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  • Thank you for joining us for this

  • webinar titled "Using Electronic Health

  • Records to Support Diabetes Management

  • and Type 2 Diabetes Prevention" Our

  • presenter is Stephanie Rutledge who is a

  • Health Scientist with the Centers for

  • Disease Control and Prevention. I am

  • Michelle Knight with ICF next and I will

  • be your moderator today. The recording

  • and transcript as well as the PowerPoint

  • slide deck will be available on the CDC

  • website later this year. For the next 60

  • minutes we will share information that

  • will help you understand the importance

  • of EHRs in supporting type 2 diabetes

  • prevention and diabetes management. We

  • will also discuss how state and local

  • health departments can talk with

  • healthcare providers about the benefits

  • of using EHRs while being able to

  • acknowledge the limitations of EHR.

  • Then we will provide examples from the field

  • to aid in learning and understanding.

  • Finally we will wrap up by sharing

  • additional resources. The companion guide

  • for this webinar is titled

  • "Using Electronic Health Records to

  • Support Diabetes Management and Type 2

  • Diabetes Prevention" and will be

  • available on the CDC website later this

  • year. I will now turn the webinar over to

  • Stephanie, Stephanie. Thank you Michelle.

  • An EHR is a digital version of a

  • patient's medical chart. A typical

  • individual EHR may include a patient's

  • medical history, diagnosis, treatment

  • plans, pharmacy records, and laboratory

  • and/or test results. EHRs are real-time

  • records that make information available

  • securely to authorized users ideally

  • including users from multiple

  • organizations.

  • Electronic health record systems are in

  • common use in both hospital systems and

  • community-based health care provider

  • offices. EHRs can help streamline

  • communication among providers including

  • community-based providers. EHRs automate

  • and streamline provider workflows and

  • allow providers access to evidence-based

  • tools to help them make patient care

  • decisions. Because of the cost of

  • diabetes care improving the quality of

  • diabetes management and type 2 diabetes

  • prevention is an important priority. EHRs

  • are one promising tool in these efforts

  • and EHRs can help support efforts to

  • increase awareness, referral, enrollment

  • and retention in the National Diabetes

  • Prevention Program also called the National

  • DPP lifestyle change programs, LCPs,

  • and in diabetes self-management

  • education and support or DSMES

  • programs for type 2 diabetes prevention

  • and diabetes management. EHRs can help

  • support the patient journey

  • which we will further define later in

  • the webinar.

  • For example, EHRs can assist health care

  • providers to educate patients about

  • prediabetes and type 2 diabetes,

  • screen or test for prediabetes and type

  • 2 diabetes and refer patients to type 2

  • diabetes prevention or diabetes

  • management programs. EHRs can also be

  • used to send health care providers

  • information about patient participation

  • and progress in National DPP lifestyle

  • change programs and diabetes

  • self-management education and support

  • programs.

  • Health care providers are the primary

  • users and owners of EHRs. Providers

  • include large health systems and

  • hospitals office based practices and

  • pharmacies although almost all hospitals

  • use EHRs not all providers use EHRs.

  • These differences in EHR use can lead to

  • challenges in interoperability or the

  • secure exchange of information between

  • authorized EHR users which can limit the

  • flow of information between providers

  • and other users. We will discuss

  • interoperability in more detail later in

  • the webinar. Individual patients are

  • secondary users of EHRs. Patient

  • access their health records that are

  • stored in an EHR through a secure web

  • site usually called a patient portal.

  • Community or clinically based

  • organizations may also be secondary

  • users of EHRs. Use by these

  • organizations can happen when they

  • receive referrals to their type 2

  • diabetes prevention and diabetes

  • management programs through an EHR in

  • limited cases. Such organizations may

  • also use EHRs to provide feedback on

  • patient progress to the provider making

  • referrals. Most EHRs are created by

  • independent companies or EHR vendors. EHR

  • vendors create a variety of EHR products

  • and platforms with varying features and

  • cost. On this slide are just a few of the

  • common vendors used by hospitals and

  • individual healthcare professionals.

  • Health care providers have many options

  • when choosing EHR vendors and products.

  • The American Medical Association

  • provides a detailed guide to selecting

  • and purchasing EHRs. There are complete

  • and modulate EHRs. One major distinction

  • is a complete EHR is a complete package

  • that has been certified as meeting all

  • of the Federal government criteria for

  • promoting interoperability or PI

  • programs. A practice with a complete

  • EHR has one

  • vendor and one system to work with, which

  • can make it easier to get support. A

  • modular EHR combines multiple EHR

  • modules that are individually certified

  • for PI programs. A modular approach

  • allows providers to use preferred

  • applications, and it can be less

  • expensive than buying a complete EHR.

  • When complete EHRs or combinations of

  • EHR modules meet federal government

  • criteria for PI programs they are

  • referred to as certified EHR technology.

  • HIPAA privacy and security rules protect

  • individually identifiable health

  • information, sometimes referred to as

  • protected health information or PHI.

  • EHRs must comply with HIPAA regulations

  • since they are electronic repositories

  • of PHI. EHRs must be HIPAA compliant

  • and providers are responsible for taking

  • the steps needed to protect

  • confidentiality, integrity, and

  • the availability of electronic PHI. You can

  • learn more in "The Guide to Privacy and

  • Security of Health Information". The 2009

  • American Reinvestment Recovery Act

  • included the HITECH Act that supported

  • Electronic Health Records Meaningful Use,

  • an effort led by CMS and the Office of

  • the National Coordinator for Health IT

  • ONC-HIT. Providers had to show

  • meaningful use, in other words that their

  • EHR was being used in a meaningful way

  • specifically to improve quality, safety,

  • efficiency, and reduce health disparities,

  • engage patients and families in their

  • health, improve care coordination,

  • improved population and public health

  • and, ensure adequate privacy and security

  • protection for PHI. In 2018, CMS

  • announced a new phase of the electronic

  • health record incentive program with an

  • increased focus on interoperability,

  • including the exchange of data between

  • health care providers and patient access

  • to health data. CMS renamed the EHR

  • Incentive program as

  • the Promoting Interoperability PI 177

  • programs. In 2019, CMS introduced the

  • Interoperability and Patient Access

  • Proposed Rule to expand access to health

  • information and improve the exchange of

  • healthcare data. Starting in 2019, CMS and

  • ONC require all eligible healthcare

  • providers and hospitals to use the 2015

  • edition criteria for certified EHR

  • technology to qualify for the PI

  • Program. Health department play an

  • essential role in partnering with health

  • care providers to support EHR used to

  • better manage and prevent type 2

  • diabetes in patients at high risk. In

  • some cases, you will also need to partner

  • with organizations offering type 2

  • diabetes prevention and diabetes

  • management programs. EHR strategies can be

  • used to increase patient awareness,

  • identify risk, appropriately refer

  • patients to evidence-based programs, and

  • help support better diabetes management.

  • When your healthcare provider partners

  • implement specific EHR strategies you

  • can provide support towards improved

  • outcomes. Let's talk about how EHR

  • interventions and partnerships with

  • local health systems and health care

  • providers can help you achieve your type

  • 2 diabetes prevention and management

  • objectives. To focus your efforts

  • consider your overall objectives

  • especially as they relate to the patient

  • journey. Are you focused on improving

  • patient awareness and education related

  • to either prediabetes or type 2

  • diabetes? Increasing patient risk

  • assessment to identify patients with

  • prediabetes or undiagnosed diabetes?

  • Increasing the rates of appropriate

  • physician referral to type 2 diabetes

  • prevention and diabetes management

  • programs? Increasing enrollment in CDC

  • recognized LDP's or DSME as programs? Or,

  • improving diabetes management and

  • clinical quality of care?

  • Once you review your objectives and

  • begin to identify where to focus your

  • effort you will want to engage with

  • potential health care provider partners

  • to see what is feasible. You may want to

  • engage with potential providers partners to

  • understand what providers in your

  • targeted area are already doing with

  • EHRs and which EHR platforms are

  • used. This slide and the next slide include

  • several potential questions you could

  • ask in interviews or surveys including:

  • Do you use EHRs? What vendors and

  • specific platforms?

  • What subpopulations does your office or

  • hospital serve? What special

  • consideration should we be aware of? Can

  • the EHR vendor accommodate EHR changes?

  • Here on this slide are more questions

  • you can ask in interviews or surveys.

  • Would you be able to identify leadership

  • or staff champions to support

  • widespread adoption? What barriers or

  • challenges to implementation

  • do you anticipate? In summary use these and

  • other questions to explore whether

  • strategies you want to implement are

  • feasible given cost, time, and other

  • constraints. Let's explore how you can

  • talk with healthcare providers about EHR

  • use from the perspective of the patient

  • journey. The concept of patient journey

  • has developed as a way to describe how a

  • patient with type 2 diabetes or

  • prediabetes interfaces with the

  • healthcare system. It is shown as a

  • linear process in this webinar however

  • an individual patient might experience

  • the parts of the journey iteratively or

  • in a different order. The patient journey

  • includes these parts: awareness and

  • education, when a patient learns about

  • prediabetes or type 2 diabetes

  • including risk and available programs;

  • risk assessment and diagnosis, when a

  • patient learns they have prediabetes or

  • type 2 diabetes or learns about diabetes

  • complications; referral, when a provider

  • refers a patient to a type 2 diabetes

  • prevention or diabetes self-management

  • education and support program program;

  • enrollment, when a patient

  • enrolls in a type 2 diabetes

  • prevention or diabetes self-management

  • education and support program, and

  • management, when a patient works with

  • health care providers to manage their

  • condition and prevent type 2 diabetes or

  • diabetes complications. One part of the

  • patient journey is patient awareness of

  • and education about prediabetes or type

  • 2 diabetes, including awareness of

  • individual risk and programs to help

  • prevent or manage these conditions. To

  • improve patient awareness and education

  • providers can strategically use patient

  • portals which are secure website through

  • which patients access health information

  • stored in the EHR. Patient portals can

  • increase access to health records by

  • allowing patients to download, share and

  • otherwise engage with their health data.

  • A patient might collect data manually or

  • with a tracking device and upload the

  • information via the patient portal.

  • Examples include blood sugar readings,

  • medication taking, body weight and

  • physical activity or nutrition logs.

  • Providers review health data that have

  • patient captures and records data in

  • EHRs. Providers can then better

  • understand their patients behaviors,

  • habits and health risk. To educate

  • patients providers can use patient

  • portals to increase patient awareness of

  • a disease and reduce the risk of

  • patients using unreliable information.

  • They can also provide tailored

  • information and educational resources to

  • involve patients and share

  • decision-making regarding treatment care

  • plans or tests. Let's discuss an example

  • from the field. The University of

  • California Davis health system initiated

  • a project to integrate patient generated

  • data into EHRs. One part of the project

  • focused on improving the health of

  • patients with type 2 diabetes. UC Davis

  • integrated fitness tracker data such as

  • steps, activity, sleep, and caloric

  • information from patients into their EHR.

  • This application of patient generated

  • data

  • mad it easier for providers to compare

  • the data to metrics like A1c and

  • have conversations with patients about

  • how behavior change impacts their

  • disease management. How state health

  • departments can facilitate awareness and

  • education using EHRs. First you will need

  • to determine the awareness and

  • educational opportunities and

  • limitations of the specific EHR system

  • used by the healthcare provider partner.

  • The following areas can be explored

  • during your conversation. Find out

  • whether your potential health care

  • provider partner currently use or would

  • promote the use of patient portals. More

  • patients access their records when

  • prompted by a provider. Identify the

  • limitations of what kinds of data and

  • information can be uploaded and

  • integrated into the EHR. You can provide

  • patient tailored educational resources

  • that providers can share through a

  • patient portal to promote awareness and

  • education. Using another example from the

  • field

  • Epic Systems and the Mayo Clinic

  • collaborated so that users of Epic

  • Systems My Chart patient portal can

  • access patient facing educational

  • resources relevant to diabetes developed

  • by the Mayo Clinic. The resources are

  • available in English and Spanish. Mayo

  • Clinic medical experts regularly review

  • and update their resources and update the resources as needed.

  • Another part of the patient journey is

  • risk assessment and diagnosis when a

  • patient learns that they have

  • prediabetes or type 2 diabetes. The

  • primary challenge for healthcare

  • providers and health departments is to

  • identify those patients with undiagnosed

  • type 2 diabetes or diabetes

  • complications. To address this challenge

  • healthcare providers and health

  • departments can use EHR data to apply

  • risk scores to identify individuals with

  • prediabetes or type 2 diabetes,

  • such as the prediabetes patient risk

  • assessment. Use EHR phenotyping, a

  • practice of developing algorithms or

  • formulas that use EHR data to identify

  • population characteristics associated

  • with prediabetes or type 2 diabetes.

  • Embed or use computerized disease

  • registry data, which is a list of

  • patients with a certain disease or

  • condition, within EHRs to aid with

  • identification of patients with

  • prediabetes or type 2 diabetes or risk

  • for diabetes complications. Use clinical

  • decision support systems, which combine

  • clinical knowledge with person specific

  • data, to help providers identify and

  • treat high-risk patients for instance.

  • EHR phenotyping can be used to screen

  • for prediabetes or potentially

  • undiagnosed type 2 diabetes. Phenotyping

  • can also be used to identify

  • non-traditional risk factors associated

  • with type 2 diabetes development.

  • Non-traditional risk factors may include

  • diet, markers of chronic inflammation, metabolic

  • abnormalities, genetic

  • markers, or other factors. If you're

  • implementing EHR phenotyping here are

  • some possible considerations. As a state

  • health department consider working with

  • healthcare partners to identify an

  • appropriate algorithm for data the

  • provider has collected. You can also

  • collaborate with your healthcare

  • provider partner to add to algorithms and

  • to provide appropriate training on the

  • use of the algorithms. In another example

  • from the field researchers at the

  • University of California Los Angeles

  • predicted patients type 2 diabetes risk

  • by using an algorithm applied to

  • information in de-identified electronic

  • health records. They also identified

  • previously unknown risk factors for type

  • 2 diabetes. The researchers estimated

  • that in the United States using EHR

  • phenotype screening could identify an

  • additional 400,000 people with active

  • and untreated type 2 diabetes compared

  • with conventional approaches.

  • The purpose of Clinical Decision Support

  • or CTS systems is to help providers get

  • the right information at the right time

  • reducing the likelihood of misdiagnosis

  • or other errors. These systems help

  • organized large volumes of EHR data. They

  • combine specific, they combine scientific

  • knowledge with person-specific data and

  • can assist providers to identify

  • high-risk patients, consider alternative

  • diagnosis, order specific tests, and more.

  • A CDS system integrated within an

  • EHR can be used to identify patients at

  • higher risk for developing type 2

  • diabetes or to help in the early

  • detection of diabetes complications such

  • as chronic kidney disease.

  • Here are some considerations for

  • implementation of clinical decision

  • support systems. You can learn the

  • specific challenges your healthcare

  • provider partner faces in identifying

  • patients with prediabetes or

  • undiagnosed type 2 diabetes or in

  • detecting diabetes complications and

  • identify ways that a CDS system might be

  • able to address these challenges. You can

  • also determine how feasible it is to

  • implement a CDS system within the EHR

  • system. In the referral part of the

  • patient journey EHR can be used to refer

  • a patient to appropriate treatment. This

  • can include referral to a type-2

  • diabetes prevention or diabetes

  • management programs.

  • The referral process can be streamlined

  • by using EHRs or electronic referral

  • using embedded referral forms. We will now

  • turn our attention to the various ways

  • that EHRs can be used in the patient

  • referral process. EHRs can be designed to

  • allow healthcare provider partners to

  • electronically refer or refer patients

  • to a community health program such as

  • type 2 diabetes prevention or diabetes

  • management program. Bi-directional

  • e-referral occurs when a provider refers a

  • patient to a type 2 diabetes prevention

  • or diabetes management program through an

  • EHR and the organization offering the

  • program is able to provide feedback to

  • providers through the EHR. This feedback

  • means providers learn whether an

  • enrolled patient participates and the

  • details of their progress closing the

  • information loop between the

  • organization and the provider. Here are

  • some considerations for implementation

  • regarding eReferrals. For eReferral, you

  • can work with a health care provider

  • partner to understand why and how they

  • refer patients to programs and how

  • they access up-to-date information about

  • available programs. Try to determine how

  • electronic referrals can be part of the EHR

  • and provide workflows. You can also

  • learn how community or clinically based

  • organizations will receive the eReferrals.

  • For bi-directional referral recognize

  • that access to EHRs is rare

  • for community-based programs compared to

  • clinic based and that workarounds to

  • direct access to EHRs may be

  • needed for community based programs

  • to provide feedback. Consider working with

  • partner organizations to understand

  • existing referral practices and

  • communication. In the Bronx New York

  • Montefiore Health System partnered with

  • the YMCA of Greater New York to deliver

  • the YMCA's IVs prevention program,

  • YDPP. They developed a referral system

  • that was fully integrated with their EHR.

  • At first the health system relied on

  • paper referral but then shifted to

  • electronic referrals integrated in the EHR.

  • One of the first challenges encountered

  • in this partnership was getting

  • Montefiore providers to agree to the

  • referral workflow which required

  • obtaining written patient consent for

  • referral to be sent to the YMCA. After

  • program enrollment the final part of the

  • patient journey is prediabetes or type

  • 2 diabetes management in which the

  • patient works with health care providers

  • to manage diabetes and prevent

  • complications. When providers, patients

  • and program sites can share information

  • readily and close feedback loops

  • prediabetes or type 2 diabetes

  • management can be a smoother process.

  • Patient portal used for patient data and

  • feedback and bi-directional

  • eReferral and

  • EHR Alerts can help stakeholders to learn

  • when a patient enrolls, stay connected,

  • and use available data for better

  • management of prediabetes or type 2

  • diabetes. As we noted earlier in the

  • presentation patient portals are secure

  • websites that allow patients to access

  • their health records from an EHR.

  • Patients can use portals to download,

  • share and otherwise engage with their

  • health data. Patient portals can be used

  • to support management of a patient's

  • condition.

  • Examples include integrating patient

  • generated health data, or data that a

  • patient captures and records in EHRs, such as blood

  • sugar readings, body weight, or medication

  • taking. Such data can be used to monitor

  • patient progress during a treatment

  • program. This can help providers create

  • more tailored strategies for the

  • management of chronic conditions.

  • Another example is allowing patients to

  • provide feedback via the patient portal

  • during their type 2 diabetes treatment program.

  • This can help patients feel a stronger

  • sense of connection to their healthcare

  • team. In addition providers can use

  • feedback from patients to adjust care

  • plans. As you're implementing patient

  • portals here are some considerations as

  • noted earlier. Find out whether your

  • potential healthcare provider partners

  • currently use, or would promote the use of

  • patient portals. More patients access

  • their records when prompted by a

  • provider. Try to identify limitations for

  • what kinds of data can be uploaded and

  • integrated into the EHR. EHR alerts are

  • reminders for providers that are

  • integrated into the clinical workflow.

  • Alerts can help with type 2 diabetes

  • management and maintenance of treatment

  • plans and ensure that critical points of

  • patient care are not overlooked by

  • patients or providers. As a part of

  • bi-directional eReferral

  • providers can receive alerts about a

  • patient's progress in a community

  • program. Alerts can help providers

  • understand which tests are needed,

  • problems that have been identified, and

  • topics a patient needs more education on.

  • Alerts and

  • reminders may be part of a clinical

  • decision support system within an EHR or

  • they may be separate. Here are some

  • considerations for implementation of EHR

  • alerts.

  • Learn how your health care provider

  • partner already uses alerts to support

  • type-2 diabetes management, if at all. You

  • can determine whether providers would

  • support the integration of alerts into

  • the EHR system. You can also find out

  • where alerts might offer the most

  • benefit.

  • Are there specific areas where the

  • provider can better support type-2

  • diabetes management such as ordering

  • appropriate tests, following up with

  • patients who've missed tests or

  • appointments or identifying patients with

  • prediabetes or undiagnosed diabetes. In

  • an example from the field Reliant

  • Medical Group took advantage of EHR

  • features to ensure a comprehensive

  • approach to type-2 diabetes management.

  • The EHR system includes alerts to

  • inform diabetes education nurses about

  • how a patient is doing in their type-2

  • diabetes self-management education and

  • support program, alerts to remind

  • providers to order needed tests,

  • reminders to patients to have tests

  • done including automated phone triggered

  • calls triggered by the EHR, reminders to

  • patients who miss appointments, and

  • processes to follow up with patients who

  • miss tests and appointments. EHRs have

  • the potential to change provider

  • workflows and improve patient care

  • including for type 2 diabetes prevention

  • and diabetes management, however there are

  • limitations in how EHRs are used and

  • perceived by providers, patients and

  • others. We'll take a few moments now to

  • provide an overview of these limitations.

  • Technological limitations for EHRs

  • include: interoperability. EHR systems

  • work in different ways. These differences

  • can limit the ability to exchange

  • information between EHR systems.

  • Standardization, EHR data are recorded,

  • stored and exchanged in different ways.

  • This lack of standardization can

  • interfere with communication between

  • EHRs. And adaptability, EHR vendors often

  • do not provide customized

  • products. Providers may be left with EHRs

  • that don't work as well as expected.

  • Legal limitations of EHRs include HIPAA.

  • The Health Insurance Portability and

  • Accountability Act law presents real and

  • sometimes perceived limits to sharing

  • patient data to improve patient care.

  • Another limitation is state regulations.

  • Because states have different patient

  • privacy and health data exchange laws

  • health care provider partners may be

  • confused by various state level

  • requirements and meaningful use policies.

  • Previous policies provided limited

  • incentives to ensure collaborative

  • healthcare as we discussed earlier. New

  • proposals aim to expand incentives for

  • collaboration and promoting

  • interoperability. Clinical workflow

  • limitations for EHRs include

  • interference with patient engagement. Use

  • of EHRs can decrease provider engagement

  • with patients and reduce the amount of

  • time they spend with patients. And

  • information overload and lack of readily

  • available information is another

  • clinical workflow limitation. EHRs can be

  • an administrative burden for providers

  • with too many alerts, decreased

  • quality of care and job satisfaction and

  • missing test results. Providers also may

  • not enter information into the EHR or

  • they may enter incorrect information.

  • There are also access limitations

  • associated with EHR. For instance not all

  • patients have access to providers who

  • use EHRs. Some patients don't have access

  • to portals and even patients willing to

  • access portals may not want to provide

  • other personal data. In addition some

  • patient populations prefer traditional

  • communication methods. In many rural

  • areas EHR technology has been

  • adopted more slowly. There are more

  • infrastructure barriers, less electronic

  • sharing of data and less overall

  • preventive care. Less buy-in, access and

  • exposure to new charts occur in some

  • urban areas as well.

  • Collaboration limitations for EHRs

  • include the standardization. Proprietary

  • EHR platforms, antiquated systems

  • and lack of standard referral processes

  • and reporting standards make it hard for

  • providers and community partners to use

  • EHR platforms as bi-directional referral

  • systems. Another collaboration limitation

  • is health care provider partner buy-in. A

  • lack of buy-in and product champions

  • leads to lags in referrals to community

  • programs. Resistance to change on the

  • part of health care provider partners

  • can also be a factor. If health care

  • provider organizations and community

  • organizations do not have a shared

  • vision and mission for how they will

  • work together to use EHRs success

  • is more challenging. One of the

  • challenges in working with EHRs is

  • changing policy and technology landscape.

  • Government policies and private sector

  • technologies specifically address

  • existing challenges and limitations of

  • EHR. CMS's focus on interoperability and

  • the emergence of third-party apps are

  • two areas that are rapidly changing.

  • Keeping current with these changes will

  • help you to keep your proposed

  • interventions relevant and effective. As

  • we mentioned earlier CMS announced new

  • proposed rules in 2018 and 2019 with an

  • increased focus on promoting

  • interoperability. Additional

  • announcements and policy changes related

  • to CMS's focus on interoperability are

  • emerging and expected. These changes

  • should help overcome some of the current

  • EHR interoperability challenges allowing

  • for better exchange of information between

  • healthcare providers, patients and

  • potentially community organizations. You

  • can stay current with updates by

  • visiting the CMS website and the Office

  • of the National Coordinator for Health

  • Information Technology ONC website. As

  • use of EHRs become increasingly common

  • the need for solutions to common EHR

  • challenges is being recognized. Third

  • parties are developing applications or apps

  • to help healthcare provider partners to

  • address specific EHR challenges.

  • One app platform is Smart Health IT

  • which is run by the not-for-profit

  • institution Boston Children's Hospital

  • Computational Health Informatics Program

  • and a Harvard Medical School Department

  • for Biomedical Informatics. The platform

  • was initially funded by the US

  • government to develop standards, open

  • source technology, and a community of app

  • developers. Smart Health IT are publicly

  • accessible. You should now be able to

  • define EHRs, describe the importance

  • of the EHRs, discuss EHR capabilities

  • with health systems and healthcare

  • providers, identify EHR strategies to

  • support type 2 diabetes prevention

  • and diabetes management objective and

  • describe the limitations of EHRs

  • including the changing landscape of EHR

  • policy and technology. Here are some

  • links to resources that you might find

  • useful. Additional resources are

  • available at www.cms.gov and www.cdc.gov. On

  • behalf of CDC I want to thank you for

  • participating in the "Using Electronic

  • Health Records to Support Diabetes

  • Management and Type 2 Diabetes

  • Prevention" webinar.

Thank you for joining us for this

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電子カルテを活用した糖尿病管理と2型糖尿病予防の支援 (Using Electronic Health Records to Support Diabetes Management and Type 2 Diabetes Prevention)

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    林宜悉 に公開 2021 年 01 月 14 日
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