Glycemic control through computerized subcutaneous insulin calculators.

Sliding scale insulin (SSI) is a reactive therapy and does not maintain euglycemia in hospitalized patients. A combination of basal insulin, prandial insulin, and correction factor dosing provides a more consistent insulin state encouraging improved glycemic control. Intermountain Healthcare developed an application consisting of four calculators incorporating scheduled (basal and prandial) and correction-factor insulin. The result is a patient-specific order set with calculated insulin orders, a correction factor dosing table, and a carbohydrate dosing table. This paper describes the SQIC, access, usage monitoring, and challenges and solutions to the computerized decision support application created to replace SSI.