70 - IMPLEMENTATION OF A DIGITAL WORKFLOW AND DECISION SUPPORT SYSTEM CONFIRMS EFFICACY AND USER-SATISFACTION OF ROUTINE DIABETES CARE IN INPATIENTS WITH TYPE 2 DIABETES
Abstract
Background and Aims
The workflow and decision support system GlucoTab® was used for diabetes management in a regional hospital as replacement for the paper-based diabetes chart. Aim: to investigate the efficacy and user satisfaction of GlucoTab in hospitalized patients with type-2-diabetes in routine use. The use of decision support for basal-bolus-insulin was not focus of this implementation.
Methods
A retrospective comparison was conducted to analyze patient data before vs. after GlucoTab implementation (n=106 vs. n=241, age 72±14 vs. 75±11 years, female 49% vs. 51%, BMI 30±8 vs. 31±9 kg/m2, HbA1c 73±22 vs. 69±25 mmol/mol, respectively).
Results
Mean blood glucose (BG) was 174±32 (before) vs. 170±37 mg/dl (after) per patient. BG values in the ranges ≤54, ≤69, 70-179, 180-299 and ≥300 mg/dl occurred in 0.2% vs. 0.5%, 0.9% vs. 1.3%, 58.2% vs. 57.5%, 35.3% vs. 36.1% and 5.7% vs. 5.1% of all BG-values, respectively. Premixed insulin was prescribed in 51% vs. 30% during inpatient stay. Basal insulin was prescribed in 23% vs. 40%, respectively. Basal-bolus decision support was used in 7 patients. Healthcare professionals stated in a questionnaire that by using GlucoTab errors could be prevented (74%), workflows are completely digital supported (77%), interdisciplinary consultation is reduced (73%) and 10-15 minutes per patient-day could be saved.
Conclusions
GlucoTab completely replaced the paper-based insulin chart, was endorsed as support by healthcare professionals and is suitable for routine diabetes care in the hospital. It can be assumed that better glycaemic control can be achieved if the basal-bolus-insulin algorithm provided by GlucoTab is used in a larger proportion of inpatients.
