dia-bese presentation at diabetes india world congress 2015
TRANSCRIPT
D I A B E T E S C O M P L I C AT I O N S Disease Management Software
Doctor’s Empowerment : Smart E.H.R. (Medical Algorithm)
Disease Management E.H.R. Challenges & Solution
2
Pain Point Macro Problem EHR Solution CDSS Tools
1 Time utilization Less productive
2 Diagnosis - Prognosis Not protocol
3 Dr’s treatment Single Dr : multiple issues
4 Referrals Biased - inconsistent
5 Basic Investigation Irregular
6 Comprehensive care reminder Unavailable
7 Clinical practice audits Not practiced
8 Providers team knowledge Inadequate
9 Patient neglects Diabetes No illustrative EHR
Preventive Care
Proactive Diagnostic Tools
Predictive - Risk stratification
Progressive - Treatment Goals
Patient Convenience & Cost
Protocol driven process
Disease Management E.H.R. Think !!!
3
Current Approach Can we improve our Clinic system ??
Disease Management E.H.R. Power of Smart E.H.R.
Protocol Personal Guideline
Satisfied Patient
Easier Referrals
Holistic Approach
Quicker Patient
Counseling SMART Electronic
Health Records
4
Disease Management E.H.R. Diabetes Systematic Management Cycle
5
ASSESS
•History
•Diagnosis
•Risk Mapping
PLAN
•Health Status
•Age - Support
•Realistic Goals•Agreement
IMPLEMENT
•Manage Weight
•Nutrition Therapy
•Lifestyle Change•Exercise - Yoga
EVALUATE
•Trend Analysis
•Successes
•Side-Effects•Cost Factor
Disease Management E.H.R. Clinical Decision Support System (for Drs)
6
Multi – Disease : Multi-organ co-morbidities
Decision Support : Evidence based and intelligent
Supports all Therapies : Diet – Lifestyle – Exercise – Education
User-friendly : many tasks managed safely by Drs Assistant
Protocols driven : Globally acclaimed and updated standards
Disease Management E.H.R. Information Delivery Flow
7
Data In Report
No need of Computer
Cloud based – no installation
Accessible Anytime - Anywhere
This facility is available only for the Dr’s Clinics. In the Hospitals Dia-Bese Apps are commonly used
Disease Management E.H.R. Data Input
8
Patient Form (User-friendly)
Name / Contacts
Vitals – Anthropometry
Medical History (self)
Medical History (family)
Life-style Habits
Co-morbidities duration (yrs)
Pain – complaint
Lab results
Medication listing
Machine results
Patient Social – habits details
Dia-Bese Allied Clinics ELECTRONIC HEALTH RECORDS
Diabetes Management Form – 1
PERSONAL DETAILS / CONTACT
G Title First Name Middle Name Surname UID Ref Reg RefDate
Today
Mr.
Ms
Mrs
Birth Dt. Age Blood Gr Occupation Religion Race
Area City State Pin
Mob Ph Res Ph Office Email
Relative Kin Phone Family Dr. Specialist Dr.
Yrs Mth Type 1 Type 2 LADA MODY DOY GDM
DIABETES PERIOD / TYPE
Birth Dt or Age Blood Gr. Occupation Refered by
Address
City / State Pin Code Email ID
Tel (Mobile) Tel (Work) Tel (Home)
Dia Yrs - Mths Type 1 or 2 GDM Others
Allergy / Intolerance Anti-Diabetic Others
Diabetes
Parents
Diabetes
Bro-SisterIHD HTN ESRD Stroke Malignacy
1 Smokng Cigarettes / day nos. yrs. Paan Yes * No Chew Tobac Yes * No
2 Alcohol numbers / week Whisky - peg nos. Wine - glass nos. Beer - glass nos.
3 Time spent (hrs / day) Travel hrs. At work hrs. Sleep hrs.
Sedentary Light Morderate Very Active Extra Activity Exercise / wk
Negligible 1 - 3 days 3 - 5 days 6 - 7 days Heavy training
HTN CHD IHD Angina MIAngioplasty
Stent
CABG
Bypass
TIA Strokes Stent
Stones CRF Dialysis Transplant Kidney - Fine
Neuropathy PVD Skin Change Deformity Ulcer Amputation Grading Foot - Fine
Mild DR Moderate DR PDR Maculopathy Cataract Laser Eyes - Fine
PCOS Thyroid Liver COPD Cancer Asthama Blood - Gums
Kid
ney
Fo
ot
Eyes
Oth
er
ANTHROPOMETRY
PERSONAL DETAILS / CONTACT
……………………………………………………………………………………………………………………………………..
DIABETES
Vit
als
FAMILY HISTORY
LIFESTYLE QUERIES
4 Physical activities
MEDICAL HISTORY (Duration - years in grey box)
CV
D
times min / d
G Title First Name Middle Name Surname UID Ref Reg RefDate
Today
Mr.
Ms
Mrs
Height Waist Hips BP Pulse SpO2
cm cm cm
kg ft-in inch inch
WeightWrist Grip Touch
(for Boday Frame size)
Overlap * Just * No
Relation Dia Type 2 Hypertension Heart Diseas Kidney Acute Thyroid Cancer
Father <55
Mother <65
Brother - Sister
FAMILY HISTORY
Heart Death
Grade ECG Stress Test 2D Echo MRI CT Scan Fundus Biothisio Vas Doppler
Normal
Abnormal
MACHINE TEST
Height Waist Hips BP Pulse SpO2
cm cm cm
kg ft-in inch inch
Weight
/
ANTHROPOMETRY
HTN (BP) Dislipidemia A-Fib Angina Heart Attack Heart Fail Congenital
Coro Artery Valves TIA Strokes Paralysis Bypass Stent
Kidney Stones Renal Fail Dialysis Transplant Kidney - Fine
Foot Neuropathy PVD Skin Change Deformity Ulcer Amputation Foot - Fine
Eyes Mild DR Moderate DR PDR Maculopathy Cataract Laser Eyes - Fine
Other PCOS Thyroid Liver COPD Cancer Asthama Arthritis
Heart
Brain
MEDICAL HISTORY - EXISTING COMORBIDITY
Disease Management E.H.R. Patient Report (1)
9
Clinical History
Health Trend
Disease Management E.H.R. Patient Report (2)
10
Organ Risk Indicator
Medicine Prescribed
Disease Management E.H.R. Patient Report (3)
11
Side - Effects
Knowledge Level
Education
Disease Management E.H.R. Health Graded Screening Packs
12
Risk-wise Diabetic Patient PackagePack
RatesRegular Mild Moderate Sever
A Consultation - Counselling
GP 200 3 4 7 8
Diabetologist 500 2 4
Dietician 250 2 4 6 12
Total Consultation - Counselling 1,100 1,800 3,900 6,600
B Lab Tests
HbA1c 350 2 4 4 4
FBG - PPG 200 2 2 4 4
Lipid profile 350 1 1 1 2
Kidney profile 150 1 1 1 2
Liver Profile 200 1 1
CBC 150 1 1 1 2
Electrolytes 300 1 2
Thyroid profile 400 1
Total Lab Tests 1,695 2,510 3,355 4,820
C Machine Tests
BP 4 6 9 12
ECG 250 1 1 2 4
USG Ultra Sound 500 1
2D Echo 1,200 1
Diabetic Foot check 400 1 1 1
Diabetic Retino check 300 1 1 1
Total Machine Tests 250 250 500 2,700
D Dia-Bese (London Report)
Health ID Card 50 1 1 1 2
Health Profile (Basic) 200 1 1 4 6
Health Profile (Advance) 350 3 6
Health Passport 500 1 1
Total Consultation - Counselling 250 250 2,400 3,900
Patient Package Total Costs (Gross) / year 3,295 4,810 10,155 18,020
Health package selected on the basis of Health Status Index
Disease Management E.H.R. Health Informatics Offerings
Electronic Passport Health I.D. Card
Health Profile
13
Doctor’s Clinic
High-Risk Patients Summary
Disease Management E.H.R. DIA-BESE : Innovation Selection
14
D S T – L o c k h e e d M a r t i n I n d i a G r o w t h P r o g r a m
Disease Management E.H.R. Take away : Roadmap
15
Change Leadership : Global Healthcare