Title: Mandatory HbA1c/Diabetes Registries as a Method of Public Health
Surveillance: The cases of New York City, San Antonio, and Vermont
Running Title: Mandatory HbA1c/Diabetes Registries
SHALLY IYER, BA, MPH (c)*
Acknowledgements: Thank you to my Capstone Field Preceptor, Terri Lipman, PhD, CRNP,
FAAN for including me in her research efforts with the Pennsylvania Diabetes Action Plan.
The author also thanks her Capstone Mentor for her tireless support, as well as helpful
comments and suggestions.
*The author is associated with the University of Pennsylvania Masters of Public Health
Program.
ABSTRACT
The emerging use of Health Information Technology in clinical care, quality improvement,
and efficiency advancement provides innovative solutions to reducing the burden of
chronic diseases such as diabetes. Effective diabetes management requires 1) proper
identification of patients with diabetes, 2) data synthesis for population health snapshots
and 3) patient health summaries that promote care coordination; diabetes registries, also
identified as HbA1c registries, meet the requirements for these three tasks.
Three municipal government HbA1c registry programs were examined via the semistructured interview process to determine: what type of registry was implemented
(voluntary or involuntary), why the registry was implemented, what data was collected,
what legislation was required (if any) to proceed with the registry, what the key challenges
and advantages are to implementing a diabetes registry, and what the current gaps in
diabetes surveillance and management are. Through oral history interviews with principal
public health officials, clinicians, entrepreneurs and academicians, as well as detailed
systematic reviews, this project will develop public health case study materials for
inclusion in academic manuscripts as well as an evidence-base for policy advocates.
The results of this research show that there are drawbacks and advantages to voluntary
and involuntary registries regarding data collection, physician participation,
generalizability, cost and privacy.