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Using IT To Reduce The Stress Of A Diabetes Clinic

Using IT To Reduce The Stress Of A Diabetes Clinic. What Happens at a Diabetes Clinic?. Screening for complications Identification of problems Intervention Prescribing Referral for advice. Why can diabetes clinics be difficult?. History Diabetes clinics are busy

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Using IT To Reduce The Stress Of A Diabetes Clinic

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  1. Using IT To Reduce The Stress Of A Diabetes Clinic

  2. What Happens at a Diabetes Clinic? • Screening for complications • Identification of problems • Intervention • Prescribing • Referral for advice

  3. Why can diabetes clinics be difficult? • History • Diabetes clinics are busy • Increasing numbers of patients

  4. New Referrals With Diabetes

  5. Review Attendance

  6. A lot of information to be gathered • SIGN minimum data

  7. Diabetes Team • Nurses • clinic, nurse specialists, auxiliary • Dietician • Podiatrist • Phlebotomist • Laboratory staff • Secretarial and receptionist • Physicians

  8. Screening • Biochemical • Hba1c • Renal function • Lipids • Microalbuminuria • Thyroid? • Protocol

  9. Screening • Retinal examination • VA • BP • Foot pulses and vibration perception • Protocol

  10. Potential problems • Missed screening • Duplicated screening

  11. Organisation • Efficiency

  12. More work Increased time Useless information Unfriendly screens Information in but none out Rubbish in rubbish out Less work Time saved Useful information Easy to use Reports and audit Sense checking IT - Useful or useless?

  13. LAB SECRETARIES DOCTOR (4) FILE SERVER NURSE PODIATRIST IT DEPT

  14. Nurse Lab Doctor IT Dept Secretaries Podiatrist Dietician Clinic summary Podiatrist GP Lab Dietician Nurse Doctor

  15. Useful • Quality • Transparent • Ordering bloods according to protocol • Download of biochemistry automatically • Reduced duplication if multiple users • Letter generation • Summaries • Addresses • Information for all • Drug and condition lists

  16. Secretary prints blood requests Patient arrives and booked in Nurse Specialist Phlebotomy Laboratory HbA1c, cholesterol, U + E, Alb/creat ratio Dietician Nurse (VA, weight +/- eye drops) Podiatrist Physician (BP, feet, eyes) Letter to GP

  17. How do we judge our performance? • Audit • Process • screening • Outcome • BP • Lipids • HbA1c

  18. Audit of screening

  19. Diagnosis CHD Risk of > 30%2 Year Follow Up Cardiovascular risk factors in Those at the highest risk are Being treated • 35.0%  25.4% Calculated lowest possible risk For this group = 22.0% • What is not at target?

  20. Diagnosis CHD Risk of > 30%2 Year Follow Up Smoking status was unaffected despite advice issued at clinics

  21. The Future 1 • Local • Link to eye photography • Link to primary care • Podiatry, GPs • Link to Lothian register

  22. The Future 2 • Central funding and support for IT • Report by the Working Group on IT to Support Shared Care for Diabetes *This is very important*

  23. The Future 3 • Scottish Diabetes Survey • HDL (2000) 12

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