Diabetes Management Using Modern Information and Communication Technologies and New Care Models
Diabetes Management Using Modern Information and Communication Technologies and New Care Models
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DOI：
10.2196/ijmr.2193
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发表时间：
2012-07-01
影响因子：
2
通讯作者：
Thestrup, Jesper
中科院分区：
文献类型：
--
作者：
Spanakis, Emmanouil G.;Chiarugi, Franco;Thestrup, Jesper
背景：糖尿病是一种代谢性疾病，在发达国家已达到流行的程度。这种疾病有两种主要形式：1型和2型。疾病管理需要胰岛素给药结合仔细的血糖监测（1型）或涉及调整饮食和运动水平，使用口服抗糖尿病药物和胰岛素给药以控制血糖（2型）。目的：最先进的技术有可能帮助医疗保健专业人员、患者和非正式护理人员更好地管理糖尿病胰岛素治疗，帮助患者了解他们的疾病，支持自我管理，并通过适当的危机管理监测不利和可能危及生命的情况来提供安全的环境。方法：结合先进信息和通信技术的新护理模式有可能提供能够改善患者的医疗保健、个性化、包容性和赋权的服务平台，并支持不同国家的不同用户偏好和需求。REACTION项目建议创建一个面向服务的架构平台，该平台基于众多单独的服务，并实施可部署在不同环境中的新型护理模型，以执行患者监护、分布式决策支持、医疗保健工作流程管理和临床反馈提供。本文介绍了在REACTION项目的背景下进行的工作，重点是开发一个能够支持糖尿病的医疗服务平台通过临床应用，如生命体征监测、向护理点提供反馈、综合风险评估以及事件和警报处理，在不同的医疗保健制度中进行管理。在全面实施该平台的同时，确定了三个主要的研发领域，并随后进行了探讨：第一个领域与葡萄糖传感器技术和可穿戴性有关，第二个领域与平台架构有关，第三个领域与最终用户服务的实施有关。已经在REACTION项目中开发的葡萄糖管理系统能够监测各种来源的一系列参数，包括葡萄糖水平、营养摄入量、给药药物和患者的胰岛素敏感性，在移动的平板电脑平台上为专业护理人员提供胰岛素给药决策支持，满足用户需求，并支持符合医疗器械指令的医疗工作流程程序requirements.Conclusions:良好的糖尿病控制，以及更加重视控制生活方式因素，可能会降低大多数并发症的风险，并有助于改善健康状况。REACTION项目旨在通过一个可互操作的通信平台，为欧洲不同医疗保健制度的糖尿病患者提供综合、专业、管理和治疗服务，以应对这些挑战。
Background: Diabetes, a metabolic disorder, has reached epidemic proportions in developed countries. The disease has two main forms: type 1 and type 2. Disease management entails administration of insulin in combination with careful blood glucose monitoring (type 1) or involves the adjustment of diet and exercise level, the use of oral anti-diabetic drugs, and insulin administration to control blood sugar (type 2).Objective: State-of-the-art technologies have the potential to assist healthcare professionals, patients, and informal carers to better manage diabetes insulin therapy, help patients understand their disease, support self-management, and provide a safe environment by monitoring adverse and potentially life-threatening situations with appropriate crisis management.Methods: New care models incorporating advanced information and communication technologies have the potential to provide service platforms able to improve health care, personalization, inclusion, and empowerment of the patient, and to support diverse user preferences and needs in different countries. The REACTION project proposes to create a service-oriented architectural platform based on numerous individual services and implementing novel care models that can be deployed in different settings to perform patient monitoring, distributed decision support, health care workflow management, and clinical feedback provision.Results: This paper presents the work performed in the context of the REACTION project focusing on the development of a health care service platform able to support diabetes management in different healthcare regimes, through clinical applications, such as monitoring of vital signs, feedback provision to the point of care, integrative risk assessment, and event and alarm handling. While moving towards the full implementation of the platform, three major areas of research and development have been identified and consequently approached: the first one is related to the glucose sensor technology and wearability, the second is related to the platform architecture, and the third to the implementation of the end-user services. The Glucose Management System, already developed within the REACTION project, is able to monitor a range of parameters from various sources including glucose levels, nutritional intakes, administered drugs, and patient's insulin sensitivity, offering decision support for insulin dosing to professional caregivers on a mobile tablet platform that fulfills the need of the users and supports medical workflow procedures in compliance with the Medical Device Directive requirements.Conclusions: Good control of diabetes, as well as increased emphasis on control of lifestyle factors, may reduce the risk profile of most complications and contribute to health improvement. The REACTION project aims to respond to these challenges by providing integrated, professional, management, and therapy services to diabetic patients in different health care regimes across Europe in an interoperable communication platform.