Using electronic health records to improve patient care

9 January, 2023

Digitally coded results in electronic health records can also be used effectively to augment patient care as shown by this study in 2008. Dr David Stables, with Peter Siowerby was the originator of the first large and effective lifelong General Practice patient record in the UK.

Multicenter Study Br J Gen Pract . 2008 Mar;58(548):192-6.

doi: 10.3399/bjgp08X277302. “*Identifying undiagnosed diabetes: *cross-sectional survey of 3.6 million patients’ electronic records, *Tim A Holt, David Stables, Julia Hippisley-Cox, Shaun O’Hanlon and Azeem Majeed*

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Electronic searches of 3.6 million patients’ records were made to identify people with no diabetes diagnosis in one of two categories (A and B), using the most recently recorded blood glucose measurement: A - random blood glucose level ≥11.1 mmol/l or fasting blood glucose level ≥7.0 mmol/l (A); (B). either a random or a fasting blood glucose level ≥7.0 mmol/l. An additional outcome measure of the study was the proportion of the population with at least one blood glucose measurement in the record.

The number (percentage) identified in category A was 3758 (0.10% of the total population); the number in category B was 32 785 (0.90%). Projected to a practice of 7000 patients, around eight patients have biochemical evidence of undiagnosed diabetes, and 68 have results suggesting the need for further follow-up.

One-third of people aged over 40 years without diabetes have a blood glucose measurement in the past 2 years in their record. [*see note below]

HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data. Email address: richardpeterfitton7 AT

[*Note from HIFA moderator (NPW): The authors conclude: 'People with possible undiagnosed diabetes are readily identifiable in UK primary care databases through electronic searches using blood glucose data. People with borderline levels, who may benefit from interventions to reduce their risk of progression to diabetes, can also be identified using practice-based software.']