Development and evaluation of a Computer-Assisted Management Protocol (CAMP): improved compliance with care guidelines for diabetes mellitus

Abstract

Disease-specific standards for directing patient management are becoming increasingly important. These standards, however, are often not followed because they are not sufficiently integrated into the clinical care setting. In this study we describe the development and evaluation of a Computer-Assisted Management Protocol (CAMP) of care guidelines for diabetes mellitus. While other studies have shown improved compliance with rule-based reminders, the CAMP customizes disease-specific care guidelines to individual patients over time. We evaluated the effect of the CAMP on compliance with guidelines in a prospective, randomized controlled study. The study was performed at a family practice clinic where much of the patient record is maintained electronically on The Medical Record (TMR). The management protocol was developed from standards published by the American Diabetes Association. Fifty-eight providers were randomized to either receive or not receive the CAMP for diabetes. Compliance with standards was assessed by chart audits of all encounters with diabetic patients during the study interval. The following conclusion was made: the Computer-Assisted Management Protocol resulted in a statistically significant improvement in compliance with diabetes care standards.