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GlucoTab®

GlucoTab® - mobile solution to support blood sugar management in hospitalized type 2 diabetes patients

GlucoTab® is a software based system to improve blood sugar management in hospitalized type 2 diabetes patients. It consist of a central server and mobile tablet computers with the user interface, making it possible to treat the patient directly at the bedside.

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Workflow management

GlucoTab® supports the clinical workflow

GlucoTab® enables the electronic planning, performance and documentation of all ward specific workflow steps necessary for managing blood sugar.

Medical doctors and nurses receive all relevant information context-sensitively. Workflow is additionally supported by a reminder application. Thus GlucoTab® allows a comprehensive electronic reproduction of the blood sugar management and relieves staff from administrative tasks.

Decision support

GlucoTab® supports decision making at the point of care

GlucoTab® supports the clinical staff in the adjustment of daily and individual insulin dosage. Automatic insulin dosage proposals for long and short acting insulins are based on a rule-based algorithm. It considers previous and still active insulin doses as well as distribution across the day.

GlucoTab® is a CE marked medical device software. It was developed, verified and validated according to the stringent requirements of the medical device directive (according to ISO/IEC 62304).

Benefits and features

  1. Desicion support for medical doctors for prescription and daily adjustment of insulin doses
  2. Decision support for nursing staff in calculating individual insulin doses
  3. Reduction of mean blood sugar by up to 20% (confirmed in the clinical validation of the dosage protocol and the whole system)
  4. GlucoTab-system is a CE marked medical product since autumn 2014 and was developed, verified and validated according to the stringent guidelines of the medical device directive for software
  5. Intuitive usability due to the interdisciplinary and common development of the user interface with the clinical staff
  6. Easy, well-structured entry and clearly represented output of the most important medical parameters, such as blood sugar, insulin doses and meals
  7. GlucoTab relieves clinical staff by standardizing workflow
  8. Standardized interface to the medical information system

Clinical study results

GlucoTab® was evaluated in a clinical study with 99 patients at 4 different wards at the university hospital Graz.

Effectiveness: 72,5% of all blood sugar measurements are within the target range. This result is equivalent to current best-practice studies and is superior to standard care.

Safety: Compared to current studies with comparable therapies the risk for hypoglycemia is not enhanced (no serious hypoglycemic events; only 1.8% mild of all blood sugar levels were mild hypoglycemic events)

Acceptance: >95% of all planned work steps were carried out according to plan and the proposed insulin doses were accepted in >95% of all cases.

Require- ments

Requirements

In principle GlucoTab® runs in any hospital providing a medical information system and WiFi.

  • Server: Data processing and storage is performed on a server. Operation and data
  • Datenverarbeitung und Speicherung werden am Server durchgeführt Betrieb und data back-up locally on site by the operator.
  • Tablet computer: no requirements on the operator. Security measures like lock down of functions and Kiosk-mode are implemented.
  • HL7 ADT interface for patient data: Configuration of the communication server by the operator.
  • User authentification Windows Active Directory: Roles for medical doctors, nursing staff and optionally nursing assistants must be assigned.
  • WiFi: 100% WiFi coverage for the range of use of the tablet computers. Linking of the tablet computers to the internal WiFi by the operator.

Literature

Literature:

  • Schaupp L, Donsa K, Neubauer KM, et al. Taking a Closer Look—Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients with Type 2 Diabetes Mellitus Under Basal-Bolus Insulin Therapy. Diabetes Technol Ther. 2015;150430131357006.
    http://www.ncbi.nlm.nih.gov/pubmed/25927357
  • Neubauer KM, Mader JK, Aberer F, et al. Standardized Glycemic Management with a Computerized Workflow and Decision Support System for Hospitalized Patients with Type 2 Diabetes on Different Wards. 2015;17(10):1–8.
    http://online.liebertpub.com/doi/pdfplus/10.1089/dia.2015.0027
  • Donsa K, Beck P, Plank J, et al. A toolbox to improve algorithms for insulin-dosing decision support. Appl Clin Inform. 2014 Jan;5(2):548–56.
    http://www.ncbi.nlm.nih.gov/pubmed/25024768
  • Mader JK, Neubauer KM, Schaupp L, et al. Efficacy, usability and sequence of operations of a workflow-integrated algorithm for basal-bolus insulin therapy in hospitalized type 2 diabetes patients. Diabetes Obes Metab. 2013 Aug 1;16(2):137–46.
    http://www.ncbi.nlm.nih.gov/pubmed/23910952
  • Neubauer KM, Schaupp L, Plank J, et al. Failure to control hyperglycemia in noncritically ill diabetes patients despite standard glycemic management in a hospital setting. J Diabetes Sci Technol. 2013 Jan;7(2):402–9.
    http://www.ncbi.nlm.nih.gov/pubmed/23566999

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