title: Patient-oriented Computerized Clinical Guidelines for Mobile Decision Support in Gestational Diabetes.
abstract: The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients' self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient's access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients' personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients' acceptance of the whole system.
authors.affiliation: Bioengineering and Telemedicine Centre, Universidad Politécnica de Madrid, Spain CIBER-BBN: Networking Research Centre for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain ggarcia@gbt.tfo.upm.es.
authors.forename: Gema
authors.initials: G
authors.lastname: García-Sáez
authors.affiliation: Endocrinology and Nutrition Department Parc Tauli Sabadell University Hospital, Sabadell, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Rigla
authors.affiliation: Bioengineering and Telemedicine Centre, Universidad Politécnica de Madrid, Spain CIBER-BBN: Networking Research Centre for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Martínez-Sarriegui
authors.affiliation: Department of Information Systems Engineering, Ben Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Erez
authors.initials: E
authors.lastname: Shalom
authors.affiliation: Department of Information Systems, University of Haifa, Haifa, Israel.
authors.forename: Mor
authors.initials: M
authors.lastname: Peleg
authors.affiliation: MobiHealth B.V., Enschede, Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Broens
authors.affiliation: Endocrinology and Nutrition Department Parc Tauli Sabadell University Hospital, Sabadell, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Pons
authors.affiliation: Bioengineering and Telemedicine Centre, Universidad Politécnica de Madrid, Spain CIBER-BBN: Networking Research Centre for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.
authors.forename: Estefanía
authors.initials: E
authors.lastname: Caballero-Ruíz
authors.affiliation: Bioengineering and Telemedicine Centre, Universidad Politécnica de Madrid, Spain CIBER-BBN: Networking Research Centre for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Gómez
authors.affiliation: Bioengineering and Telemedicine Centre, Universidad Politécnica de Madrid, Spain CIBER-BBN: Networking Research Centre for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain.
authors.forename: M Elena
authors.initials: ME
authors.lastname: Hernando
keywords: clinical guidelines; decision support system; gestational diabetes; m-health; telemedicine