D I A B E T E S C O M P L I C AT I O N S Disease Management Software

Doctor’s Empowerment : Smart E.H.R. (Medical Algorithm)

Disease Management E.H.R. Challenges & Solution

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Pain Point Macro Problem EHR Solution CDSS Tools

1 Time utilization Less productive

2 Diagnosis - Prognosis Not protocol

3 Dr’s treatment Single Dr : multiple issues

4 Referrals Biased - inconsistent

5 Basic Investigation Irregular

6 Comprehensive care reminder Unavailable

7 Clinical practice audits Not practiced

8 Providers team knowledge Inadequate

9 Patient neglects Diabetes No illustrative EHR

Preventive Care

Proactive Diagnostic Tools

Predictive - Risk stratification

Progressive - Treatment Goals

Patient Convenience & Cost

Protocol driven process

Disease Management E.H.R. Think !!!

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Current Approach Can we improve our Clinic system ??

Disease Management E.H.R. Power of Smart E.H.R.

Protocol Personal Guideline

Satisfied Patient

Easier Referrals

Holistic Approach

Quicker Patient

Counseling SMART Electronic

Health Records

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Disease Management E.H.R. Diabetes Systematic Management Cycle

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ASSESS

•History

•Diagnosis

•Risk Mapping

PLAN

•Health Status

•Age - Support

•Realistic Goals•Agreement

IMPLEMENT

•Manage Weight

•Nutrition Therapy

•Lifestyle Change•Exercise - Yoga

EVALUATE

•Trend Analysis

•Successes

•Side-Effects•Cost Factor

Disease Management E.H.R. Clinical Decision Support System (for Drs)

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Multi – Disease : Multi-organ co-morbidities

Decision Support : Evidence based and intelligent

Supports all Therapies : Diet – Lifestyle – Exercise – Education

User-friendly : many tasks managed safely by Drs Assistant

Protocols driven : Globally acclaimed and updated standards

Disease Management E.H.R. Information Delivery Flow

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Data In Report

No need of Computer

Cloud based – no installation

Accessible Anytime - Anywhere

This facility is available only for the Dr’s Clinics. In the Hospitals Dia-Bese Apps are commonly used

Disease Management E.H.R. Data Input

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Patient Form (User-friendly)

Name / Contacts

Vitals – Anthropometry

Medical History (self)

Medical History (family)

Life-style Habits

Co-morbidities duration (yrs)

Pain – complaint

Lab results

Medication listing

Machine results

Patient Social – habits details

Dia-Bese Allied Clinics ELECTRONIC HEALTH RECORDS

Diabetes Management Form – 1

PERSONAL DETAILS / CONTACT

G Title First Name Middle Name Surname UID Ref Reg RefDate

Today

Mr.

Ms

Mrs

Birth Dt. Age Blood Gr Occupation Religion Race

Area City State Pin

Mob Ph Res Ph Office Email

Relative Kin Phone Family Dr. Specialist Dr.

Yrs Mth Type 1 Type 2 LADA MODY DOY GDM

DIABETES PERIOD / TYPE

Birth Dt or Age Blood Gr. Occupation Refered by

Address

City / State Pin Code Email ID

Tel (Mobile) Tel (Work) Tel (Home)

Dia Yrs - Mths Type 1 or 2 GDM Others

Allergy / Intolerance Anti-Diabetic Others

Diabetes

Parents

Diabetes

Bro-SisterIHD HTN ESRD Stroke Malignacy

1 Smokng Cigarettes / day nos. yrs. Paan Yes * No Chew Tobac Yes * No

2 Alcohol numbers / week Whisky - peg nos. Wine - glass nos. Beer - glass nos.

3 Time spent (hrs / day) Travel hrs. At work hrs. Sleep hrs.

Sedentary Light Morderate Very Active Extra Activity Exercise / wk

Negligible 1 - 3 days 3 - 5 days 6 - 7 days Heavy training

HTN CHD IHD Angina MIAngioplasty

Stent

CABG

Bypass

TIA Strokes Stent

Stones CRF Dialysis Transplant Kidney - Fine

Neuropathy PVD Skin Change Deformity Ulcer Amputation Grading Foot - Fine

Mild DR Moderate DR PDR Maculopathy Cataract Laser Eyes - Fine

PCOS Thyroid Liver COPD Cancer Asthama Blood - Gums

Kid

ney

Fo

ot

Eyes

Oth

er

ANTHROPOMETRY

PERSONAL DETAILS / CONTACT

……………………………………………………………………………………………………………………………………..

DIABETES

Vit

als

FAMILY HISTORY

LIFESTYLE QUERIES

4 Physical activities

MEDICAL HISTORY (Duration - years in grey box)

CV

D

times min / d

G Title First Name Middle Name Surname UID Ref Reg RefDate

Today

Mr.

Ms

Mrs

Height Waist Hips BP Pulse SpO2

cm cm cm

kg ft-in inch inch

WeightWrist Grip Touch

(for Boday Frame size)

Overlap * Just * No

Relation Dia Type 2 Hypertension Heart Diseas Kidney Acute Thyroid Cancer

Father <55

Mother <65

Brother - Sister

FAMILY HISTORY

Heart Death

Grade ECG Stress Test 2D Echo MRI CT Scan Fundus Biothisio Vas Doppler

Normal

Abnormal

MACHINE TEST

Height Waist Hips BP Pulse SpO2

cm cm cm

kg ft-in inch inch

Weight

/

ANTHROPOMETRY

HTN (BP) Dislipidemia A-Fib Angina Heart Attack Heart Fail Congenital

Coro Artery Valves TIA Strokes Paralysis Bypass Stent

Kidney Stones Renal Fail Dialysis Transplant Kidney - Fine

Foot Neuropathy PVD Skin Change Deformity Ulcer Amputation Foot - Fine

Eyes Mild DR Moderate DR PDR Maculopathy Cataract Laser Eyes - Fine

Other PCOS Thyroid Liver COPD Cancer Asthama Arthritis

Heart

Brain

MEDICAL HISTORY - EXISTING COMORBIDITY

Disease Management E.H.R. Patient Report (1)

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Clinical History

Health Trend

Disease Management E.H.R. Patient Report (2)

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Organ Risk Indicator

Medicine Prescribed

Disease Management E.H.R. Patient Report (3)

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Side - Effects

Knowledge Level

Education

Disease Management E.H.R. Health Graded Screening Packs

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Risk-wise Diabetic Patient PackagePack

RatesRegular Mild Moderate Sever

A Consultation - Counselling

GP 200 3 4 7 8

Diabetologist 500 2 4

Dietician 250 2 4 6 12

Total Consultation - Counselling 1,100 1,800 3,900 6,600

B Lab Tests

HbA1c 350 2 4 4 4

FBG - PPG 200 2 2 4 4

Lipid profile 350 1 1 1 2

Kidney profile 150 1 1 1 2

Liver Profile 200 1 1

CBC 150 1 1 1 2

Electrolytes 300 1 2

Thyroid profile 400 1

Total Lab Tests 1,695 2,510 3,355 4,820

C Machine Tests

BP 4 6 9 12

ECG 250 1 1 2 4

USG Ultra Sound 500 1

2D Echo 1,200 1

Diabetic Foot check 400 1 1 1

Diabetic Retino check 300 1 1 1

Total Machine Tests 250 250 500 2,700

D Dia-Bese (London Report)

Health ID Card 50 1 1 1 2

Health Profile (Basic) 200 1 1 4 6

Health Profile (Advance) 350 3 6

Health Passport 500 1 1

Total Consultation - Counselling 250 250 2,400 3,900

Patient Package Total Costs (Gross) / year 3,295 4,810 10,155 18,020

Health package selected on the basis of Health Status Index

Disease Management E.H.R. Health Informatics Offerings

Electronic Passport Health I.D. Card

Health Profile

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Doctor’s Clinic

High-Risk Patients Summary

Disease Management E.H.R. DIA-BESE : Innovation Selection

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D S T – L o c k h e e d M a r t i n I n d i a G r o w t h P r o g r a m

Disease Management E.H.R. Take away : Roadmap

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Change Leadership : Global Healthcare