practices by U.S. Physicians for patients with diabetes. J Gen Intern Med. 15: 220– 228.Google Scholar
Mokdad AH, Ford ES, Bowman BA, et al. 2000 Diabetes trends in the US: 1990-1998. Diabetes Care. 23: 1278– 1283.Google Scholar
Saaddine JB, Engelgau MM, Beckles GL, et al. 2002 A diabetes report card for the United States: Quality of care in the 1990s. Ann Intern Med. 136: 565– 574.Google Scholar
Saydah SH, Fradkin J, Cowie CC. 2004 Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 291: 335– 342.Google Scholar
Shorr RI, Franse LV, Resnick HE, et al. 2000 Glycemic control of older adults with type 2 diabetes: Findings from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Geriatr Soc. 48: 264– 267.Google Scholar
Wagner EH, Austin BT, Von Korff M. 1996 Organizing care for patients with chronic illness. Milbank Q. 74: 511– 544.Google Scholar
Wagner EH. 1995 Population-based management of diabetes care. Patient Educ Couns. 26: 225– 230.Google Scholar