Thousands of lives could be saved with information technology for diabetes management, but a new report suggests that only one form of diabetes IT is cost-effective as well.
The Center for Information Technology Leadership found that electronic diabetes registries offer the potential to provide savings that would produce a positive return on investment. Other adaptations of IT would end up costing far more than the savings they would produce, CITL's study concluded.
The Boston-based, not-for-profit research group's report gives a sobering assessment of whether advanced technology can be a cure-all for reducing healthcare costs, and associates dollar signs with potential savings in lives.
The CITL research also indicated market inefficiencies still need to be addressed. The report, funded by the Robert Wood Johnson Foundation and supported by the Healthcare Information and Management Systems Society, is based on model projections and aided by literature reviews, expert assessments and market research.
"At the national level, electronic diabetes registries are the only form of information technology-enabled diabetes management we found to be cost-beneficial when adopted for all patients with Type 2 diabetes," said Blackford Middleton, MD, CITL's chairman. "Costs are a major factor in realizing value from ITDM, and we need to find the means to lower the costs of these IT-enabled interventions."
Over 10 years of full implementation for provider-based diabetes registries, CITL estimates total savings of $14.5 billion, compared with total costs of $6.1 billion, for a positive return of nearly $8.4 billion. Registries, which provide reminders about care to both providers and patients, and provide other information as needed, also would reduce diabetes-related mortality by 710,000 over the 10-year span, CITL estimates.
"The implication is that if registries are effective in improving the care of patients with diabetes and produce savings, then we should look toward policies to get this into place," said Doug Johnston, CITL's executive director.
Research also indicated that payers, including Medicare, would reap the most savings from implementing registries, but providers would bear the majority of the cost, Johnston said. Additionally, such registries are not widely adopted, and the savings predicted by the CITL report wouldn't be fully realized until such registries are broadly implemented, he said.
Other types of technology reduce mortality, but at costs that are not covered by savings. For example, implementing and using clinical decision support on a national level for 10 years in diabetes care was estimated to cost $19.3 billion, compared with care savings of $10.7 billion.
Integrated provider-patient systems, which would fully coordinate efforts of providers and patients for optimal care, could cost $58.8 billion over 10 years, but would produce savings of only $16.9 billion. However, CITL estimates a reduction of 920,000 in diabetes-related mortality with such an approach.