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Accepted Paper:
Experience of design and hospital-wide implementation of a decision support system for treating diabetes in hospitalized patients.
Irit Hochberg
(Technion - Israel Institute of Technology)
We herein describe the design and implementation of a computerized decision support system which simply and efficiently increased compliance with diabetes inpatient treatment by medical staff.
Paper long abstract:
Over a third of inpatients have diabetes and high blood glucose is very common in the hospital setting. Diabetes and high blood glucose significantly increase medical complications during hospital stay. Treatment of high glucose requires multiple medical team members to collaborate in a relatively complicated protocol of repeat glucose measurements and medications. Our diabetes team implemented a user friendly computerized decision support system integrated into the patient treatment software to assist with treatment and follow-up. The system included guiding alerts that diabetes treatment should be changed; a treatment calculator that personalizes insulin doses for each patient at each moment; and a clear display of glucose measurements and insulin doses. Implementation was conducted gradually through the hospital by brief training sessions of physicians and nurses with repeat instructions as needed. Hospital-wide use of this system increased cooperation with the diabetes treatment protocol due to a better and clearer recognition of needed steps in different situations. Nurses were highly satisfied with their autonomy in increasing insulin doses as needed and minimization of their need to consult a physician when they detect high blood glucose. According to our experience carefully designed computerized decision support systems that reduce workload and efficiently guide medical care have a potential to improve treatment.