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AJPH First Look, published online ahead of print Feb 28, 2006
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April 2006, Vol 96, No. 4 | American Journal of Public Health 593-595
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.065391

FIELD ACTION REPORT

Diabetes Decision Support: Initial Experience With the Vermont Diabetes Information System

Charles D. MacLean, MDCM, Benjamin Littenberg, MD and Michael Gagnon, MS

The authors are with the Division of General Internal Medicine, University of Vermont College of Medicine, Burlington, Vt. Michael Gagnon also is with the Department of Information Services, Fletcher Allen Health Care, Burlington.

Correspondence: Requests for reprints should be sent to Charles D. MacLean, MDCM, 371 Pearl St, Burlington, VT 05401 (e-mail: charles.maclean{at}vtmednet.org).

Interventions that have proven effective in the management of chronic illness have often been difficult to establish in widespread practice. The Chronic Care Model provides a framework for implementing interventions, but it is expensive and difficult to implement.

We developed a decision support system based on this model to improve the care of adults who have diabetes and receive primary care in Vermont or adjacent New York. The Vermont Diabetes Information System uses a network of community laboratories for providing data to produce flowsheets, reminders, action alerts, and population reports that are sent to primary care providers by fax and to patients by mail. Currently, 7295 patients are cared for by 124 primary care providers in 62 practices and are enrolled in a randomized controlled trial to study its effects.




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