IMPLEMENTATION OF AN ELECTRONIC DASHBOARD WITH A REMOTE MANAGEMENT SYSTEM TO IMPROVE GLYCEMIC MANAGEMENT AMONG HOSPITALIZED ADULTS.

IMPLEMENTATION OF AN ELECTRONIC DASHBOARD WITH A REMOTE MANAGEMENT SYSTEM TO IMPROVE GLYCEMIC MANAGEMENT AMONG HOSPITALIZED ADULTS.

Sheen, Yi-Jing;Huang, Chien-Chung;Huang, Shih-Che;Hung, Ming-De;Lin, Ching-Heng;Lee, I-Te;Lin, Shih-Yi;Sheu, Wayne H-H;
endocrine practice : official journal of the american college of endocrinology and the american association of clinical endocrinologists 2019
271
sheen2019implementationendocrine

Abstract

Better glycemic control for hospitalized diabetic patients significantly reduces health expenditures and improves disease outcomes. We developed a dynamic dashboard with a remote management system and evaluated its impact on inpatient glycemic control. This was an observational institution-wide study; study participants were enrolled from a 1500-bed public medical center from 2016 to 2018. We evaluated the impact of a dynamic dashboard system, which analyzed and monitored all glucose data with virtual glycemic management recommendation by a team of endocrinologists, over three one-year periods: 2016 (pre-implementation), 2017 (development), and 2018 (implementation). A total of 51,641 discharges with 878,159 blood glucose measurements were obtained during the 3-year period. After implementation of the dashboard system, the proportion of patients with poor glycemic control (hyperglycemia or hypoglycemia) was reduced by 31% (from 10.2 to 7.0 per day per 100 patients with glucose monitoring; p < 0.001); hyperglycemia decreased by 25% (from 6.1 to 4.6 per day per 100 patients with glucose monitoring; p < 0.001), and hypoglycemia decreased by 45% (from 4.2 to 2.3 per day per 100 patients with glucose monitoring; p < 0.001). Furthermore, the trend in the proportion of patients within the treat-to-target range showed significant improvement (p<0.001) during the development period, with effectiveness maintained throughout the implementation period. We successfully installed a dynamic, electronic medical records-based dashboard monitoring system to improve inpatient glycemic control. The system, supported by a team of endocrinologists via remote recommendations, could efficiently fill an important need for improved glycemic management among hospitalized adults.

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