Online health record of limited use for diabetic patients
23 September 2008
An online personal health record system that allowed people with
diabetes to check their lab results and get guidance about medication
proved to be of only limited use in improving their health outcomes,
according to a new American study published in the Archives of
The patients who used the system did not do a better job of getting
their diabetes under control after one year compared to a second group
who used a simpler online health program. However, the news wasn’t all
bad, said Richard Grant, MD, assistant professor at Massachusetts
General Hospital and Harvard Medical School.
“We did show that by having patients use a personal health record and
be engaged in thinking about what they want done, they’re more likely to
have changes made to their medication,” Grant said. “It seemed to work
to make patients more engaged in their care.”
Research suggests that most people with type 2 diabetes under medical
care have difficulty controlling their condition. In many cases, they
are unable to reach the recommended glycemic (blood sugar), blood
pressure and cholesterol levels.
The new study aimed to link patients’ online personal health records
to their doctors’ electronic medical databases. The researchers set up
the systems at 11 primary care practices in eastern Massachusetts and
recruited 244 patients to take part.
According to Grant, researchers assigned some patients to an
'intervention' system that, based on lab results, provided suggestions
such as, “Do you want to talk to your doctor about starting a medicine
or getting your cholesterol tested?” If a patient expressed interest
about getting a test or trying a new medicine, the system would send a
note to the patient's doctor.
Researchers compared the intervention group to other patients who
could use personal health records to input information about family
health issues and details about their own health.
Ultimately, the researchers found that participating in the
intervention group did not improve the health of the patients. However,
those who took part tended to be in better health anyway, Grant said.
“The kinds of people who sign up aren’t necessarily those with the
most to benefit,” Grant said. “The sickest people with the worst disease
didn’t sign up.”
Ted Eytan, MD, a Washington DC family physician who blogs about
decision-making health tools, said personal health records hold great
promise, pointing to a study published in the Journal of the American
Medical Association in June that showed patients lowered their blood
pressure when they used an online system to monitor their health and
communicate with pharmacists.
That program might have been successful because the personal health
record system was adopted systemwide and used by every physician, said
Eytan, who served as the system’s operations manager.
“The key isn’t having a (personal health record system) or not, it’s
how the organization thinks of it and presents it to its patients,” he
1. Grant RW, et al. Practice-linked online personal health
records for type 2 diabetes. A randomized controlled trial. Arch
Intern Med 2008; 168(16),
The abstract is free to view online: