COVID-19 Global Pandemic As A Driver For Optimizing Data-Driven Diabetes Care Delivery and Diabetes Outcomes In BC Canada

2021 ◽  
Author(s):  
Wendy Leong
Keyword(s):  
Diabetes Care ◽  
Care Delivery ◽  
Data Driven ◽  
Diabetes Outcomes ◽  
Global Pandemic

scholarly journals Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Routine Care ◽  
Future Research ◽  
Healthcare Organizations ◽  
Care Services ◽  
Global Pandemic ◽  
Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

scholarly journals Rapid implementation of virtual neurology in response to the COVID-19 pandemic

Neurology ◽  
2020 ◽  
Vol 94 (24) ◽  
pp. 1077-1087 ◽  
Author(s):  
Scott N. Grossman ◽  
Steve C. Han ◽  
Laura J. Balcer ◽  
Arielle Kurzweil ◽  
Harold Weinberg ◽  
...  
Keyword(s):  
Care Delivery ◽  
Mitigation Strategies ◽  
Urgent Care ◽  
Technology Infrastructure ◽  
Information Technology Infrastructure ◽  
Care Services ◽  
Global Pandemic ◽  
Specific Practice ◽  
Government Rules ◽  
Rapid Deployment

The COVID-19 pandemic is causing world-wide social dislocation, operational and economic dysfunction, and high rates of morbidity and mortality. Medical practices are responding by developing, disseminating, and implementing unprecedented changes in health care delivery. Telemedicine has rapidly moved to the frontline of clinical practice due to the need for prevention and mitigation strategies; these have been encouraged, facilitated, and enabled by changes in government rules and regulations and payer-driven reimbursement policies. We describe our neurology department's situational transformation from in-person outpatient visits to a largely virtual neurology practice in response to the COVID-19 pandemic. Two key factors enabled our rapid deployment of virtual encounters in neurology and its subspecialties. The first was a well-established robust information technology infrastructure supporting virtual urgent care services at our institution; this connected physicians directly to patients using both the physician's and the patient's own mobile devices. The second is the concept of one patient, one chart, facilitated by a suite of interconnected electronic medical record (EMR) applications on several different device types. We present our experience with conducting general teleneurology encounters using secure synchronous audio and video connections integrated with an EMR. This report also details how we perform virtual neurologic examinations that are clinically meaningful and how we document, code, and bill for these virtual services. Many of these processes can be used by other neurology providers, regardless of their specific practice model. We then discuss potential roles for teleneurology after the COVID-19 global pandemic has been contained.

Diabetes Care During COVID-19 Pandemic in Singapore Using a Telehealth Strategy

2021 ◽  
Author(s):  
Xia Lian ◽  
Rinkoo Dalan ◽  
Cherng Jye Seow ◽  
Huiling Liew ◽  
Michelle Jong ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Ad Hoc ◽  
Care Delivery ◽  
Diabetes Education ◽  
Circuit Breaker ◽  
Glucose Monitoring ◽  
Retrospective Assessment ◽  
Phone Calls ◽  
Intensively Managed ◽  
Health Applications

AbstractSingapore currently has one of highest number of confirmed COVID-19 cases in Southeast Asia. To curb the further spread of COVID-19, Singapore government announced a temporary nationwide lockdown (circuit breaker). In view of restrictions of patients’ mobility and the enforcement of safe distancing measures, usual in-person visits were discouraged. Here we describe how diabetes care delivery was ad hoc redesigned applying a telehealth strategy. We describe a retrospective assessment of subjects with diabetes, with and without COVID-19 infection, during the circuit breaker period of 7th April to 1st June 2020 managed through Tan Tock Seng Hospital’s telehealth platform. The virtual health applications consisted of telephone consultations, video telehealth visits via smartphones, and remote patient monitoring. The TTSH team intensively managed 298 diabetes patients using a telehealth strategy. The group comprised of (1) 84 inpatient COVID-19 patients with diabetes who received virtual diabetes education and blood glucose management during their hospitalisation and follow-up via phone calls after discharge and (2) 214 (n=192 non-COVID; n=22 COVID-positive) outpatient subjects with suboptimal glycaemic control who received intensive diabetes care through telehealth approaches. Remote continuous glucose monitoring was applied in 80 patients to facilitate treatment adjustment and hypoglycaemia prevention. The COVID-19 pandemic situation mooted an immediate disruptive transformation of healthcare processes. Virtual health applications were found to be safe, effective and efficient to replace current in-person visits.

scholarly journals Contributions on Clinical Decision Support from the 2018 Literature

2019 ◽  
Vol 28 (01) ◽  
pp. 135-137 ◽  
Author(s):  
Vassilis Koutkias ◽  
Jacques Bouaud ◽  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Care Delivery ◽  
Metastatic Cancer ◽  
Clinical Decision ◽  
Data Driven ◽  
Editorial Team ◽  
Cancer Center ◽  
Bibliographic Databases ◽  
Free Text

Objectives: To summarize recent research and select the best papers published in 2018 in the field of computerized clinical decision support for the Decision Support section of the International Medical Informatics Association (IMIA) yearbook. Methods: A literature review was performed by searching two bibliographic databases for papers referring to clinical decision support systems (CDSSs). The aim was to identify a list of candidate best papers from the retrieved bibliographic records, which were then peer-reviewed by external reviewers. A consensus meeting of the IMIA editorial team finally selected the best papers on the basis of all reviews and the section editors' evaluation. Results: Among 1,148 retrieved articles, 15 best paper candidates were selected, the review of which resulted in the selection of four best papers. The first paper introduces a deep learning model for estimating short-term life expectancy (>3 months) of metastatic cancer patients by analyzing free-text clinical notes in electronic medical records, while maintaining the temporal visit sequence. The second paper takes note that CDSSs become routinely integrated in health information systems and compares statistical anomaly detection models to identify CDSS malfunctions which, if remain unnoticed, may have a negative impact on care delivery. The third paper fairly reports on lessons learnt from the development of an oncology CDSS using artificial intelligence techniques and from its assessment in a large US cancer center. The fourth paper implements a preference learning methodology for detecting inconsistencies in clinical practice guidelines and illustrates the applicability of the proposed methodology to antibiotherapy. Conclusions: Three of the four best papers rely on data-driven methods, and one builds on a knowledge-based approach. While there is currently a trend for data-driven decision support, the promising results of such approaches still need to be confirmed by the adoption of these systems and their routine use.

scholarly journals Quantification and visualisation methods of data-driven chronic care delivery pathways: protocol for a systematic review and content analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033573 ◽  
Author(s):  
Luiza Siqueira do Prado ◽  
Samuel Allemann ◽  
Marie Viprey ◽  
Anne-Marie Schott ◽  
Dan Dediu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Content Analysis ◽  
Chronic Conditions ◽  
Data Science ◽  
Care Delivery ◽  
Meta Analysis ◽  
Healthcare Utilisation ◽  
Data Driven ◽  
Term Care ◽  
Electronic Healthcare Databases

IntroductionChronic conditions require long periods of care and often involve repeated interactions with multiple healthcare providers. Faced with increasing illness burden and costs, healthcare systems are currently working towards integrated care to streamline these interactions and improve efficiency. To support this, one promising resource is the information on routine care delivery stored in various electronic healthcare databases (EHD). In chronic conditions, care delivery pathways (CDPs) can be constructed by linking multiple data sources and extracting time-stamped healthcare utilisation events and other medical data related to individual or groups of patients over specific time periods; CDPs may provide insights into current practice and ways of improving it. Several methods have been proposed in recent years to quantify and visualise CDPs. We present the protocol for a systematic review aiming to describe the content and development of CDP methods, to derive common recommendations for CDP construction.Methods and analysisThis protocol followed the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. A literature search will be performed in PubMed (MEDLINE), Scopus, IEEE, CINAHL and EMBASE, without date restrictions, to review published papers reporting data-driven chronic CDPs quantification and visualisation methods. We will describe them using several characteristics relevant for EHD use in long-term care, grouped into three domains: (1) clinical (what clinical information does the method use and how was it considered relevant?), (2) data science (what are the method’s development and implementation characteristics?) and (3) behavioural (which behaviours and interactions does the method aim to promote among users and how?). Data extraction will be performed via deductive content analysis using previously defined characteristics and accompanied by an inductive analysis to identify and code additional relevant features. Results will be presented in descriptive format and used to compare current CDPs and generate recommendations for future CDP development initiatives.Ethics and disseminationDatabase searches will be initiated in May 2019. The review is expected to be completed by February 2020. Ethical approval is not required for this review. Results will be disseminated in peer-reviewed journals and conference presentations.PROSPERO registration numberCRD42019140494.

PO099 IMPROVED ACCESS OF DIABETES CARE IN LOW RESOURCE AREA BY MOBILE CARE DELIVERY

2014 ◽  
Vol 106 ◽  
pp. S96 ◽  
Author(s):  
E.A.E. Hind ◽  
M. Eltom ◽  
C. Östensori ◽  
P. Johansson ◽  
R. Wahlstrom
Keyword(s):  
Diabetes Care ◽  
Care Delivery ◽  
Low Resource

scholarly journals The Impact of Pharmacist Care on Diabetes Outcomes in Primary Care Settings: An Umbrella Review of Systematic Reviews

2020 ◽  
Author(s):  
Sara Hamdi Abdulrhim ◽  
Sownd Sankaralingam ◽  
Mohamed Izham
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Systematic Reviews ◽  
Diabetes Care ◽  
Economic Outcomes ◽  
Diabetes Outcomes ◽  
Primary Care Settings ◽  
Pharmacist Interventions ◽  
The Impact ◽  
Pharmacist Care

Objective: To systematically review published systematic reviews (SRs) examining the impact of pharmacist interventions in multidisciplinary diabetes care teams on diabetes-related clinical, humanistic, and economic outcomes in primary care settings. Methods: PubMed, EMBASE, Scopus, Database of Abstracts of Reviews of Effects, Cochrane Library, Joanna Briggs Institute (JBI) Database, Google Scholar, and PROSPERO were searched from inception to 2018. Studies published in English evaluating the effect of pharmacist interventions on diabetes outcomes were included. Two independent reviewers were involved in the screening of titles and abstracts, selection of studies, and methodological quality assessment. Results: Seven SRs were included in the study. Three of them included only randomized controlled trials, while the rest involved other study designs. Educational interventions by clinical pharmacists within the healthcare team were the most common types of interventions reported across all SRs. Pharmacist’s interventions compared to usual care resulted in favorable significant improvements in hemoglobin A1c (HbA1c), fasting blood glucose, blood pressure, body mass index, total cholesterol, lowdensity lipoprotein, high-density lipoprotein and triglycerides in more than 50% of the SRs. Improvement in HbA1c was the mostly reported clinical outcome of pharmacist intervention in the literature (reported in six SRs). Pharmacist’s interventions led to significant cost-saving ($8–$85,000 per person per year), cost-utility, and cost-benefit (benefit-to-cost ratio range from 1:1 to 8.5:1) versus usual care. Pharmacist’s interventions improved patients’ quality of life (QoL) in three SRs; however, no conclusion can be drawn due to the use of diverse QoL assessment tools. Conclusion: Most SRs support the benefit of pharmacist care on diabetes-related clinical, humanistic, and economic outcomes in primary care settings. Improvements in diabetes outcomes can significantly reduce the burden of diabetes on the healthcare system. Hence, the incorporation of pharmacists into multidisciplinary diabetes care teams is beneficial and should be strongly considered by clinicians and health policymakers.

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