CDRM Project Diabetes Management

1. CDRM ProjectDiabetes Management Stefan Stadler – November 2009

2. CDRM – Goals of the CDRM Project • Corporate development and testing in clinical practice • Scientific evaluation of economic and medical effects • of an e-health assisted Diabetes Risk Management and Monitoring Approach for large scale population settings. • The computer-assisted diabetes risk management system (CDRM) combines several different clinical and information technology (IT) tools to improve diabetes care, patient adherence, and thus outcomes in population based disease management programs (DMP). Care provider and the patient take a centre stage within this approach which supports services of health care professionals, eases patients’ dealing with their own disease, and enhances the value of diagnostic information by improving the integration of different health care services. The CDRM Study will scientifically evaluate the economic and medical effect of this approach. www.study-on-diabetes-management-systems.de CDRM Diabetes Management

3. CDRM – Clinical trial setting • Prospective, longitudinal CRT designTarget population for diabetes management: • Type II diabetes patients (Age: 40-70) • DMP-RSAV Participants • approx. 1200 patients for 2 yrs • 24 primary care practicesProject objective • Clinical proof of effectiveness: “Intensified diabetes risk management in Germany” The study design is registered at the German Clinical Trials Register: ID: DRKS00000056 CDRM Diabetes Management

4. CDRM – Clinical trial Questions • Among others questions we address: • Are there sgnificant effects?  Outcomes + Costs • Are there significant demographic differences?  Target groups • What kind of tools are most significant?  e.g. Risk assessment • Is there a change in quality of life and patient health related behaviour?  e.g. Amount of blood glucose measurments !!! CDRM Diabetes Management

5. Scientific Partners University of Groningen, NL Phillips-Universität Marburg CDRM - Cooperation Industry Partners ICW AG Roche Diagnostics GmbH GeTeG mbH Co KG CDRM Diabetes Management

6. InterComponentWare KKSMarburg Patients GeTeG Roche Diagnostics ControlPhysicians ProjectOrganisation University Medical Center Groningen EthicsCommittee DiabetesSpecialist GP network(Qu@linet) Marburg University InterventionPhysicians CDRM - Organizational structure CDRM Project EthicalRequirements Project Organisation Department Name Name Job Title Department Name Name Job Title Name Job Title 123-456-7890 Funding /Support ScientificEvaluation TelematicTechnology Diabetes Care CDRM Diabetes Management

7. Core Requirements • Screening • Communication • Recruitment • Monitoring Disease Management Business Requirements on population (DMP) level Care Organization Care Providers + Patients CDRM Diabetes Management

8. Core Requirements • Collection of data • Analysis and interpretation of data • Decision making • Intervention, therapy • Monitoring of care progress Care provision Case Management Business Requirements on case management level Care Organization Care Providers + Patients CDRM Diabetes Management

9. System Infrastructure Postal services AnalyzedInformation VPNAccess VPN Access MedicalParameters Dataupload BGData Data Monitoring Care OrganisationService PrintService ClientNotebook(Browser) CDRM Tool Client PC Technology Provider Care Provider(GP, Coach etc.) Computer Centre Diabetes CareWorkflowProcessing CDM Diabetes Monitor(Life and Backup Server) Client PC PHR + Devices Study Coordination Patient CDRM Diabetes Management

10. Therapy GoalsTherapy Plan Compliance-/Success Report Risk Report CareProvider Patient Patient Empowerment via CDRM Doctor-Patient Communication Controlparameters Documentparameter progress(BG) Analyzetrends Specifygoals DigitaleMessgeräte LaborIntegration PraxisIntegration* KHIntegration* DiabetesManagementSystem continuous 1x / 6 months 1x / GP visit 1x / 6 months CDRM Diabetes Management

11. Expected Results of the CDRMIntervention Process Transparency onHealth Status Awareness on Risks Planning andControl Empowerment CDRM Diabetes Management

12. Potential EbM Knowledge Risk prognosis included intoday's decision making Risk Today Years CDRM Diabetes Management

13. Going LiveData Measurement 4. 1. 2. 3. Contracts SoftwareIntegration RolloutRecruitment in progress Medical Partners MarburgGroningen RocheICW AG GeTeG ICW AG Roche GeTeG (ICW LG)UNI Marburg Participants Potential ~650 ~260 Core Actors Patients ~190 23 21 21 GPs Rollouts Contracts Trainings Contacts Milestones, StatusNovember 2009 CDRM Diabetes Management

14. stadler@study-on-diabetes-management-systems.de CDRM Diabetes Management