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HD4-C Information technology based ubiquitous diabetes care system
DIABETES RESEARCH A N D CLINICAL PRACTICE
realities of diabetes as a self-managed disease. It is further based on the recognition of the need to provide patient-centered care and the importance of working as partners with our patients. Although we know this approach is effective, implementing the empowerment philosophy requires a paradigm shift and that we learn new skills. This session will provide an overview of empowerment and provide practical and effective strategies for health professionals to implement with their own patients.
HD4-B Telemedicine facilitated diabetes health care delivery Sven-Erik Bursell Telehealth Research Institute, University of Hawaii Traditional health care delivery involves individual providers reacting to patient-initiated complaints and visits. Care is often fragmented, disorganized, duplicative and focused on managing established disease and complications. Management of diabetes is provider directed and focuses on pharmacologic and technologic interventions with little attention given to patient self-management behaviors and provider-patient interactions. Evidence shows that improving care for diabetic patients, such as interventions to lower glucose levels, increase eye care, or prevent neuropathy, is cost saving for health care organizations, especially when delivered with educational interventions, decision support and reminders to care managers and patients on performance issues, such as timely retinal evaluation. We have implemented the Comprehensive Diabetes Management Program (CDMP), a web-based diabetes care management tool to facilitate health care delivery and care coordination including a well-established telehealth eye care component. This application also provides direct patient internet access via a secure patient portal. The combination of the patient portal and the core diabetes management application fosters continuous care and communication among patients, care managers, and physicians, insures that the latest clinical guidelines and education components are used in the care, and focuses on both clinical and behavioral patient problem areas. The system aggregates data from diverse sources such as lab systems and electronic medical records, displays the data in a medically relevant dashboard format and provides a robust portfolio of clinical and behavioral alerts, decision support, reminders and risk profiles. Preliminary data from CDMP system usage shows significant improvements in glycemic control, lipid levels, blood pressure and reductions in associated patient emotional stress.
HD4-C Information technology based ubiquitous diabetes care system Jae-Hyoung Cho, Kun-Ho Yoon Department of Endocrinology & Metabolism, The Catholic University of Korea, Seoul, South Korea Although clear evidence of the beneficial effects of tight glycemic control on diabetic patients had been already made, the past decade has not seen any noticeable improvement in terms of glycemic control. Moreover, the number of subjects with diabetes are sharply escalating. So it is absolutely needed to develop a new tool for more effective diabetes management. “Ubiquitous
79 (2008) S1 – S127
S13
health care system”, which is one of the developing fusion technologies of IT, BT and NT, could give us new solutions in future. We established the Internet based glucose monitoring system (IBGMS) and reported its short-term and long-term effect on Type 2 diabetes. And we also introduced new diabetes control system to overcome time and place limitation. Such a ubiquitous health care system is already applied to various disease models. We need to develop various communication system using advanced information technologies and bio-technologies. However, to implement such the new diabetes care system, investigations on economic benefits have to be performed in the first. In this session, we will show the results of economic impact of the IBGMS. Based on the IBGMS, currently we try to develop some more advanced diabetes care system. We are also able to introduce telecommunication based diabetes management system and a system using advanced device such as PDA type blood glucometer. Ubiquitous health care system is expected to be an important part in our real life. We expect the new health care system will be able to implement in real practice in the world in near future and contribute to reducing diabetic complications and improving the quality of life for patients with diabetes.
HD5-A How to deliver better care by enhancing diabetes team care education? Wayne H.-H. Sheu President, Taiwanese Association of Diabetes Educators (TADE), Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan Diabetes represents a public health challenge and it is emerging as a pandemic worldwide. In order to provide optimal diabetes care, all health care providers need sufficient diabetes knowledge and skills to ensure safe, competent care to persons with or even those at risk for diabetes. To accomplish these goals, continuous medical education along with credits and qualification system through various measures were undertaken. In addition, diabetes self-management education is also widely accepted as a critical component of care. Taiwanese Association of Diabetes Educators (TADE) established since 1996 aiming to promote skill and booster knowledge of diabetes education in order to cope with increasing need of diabetes care. Currently, TADE have membership up to 10,000, composing of MD, RN, RD, Pharmacists and other diabetes care subspecialties. More than 2,500 diabetes educators (CDE) certified after certain hours of course, training and passing tests. It is missions of TADE to provide comprehensive care, to promote better quality of life for diabetes subjects through team-cared strategies. A total of 136 diabetes health promotion centers or settings, composed of MD, RN, RD, certified by TADE, provide care for a certain portion of diabetes subjects in Taiwan. In year 2006, a survey of quality of diabetes care conducted at qualified diabetes care centers or settings involved almost 7,000 diabetes individuals, most of them are Type 2 diabetes with an average age 63 years old. Most of them are under regimens of various oral hypoglycemic agents, while 17% of them are on insulin injection. This survey revealed average fasting glucose levels and HbA1c were 155 mg/dl and HbA1c 7.9%, respectively. We will share out experience in conducting a diabetes team care for diabetes in Taiwan.
realities of diabetes as a self-managed disease. It is further based on the recognition of the need to provide patient-centered care and the importance of working as partners with our patients. Although we know this approach is effective, implementing the empowerment philosophy requires a paradigm shift and that we learn new skills. This session will provide an overview of empowerment and provide practical and effective strategies for health professionals to implement with their own patients.
HD4-B Telemedicine facilitated diabetes health care delivery Sven-Erik Bursell Telehealth Research Institute, University of Hawaii Traditional health care delivery involves individual providers reacting to patient-initiated complaints and visits. Care is often fragmented, disorganized, duplicative and focused on managing established disease and complications. Management of diabetes is provider directed and focuses on pharmacologic and technologic interventions with little attention given to patient self-management behaviors and provider-patient interactions. Evidence shows that improving care for diabetic patients, such as interventions to lower glucose levels, increase eye care, or prevent neuropathy, is cost saving for health care organizations, especially when delivered with educational interventions, decision support and reminders to care managers and patients on performance issues, such as timely retinal evaluation. We have implemented the Comprehensive Diabetes Management Program (CDMP), a web-based diabetes care management tool to facilitate health care delivery and care coordination including a well-established telehealth eye care component. This application also provides direct patient internet access via a secure patient portal. The combination of the patient portal and the core diabetes management application fosters continuous care and communication among patients, care managers, and physicians, insures that the latest clinical guidelines and education components are used in the care, and focuses on both clinical and behavioral patient problem areas. The system aggregates data from diverse sources such as lab systems and electronic medical records, displays the data in a medically relevant dashboard format and provides a robust portfolio of clinical and behavioral alerts, decision support, reminders and risk profiles. Preliminary data from CDMP system usage shows significant improvements in glycemic control, lipid levels, blood pressure and reductions in associated patient emotional stress.
HD4-C Information technology based ubiquitous diabetes care system Jae-Hyoung Cho, Kun-Ho Yoon Department of Endocrinology & Metabolism, The Catholic University of Korea, Seoul, South Korea Although clear evidence of the beneficial effects of tight glycemic control on diabetic patients had been already made, the past decade has not seen any noticeable improvement in terms of glycemic control. Moreover, the number of subjects with diabetes are sharply escalating. So it is absolutely needed to develop a new tool for more effective diabetes management. “Ubiquitous
79 (2008) S1 – S127
S13
health care system”, which is one of the developing fusion technologies of IT, BT and NT, could give us new solutions in future. We established the Internet based glucose monitoring system (IBGMS) and reported its short-term and long-term effect on Type 2 diabetes. And we also introduced new diabetes control system to overcome time and place limitation. Such a ubiquitous health care system is already applied to various disease models. We need to develop various communication system using advanced information technologies and bio-technologies. However, to implement such the new diabetes care system, investigations on economic benefits have to be performed in the first. In this session, we will show the results of economic impact of the IBGMS. Based on the IBGMS, currently we try to develop some more advanced diabetes care system. We are also able to introduce telecommunication based diabetes management system and a system using advanced device such as PDA type blood glucometer. Ubiquitous health care system is expected to be an important part in our real life. We expect the new health care system will be able to implement in real practice in the world in near future and contribute to reducing diabetic complications and improving the quality of life for patients with diabetes.
HD5-A How to deliver better care by enhancing diabetes team care education? Wayne H.-H. Sheu President, Taiwanese Association of Diabetes Educators (TADE), Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan Diabetes represents a public health challenge and it is emerging as a pandemic worldwide. In order to provide optimal diabetes care, all health care providers need sufficient diabetes knowledge and skills to ensure safe, competent care to persons with or even those at risk for diabetes. To accomplish these goals, continuous medical education along with credits and qualification system through various measures were undertaken. In addition, diabetes self-management education is also widely accepted as a critical component of care. Taiwanese Association of Diabetes Educators (TADE) established since 1996 aiming to promote skill and booster knowledge of diabetes education in order to cope with increasing need of diabetes care. Currently, TADE have membership up to 10,000, composing of MD, RN, RD, Pharmacists and other diabetes care subspecialties. More than 2,500 diabetes educators (CDE) certified after certain hours of course, training and passing tests. It is missions of TADE to provide comprehensive care, to promote better quality of life for diabetes subjects through team-cared strategies. A total of 136 diabetes health promotion centers or settings, composed of MD, RN, RD, certified by TADE, provide care for a certain portion of diabetes subjects in Taiwan. In year 2006, a survey of quality of diabetes care conducted at qualified diabetes care centers or settings involved almost 7,000 diabetes individuals, most of them are Type 2 diabetes with an average age 63 years old. Most of them are under regimens of various oral hypoglycemic agents, while 17% of them are on insulin injection. This survey revealed average fasting glucose levels and HbA1c were 155 mg/dl and HbA1c 7.9%, respectively. We will share out experience in conducting a diabetes team care for diabetes in Taiwan.