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Remote Accessibility to Diabetes Management and Therapy in Operational healthcare Networks

Background and Problem

International clinical studies have shown that elevated blood sugar (hyperglycemia) in patients admitted in the hospital is an important marker for a poor clinical outcome (e.g., increased mortality rates). If diabetes patients with acute illnesses or patients with disease-related hyperglycemia are treated in a hospital, therefore, they require controlled, standardized glucose management. Studies in England and Austria have demonstrated that glucose management in the hospital is not satisfactory. One possible reason for this is that glucose management is often considered to be of secondary importance in acutely ill patients within a hospital environment. Much information is also lost during shift changes of health care personnel and when the responsible doctor changes.


Within the framework of the EU project REACTION, an electronic workflow and decision support system is being developed by the Institute HEALTH. This system will allow safe and efficient glucose management to be performed at the hospital station with the help of Android-based tablet PCs. The software developed for this technical assistant, which is linked to the hospital information system and laboratory, maps out the complete hospital workflow in a user-friendly way. Additionally, it sends out reminders for blood glucose measurements and optimizes the insulin therapy using a machine learning algorithm, ideally with input from both doctors and nurses. Glucose and insulin profiles can be visualized directly on the tablet PC at the bedside.

We are entering virgin territory, because a technical solution that assists the medical workflow of glucose management in the hospital is being for the first time. Workflow management is one of the largest challenges to creating optimized processes in the hospital environment.

Quality Support

Such workflow management and decision support system software is considered a medical device and, therefore, must be regulated according to the ISO EN 62304 standard. HEALTH introduced and certified a quality management system for the development of medical products some time ago and is currently working on extending the certification scope to ensure high-quality development of the medical device software.


With the implementation of this workflow management and decision support system, patient safety is enhanced because case numbers of hyper- and hypoglycaemia are reduced. For caregivers, the work is made easier because the software provides individual patient management information and, for this reason, it is possible to integrate treatment and documentation. For physicians and caregivers, the system provides a support for decisions about therapy.

Financial Support

The EU project REACTION was co-funded by the European-Commission in the 7th Framework Program (Grant Agreement no. 248590).

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