title: Using web technology to support population-based diabetes care.
abstract: BACKGROUND
  Managed clinical networks have been used to coordinate chronic disease management across geographical regions in the United Kingdom. Our objective was to review how clinical networks and multidisciplinary team-working can be supported by Web-based information technology while clinical requirements continually change.
  
  
  METHODS
  A Web-based population information system was developed and implemented in November 2000. The system incorporates local guidelines and shared clinical information based upon a national dataset for multispecialty use. Automated data linkages were developed to link to the master index database, biochemistry, eye screening, and general practice systems and hospital diabetes clinics. Web-based data collection forms were developed where computer systems did not exist. The experience over the first 10 years (to October 2010) was reviewed.
  
  
  RESULTS
  The number of people with diabetes in Tayside increased from 9694 (2.5% prevalence) in 2001 to 18,355 (4.6%) in 2010. The user base remained stable (~400 users), showing a high level of clinical utility was maintained. Automated processes support a single point of data entry with 10,350 clinical messages containing 40,463 data items sent to external systems during year 10. The system supported quality improvement of diabetes care; for example, foot risk recording increased from 36% in 2007 to 73.3% in 2010.
  
  
  CONCLUSIONS
  Shared-care datasets can improve communication between health care service providers. Web-based technology can support clinical networks in providing comprehensive, seamless care across a geographical region for people with diabetes. While health care requirements evolve, technology can adapt, remain usable, and contribute significantly to quality improvement and working practice.
authors: Clinical Technology Centre, University of Dundee, Dundee, UK. scott.cunningham@nhs.net
authors: Scott
authors: S
authors: Cunningham
authors: Ritchie
authors: R
authors: McAlpine
authors: Graham
authors: G
authors: Leese
authors: Geraldine
authors: G
authors: Brennan
authors: Frank
authors: F
authors: Sullivan
authors: Alan
authors: A
authors: Connacher
authors: Annalu
authors: A
authors: Waller
authors: Douglas Ir
authors: DI
authors: Boyle
authors: Stephen
authors: S
authors: Greene
authors: Elaine
authors: E
authors: Wilson
authors: Alistair
authors: A
authors: Emslie-Smith
authors: Andrew D
authors: AD
authors: Morris
mesh_terms: D022126:Access to Information; D001331:Automation; D003625:Data Collection; D003920:Diabetes Mellitus / Q000628:therapy*; D001330:Electronic Data Processing; D005843:Geography; D017408:Guidelines as Topic; D006801:Humans; D020407:Internet; D008490:Medical Informatics; D017146:Models, Organizational; D015995:Prevalence; D011786:Quality Control; D012306:Risk; D012815:Signal Processing, Computer-Assisted; D017216:Telemedicine / Q000379:methods*; D006113:United Kingdom