COMPUTER-ASSISTED HISTORY TAKING FOR THE IMPROVEMENT OF THE DIABETES PRIMARY CARE CONSULTATION
- Geronimo Jimenez, Singapore
- Geronimo Jimenez, Singapore
- Shilpa Tyagi, Singapore
- Josip Car, Singapore
Abstract
Background and Aims
Primary care (PC) is a key setting for the management of diabetes, as the PC provider is in a unique position to provide early, comprehensive, continuous and coordinated care, improving the outcomes for these patients. Digital, intelligent, computer-assisted history taking (CAHT) systems retrieve high-quality patient information prior to the consultation and can improve the PC consultation for diabetes.
Methods
We reviewed PC medical textbooks and published literature on CAHT between June-August 2019, focusing on the diabetes consultation. We conceptually mapped the identified specific elements of the diabetes PC consultation that a CAHT system can improve, summarizing our findings into a proposed framework (Table).
Results
At the initial consultation, a CAHT system can improve screening and diagnosis, by implementing a comprehensive assessment (lifestyle/health behaviours, family, social and work conditions, patient's beliefs) while screening for hypertension, obesity, and other risk factors. Each of these can be explored deeper without taking up consultation time and allowing a streamlined experience with an earlier, more accurate diagnosis. At subsequent consultations, a CAHT system aids with monitoring the patient’s management and progression of diabetes, allowing the interaction to focus on suboptimal behaviour, education, and early identification of complications, with more updated data coming from other specialists or tests.
Conclusions
Accurate and comprehensive patient information obtained outside the consultation through a CAHT system improves screening, diagnosis, monitoring and management of complications. It returns the focus of the consultation back to the provider-patient relationship, allowing for a better quality diagnosis, more consistent treatment, and guided and seamless patient engagement for diabetes.