Diabetes Specialist Uses Health IT Tools To Help Patients Improve Their Care – Part I

Damon Davis | April 27, 2012

Patients and physicians nationwide are leveraging health information technology (health IT) to make their health care interaction more efficient and effective without necessarily having to be face-to-face. The use of existing and emerging technologies—such as cell phones, personal health records, mobile apps, and monitoring devices—are creating ways for patients and providers to monitor health conditions remotely. Endocrinologist, Dr. Gail Nunlee-Bland, shared her story with ONC about several studies she has done looking at how using health information technology can improve her patients’ diabetes self-management.


Tell us about yourself and your practice.


I’m an endocrinologist specializing in diabetes care, in the diabetes treatment center at Howard University. About 89 percent of our patients in the clinic are African American and roughly 60 percent  of our patients have diabetes. Given most of my patients have multiple health care providers involved with their care, health IT is very beneficial for improving their care coordination.

I started with a grant from the D.C. Department of Health to explore novel health information technologies. We adopted an electronic health record (EHR) that was focused on diabetes, later implementing a personal health record (PHR) to work with the EHR. Certain fields in the EHR automatically populated information in the PHR, allowing key information to flow from the provider to the patients like their medication list, problem list, and diagnoses.  Patients could enter their own information and share information with other providers. In my opinion, the personal health record is a valuable tool for our patients.

The Value of  PHRs And Online Patient Portals


You’ve used other health IT technologies. Why do you feel the personal health record is such a valuable tool for your patients?


On one occasion, one of my patients was in an emergency room in South Carolina.  He was able to provide his username and password to the ER physician to open his PHR. The PHR contained accurate information regarding the doses of his medications, problem lists, and certain laboratory studies. Too often patients visit  a physician’s office not knowing their diagnoses, or the correct names or doses of medications that they are taking. Patients will say, “I am taking that little white pill for my blood pressure,” but there are thousands of little white pills. Physicians are reluctant to record information that they cannot verify, so access to the PHR provides this verification.

We also have a disease management portal where folks can learn more about their diabetes. This portal is a separate module that can be accessed on our website with a username and password. Our diabetes educators search the web for useful, accurate health information related to diabetes for better self-management of our patients’ nutrition, exercise, medications, and diagnoses; then we link to these websites through the portal. It’s full of valuable information. For instance, a diabetic patient of mine with an insulin pump was eating breakfast at a fast food restaurant.  She was guessing the nutritional value of the carbohydrates in the fast food breakfast, but her guess was  too high. She was making the insulin pump give more insulin than it should, causing her blood sugar to go too low. Later I showed her how she can use the disease management portal to look up the nutritional value of various food items at fast food restaurants so she did not  have to guess anymore. Instead of patients going to the various websites of different restaurants, this online patient portal collects it all for them in one convenient location.

To learn more about Dr. Nunlee-Bland’s health IT programs, visit the Health IT Buzz Blog next week to see Part II of ONC’s interview! For more information on health information technology, visit HealthIT.gov.