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

J Diabetes Sci Technol. September 2020:1932296820957043

https://dx.doi.org/10.1177/1932296820957043

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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.

Authors

Julia Kopanz (1), Katharina M Lichtenegger (1), Constanze Koenig (2), Angela Libiseller (1), Julia K Mader (1), Klaus Donsa (2), Thomas Truskaller (2), Norbert Bauer (3), Brigitte Hahn (4), Gerald Sendlhofer (5), Peter Beck (6), Bernhard Höll (6), Frank Sinner (1, 2), Franz Feichtner (2), Thomas R Pieber (1, 2)

Affiliations

  1. Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Austria.
  2. JOANNEUM RESEARCH Forschungsgesellschaft mbH, HEALTH, Institute for Biomedicine and Health Sciences, Graz, Austria.
  3. Department of Internal Medicine, LKH Hartberg, Austria.
  4. LKH Hartberg, Austria.
  5. Department for Surgery, Research Unit for Safety in Health, Division for Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, Austria.
  6. decide Clinical Software GmbH, Graz, Austria.
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