Literature DB >> 32935559

Electronic Diabetes Management System Replaces Paper Insulin Chart: Improved Quality in Diabetes Inpatient Care Processes Due to Digitalization.

Julia Kopanz1, Katharina M Lichtenegger1, Constanze Koenig2, Angela Libiseller1, Julia K Mader1, Klaus Donsa2, Thomas Truskaller2, Norbert Bauer3, Brigitte Hahn4, Gerald Sendlhofer5, Peter Beck6, Bernhard Höll6, Frank Sinner1,2, Franz Feichtner2, Thomas R Pieber1,2.   

Abstract

BACKGROUND: GlucoTab, an electronic diabetes management system (eDMS), supports healthcare professionals (HCPs) in inpatient blood glucose (BG) management at point-of-care and was implemented for the first time under routine conditions in a regional hospital to replace the paper insulin chart.
METHOD: To investigate quality of the eDMS for inpatients with type 2 diabetes mellitus a monocentric retrospective before-after evaluation was conducted. We compared documentation possibilities by assessing a blank paper chart vs the eDMS user interface. Further quality aspects were compared by assessing filled-in paper charts (n = 106) vs filled-in eDMS documentation (n = 241). HCPs (n = 59) were interviewed regarding eDMS satisfaction.
RESULTS: The eDMS represented an improvement of documentation possibilities by offering a more structured and comprehensive user interface compared to the blank paper chart. The number of good diabetes days averaged to a median value of four days in both groups (paper chart: 4.38 [0-7] vs eDMS: 4.38 [0-7] days). Median daily BG was 170 (117-297) mg/dL vs 168 (86-286) mg/dL and median fasting BG was 152 (95-285) mg/dL vs 145 (69-333) mg/dL, and 0.1% vs 0.4% BG values <54 mg/dL were documented. Diabetes documentation quality improved when using eDMS, for example, documentation of ordered BG measurement frequency (1% vs 100%) and ordered BG targets (0% vs 100%). HCPs stated that by using eDMS errors could be prevented (74%), and digital support of work processes was completed (77%). Time saving was noted by 8 out of 11 HCPs and estimated at 10-15 minutes per patient day by two HCPs.
CONCLUSIONS: The eDMS completely replaced the paper chart, showed comparable glycemic control, was positively accepted by HCPs, and is suitable for inpatient diabetes management.

Entities:  

Keywords:  clinical decision support; diabetes; diabetes therapy; digitalization; hospital; treatment quality

Year:  2020        PMID: 32935559      PMCID: PMC8256067          DOI: 10.1177/1932296820957043

Source DB:  PubMed          Journal:  J Diabetes Sci Technol        ISSN: 1932-2968


  11 in total

1.  Impact of errors in paper-based and computerized diabetes management with decision support for hospitalized patients with type 2 diabetes. A post-hoc analysis of a before and after study.

Authors:  Klaus Donsa; Peter Beck; Bernhard Höll; Julia K Mader; Lukas Schaupp; Johannes Plank; Katharina M Neubauer; Christian Baumgartner; Thomas R Pieber
Journal:  Int J Med Inform       Date:  2016-03-23       Impact factor: 4.046

2.  Taking a Closer Look--Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients with Type 2 Diabetes Mellitus Under Basal-Bolus Insulin Therapy.

Authors:  Lukas Schaupp; Klaus Donsa; Katharina M Neubauer; Julia K Mader; Felix Aberer; Bernhard Höll; Stephan Spat; Thomas Augustin; Peter Beck; Thomas R Pieber; Johannes Plank
Journal:  Diabetes Technol Ther       Date:  2015-04-30       Impact factor: 6.118

3.  A Mobile Computerized Decision Support System to Prevent Hypoglycemia in Hospitalized Patients With Type 2 Diabetes Mellitus.

Authors:  Stephan Spat; Klaus Donsa; Peter Beck; Bernhard Höll; Julia K Mader; Lukas Schaupp; Thomas Augustin; Franco Chiarugi; Katharina M Lichtenegger; Johannes Plank; Thomas R Pieber
Journal:  J Diabetes Sci Technol       Date:  2016-11-03

4.  Insulin, hospitals and harm: a review of patient safety incidents reported to the National Patient Safety Agency.

Authors:  David Cousins; Catherine Rosario; John Scarpello
Journal:  Clin Med (Lond)       Date:  2011-02       Impact factor: 2.659

5.  MEASURE IT, IMPROVE IT: the Safer Patients Initiative and quality improvement in subcutaneous insulin therapy for hospital in-patients.

Authors:  R Rushmer; D Voigt
Journal:  Diabet Med       Date:  2008-08       Impact factor: 4.359

Review 6.  15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2020.

Authors: 
Journal:  Diabetes Care       Date:  2020-01       Impact factor: 19.112

7.  Pathways to quality inpatient management of hyperglycemia and diabetes: a call to action.

Authors:  Boris Draznin; Janice Gilden; Sherita H Golden; Silvio E Inzucchi; David Baldwin; Bruce W Bode; Jeffrey B Boord; Susan S Braithwaite; Enrico Cagliero; Kathleen M Dungan; Mercedes Falciglia; M Kathleen Figaro; Irl B Hirsch; David Klonoff; Mary T Korytkowski; Mikhail Kosiborod; Lillian F Lien; Michelle F Magee; Umesh Masharani; Gregory Maynard; Marie E McDonnell; Eti S Moghissi; Neda Rasouli; Daniel J Rubin; Robert J Rushakoff; Archana R Sadhu; Stanley Schwartz; Jane Jeffrie Seley; Guillermo E Umpierrez; Robert A Vigersky; Cecilia C Low; Deborah J Wexler
Journal:  Diabetes Care       Date:  2013-07       Impact factor: 19.112

8.  Standardized Glycemic Management with a Computerized Workflow and Decision Support System for Hospitalized Patients with Type 2 Diabetes on Different Wards.

Authors:  Katharina M Neubauer; Julia K Mader; Bernhard Höll; Felix Aberer; Klaus Donsa; Thomas Augustin; Lukas Schaupp; Stephan Spat; Peter Beck; Friedrich M Fruhwald; Christian Schnedl; Alexander R Rosenkranz; David B Lumenta; Lars-Peter Kamolz; Johannes Plank; Thomas R Pieber
Journal:  Diabetes Technol Ther       Date:  2015-06-05       Impact factor: 6.118

9.  GlucoTab-guided insulin therapy using insulin glargine U300 enables glycaemic control with low risk of hypoglycaemia in hospitalized patients with type 2 diabetes.

Authors:  Felix Aberer; Katharina M Lichtenegger; Edin Smajic; Klaus Donsa; Oliver Malle; Judith Samonigg; Bernhard Höll; Peter Beck; Thomas R Pieber; Johannes Plank; Julia K Mader
Journal:  Diabetes Obes Metab       Date:  2018-11-11       Impact factor: 6.577

10.  Clinical inertia with regard to intensifying therapy in people with type 2 diabetes treated with basal insulin.

Authors:  K Khunti; A Nikolajsen; B L Thorsted; M Andersen; M J Davies; S K Paul
Journal:  Diabetes Obes Metab       Date:  2016-02-09       Impact factor: 6.577

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  1 in total

1.  Comparing Single-Page, Multipage, and Conversational Digital Forms in Health Care: Usability Study.

Authors:  Aleeha Iftikhar; Raymond R Bond; Victoria McGilligan; Stephen J Leslie; Khaled Rjoob; Charles Knoery; Ciara Quigg; Ryan Campbell; Kyle Boyd; Anne McShane; Aaron Peace
Journal:  JMIR Hum Factors       Date:  2021-05-26
  1 in total

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