A Mobile Computerized Decision Support System to Prevent Hypoglycemia in Hospitalized Patients With Type 2 Diabetes Mellitus: Lessons Learned From a Clinical Feasibility Study

J Diabetes Sci Technol. 2016 Nov 2; Epub ahead of print.
https://dx.doi.org/10.1177/1932296816676501

This article reports on results from the first clinical trial performed with the prototype of the GlucoTab® system, a mobile, tablet-based client-server system for computerized decision and workflow support.

Diabetes management requires complex and interdisciplinary cooperation of health care professionals (HCPs). To support this complex process, IT-support is recommended by clinical guidelines.

Methods:

The study was a monocentric, open, noncontrolled intervention study in 30 patients with type 2 diabetes mellitus (T2DM). Diabetes therapy, adverse events, software errors and user feedback were documented. Safety, efficacy and user acceptance of the system were investigated.

Results:

  • Only 1.3% of blood glucose (BG) measurements were <70 mg/dl and only 2.6% were >300 mg/dl.
  • The availability of the system (97.3%) and the rate of treatment activities documented with the system (>93.5%) were high.
  • Only few suggestions from the system were overruled by the users (>95.7% adherence).
  • Evaluation of the 3 anonymous questionnaires showed that confidence in the system increased over time. The majority of users believed that treatment errors could be prevented by using this system.

Conclusions:

Data from our feasibility study show a significant reduction of hypoglycemia by implementing a computerized system for workflow and decision support for diabetes management, compared to a paper-based process. The system was well accepted by HCPs, which is shown in the user acceptance analysis and that users adhered to the insulin dose suggestions made by the system.

Authors: Spat S(1), Donsa K(1), Beck P(2,3), Höll B(1), Mader JK(4), Schaupp L(4), Augustin T(1), Chiarugi F(5), Lichtenegger KM(4), Plank J(4), Pieber TR(1,4).

Author information:

  1. Health-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbh, Graz, Austria.
  2. Health-Institute for Biomedicine and Health Sciences, Joanneum Research Forschungsgesellschaft mbh, Graz, Austria
  3. decide Clinical Software GmbH, Graz, Austria.
  4. Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  5. Computational Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas, Crete, Greece.
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