title: Improved care of patients with diabetes through telecommunications.
abstract: This project tested the importance of enhanced information transfer of home monitoring results to health care providers. The study tested whether computer-assisted communication of medical information between the chronic care patient and the physician can result in health care benefit. The information tools were constructed/adapted as a test of this hypothesis for diabetes mellitus. Patients connected a glucometer to an intelligent modem weekly for six to nine months. Graphical and mathematical tools extracted and emphasized the information content of the home monitoring data arriving at the central site. Data smoothing, trend analysis, and calculation of quality control statistics were incorporated into a graphical time series oriented report that was used by the health care provider during an outpatient visit. The integrated home monitoring system was tested on 20 patients with diabetes in a double cross-over design over a 15-month period. A significant improvement in serum glucose control as measured by glycated hemoglobin was shown in the study group, but not in the control group.
authors.affiliation: Program in Medical Information Science, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
authors.forename: E K
authors.initials: EK
authors.lastname: Shultz
authors.forename: A
authors.initials: A
authors.lastname: Bauman
authors.forename: M
authors.initials: M
authors.lastname: Hayward
authors.forename: R
authors.initials: R
authors.lastname: Holzman
mesh_terms: D000465:Algorithms; D015190:Blood Glucose Self-Monitoring; D003195:Computer Communication Networks / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006701:Home Nursing; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007003:Hypoglycemia / Q000097:blood; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008499:Medical Records; D008838:Microcomputers; D011787:Quality of Health Care
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin