New technologies, such as online networking tools, offer innovative ways to engage patients in their diabetes care. Second Life (SL) is one such virtual world that allows patients to interact in a 3D environment with peers and healthcare providers. This article presents a framework that demonstrates how applications within SL can be constructed to meet the needs of patients with diabetes, allowing them to attend group visits, learn more about lifestyle changes, and foster a sense of support and emotional well-being. This experiential approach to education may prove more engaging, and therefore successful, than existing strategies. Addressing concerns relating to privacy and liability is a necessary first step to engage providers in this new approach to patient care.
The growing availability of continuous data from medical devices in diabetes management makes it crucial to define novel information technology architectures for efficient data storage, data transmission, and data visualization. The new paradigm of care demands the sharing of information in interoperable systems as the only way to support patient care in a continuum of care scenario. The technological platforms should support all the services required by the actors involved in the care process, located in different scenarios and managing diverse information for different purposes. This article presents basic criteria for defining flexible and adaptive architectures that are capable of interoperating with external systems, and integrating medical devices and decision support tools to extract all the relevant knowledge to support diabetes care.
Data mining is the process of selecting, exploring, and modeling large amounts of data to discover unknown patterns or relationships useful to the data analyst. This article describes applications of data mining for the analysis of blood glucose and diabetes mellitus data. The diabetes management context is particularly well suited to a data mining approach. The availability of electronic health records and monitoring facilities, including telemedicine programs, is leading to accumulating huge data sets that are accessible to physicians, practitioners, and health care decision makers. Moreover, because diabetes is a lifelong disease, even data available for an individual patient may be massive and difficult to interpret. Finally, the capability of interpreting blood glucose readings is important not only in diabetes monitoring but also when monitoring patients in intensive care units. This article describes and illustrates work that has been carried out in our institutions in two areas in which data mining has a significant potential utility to researchers and clinical practitioners: analysis of (i) blood glucose home monitoring data of diabetes mellitus patients and (ii) blood glucose monitoring data from hospitalized intensive care unit patients.
Current computerized reminder and decision support systems intended to improve diabetes care have had a limited effect on clinical outcomes. Increasing pressures on health care networks to meet standards of diabetes care have created an environment where information technology systems for diabetes management are often created under duress, appended to existing clinical systems, and poorly integrated into the existing workflow. After defining the components of diabetes disease management, the authors present an eight-step conceptual framework to guide the development of more effective diabetes information technology systems for translating clinical information into clinical action.
Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes.
Latinos have higher rates of diabetes and diabetes-related complications compared to non-Latinos. Clinical diabetes self-management tools that rely on innovative health information technology (HIT) may not be widely used by Latinos, particularly those that have low literacy or numeracy, low income, and/or limited English proficiency. Prior work has shown that tailored diabetes self-management educational interventions are feasible and effective in improving diabetes knowledge and physiological measures among Latinos, especially those interventions that utilize tailored coaching and navigator programs. In this article, we discuss the role of HIT for diabetes management in Latinos and describe a novel “eNavigator” role that we are developing to increase HIT adoption and thereby reduce health care disparities.
There is a clear and present need to improve the quality of diabetes care. Information technology can be used as a means to that end. In this article, we discuss the design and implementation of a web-based diabetes application. We show the role of modeling clinical workflow in the design philosophy of our application, and summarize our application's features and usage. Next, we describe observations made during and after design and implementation, and how they relate to the informatics literature. Finally, we elaborate on the paradigm of feedback control systems, its parallels with the design philosophy of our application, and its use as an organizational framework for the roles of information technology in diabetes care.; by Anil Kumar Dubey.; Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2003.; Includes bibliographical references (p. 40-44).
Information management is becoming a necessary task for modem research laboratories. As scientific research within a particular domain progresses, the amount of data and publications in the domain increases drastically. Type one diabetes (TID) research is no exception. The DRV (Diabetes Research Vortex) addresses the information management challenge. The DRV's main objective is to provide a web accessible information management system for diabetes related publications and experimental data. The DRV was inspired by current T1D research paradigms. A user can choose to upload a publication or experimental data under one of four research categories: a strain, gene, Idd (Insulin Dependent Diabetic) genetic region, or custom keyword. The effectiveness of the DRV lies in the biological concepts it encapsulates. The DRV allows a user to view the system's contents by browsing a strain, gene, Idd, or custom keyword. Furthermore, the DRV allows a user to seamlessly browse among related strains, genes, and Idd's. The DRV links information between each of these domains and allows a user to intuitively acquire knowledge about a specific interest. The system can also be asked to mine publications from PubMed based the terms stored in the -four aforementioned categories. Furthermore...
There has been a rapid advancement of information technology in the area of clinical and population health data management since 2000. However, with the fast growth of electronic medical records (EMRs) and the increasing complexity of information systems, it has become challenging for researchers to effectively access, locate, extract, and analyze information critical to their research. This article introduces an outpatient encounter data framework designed to construct an EMR-based population data repository for diabetes screening research. The outpatient encounter data framework is developed on a hybrid data structure of entity–attribute–value models, dimensional models, and relational models. This design preserves a small number of subject-specific tables essential to key clinical constructs in the data repository. It enables atomic information to be maintained in a transparent and meaningful way to researchers and health care practitioners who need to access data and still achieve the same performance level as conventional data warehouse models. A six-layer information processing strategy is developed to extract and transform EMRs to the research data repository. The data structure also complies with both Health Insurance Portability and Accountability Act regulations and the institutional review board's requirements. Although developed for diabetes screening research...
Self-care is essential in chronic disease management; however, adherence to self-care plans is often far from optimal. Advances in technology can facilitate self-management of chronic disease through patient empowerment and timely feedback. The Confidant system is a novel wireless remote patient monitoring and response system, centered around mobile phone technology, that translates scientifically supported knowledge for chronic disease management into action by providing easily followed daily coaching using the patient's own data. Daily provision of interactive, informative messages removes the burdens of recall, record keeping, decision making, scheduling, and data analysis. A pilot-controlled clinical trial evaluated the feasibility and efficacy of the Confidant system in the management of type 2 diabetes in 15 patients utilizing the cell-phone technology and 15 individuals in a control group (standard type 2 diabetes care). The study demonstrated improved levels of glycosylated hemoglobin, positive changes in diabetes management self-efficacy, and diabetes self-care activities among intervention group patients. A larger trial is now in development to demonstrate the clinical benefit of using the Confidant system among type 2 diabetic patients. This article describes the novel technology and applications of the Confidant system.
In this issue of Journal of Diabetes Science and Technology, the intervention described by D. Katz, “Novel Interactive Cell-Phone Technology for Health Enhancement,” uses cell phones to provide the rapid communication necessary for the support of intensive management of diabetes. Mobile technology is widely accepted in today's society and can be an effective tool for this cause. There have been numerous interventions using various communication tools, including cell phones, to manage chronic disease, which all propose that improved communication and feedback to patients would improve health status. Dr. Katz has taken the next step by giving semiautomated, real-time, immediate feedback on each data point all transmitted by cell phone.
Background: With the rapid advances in information technology in the last decade, various diabetes information systems have evolved in different parts of the world. Availability of new technologies and information systems for monitoring and treating diabe