From Hong Kong Diabetes Register to JADE Program to RAMP-DM for Data-Driven Actions
| Autor: | Alice P.S. Kong, Andrea O.Y. Luk, Ronald Cw Ma, Su-Vui Lo, Lee Ling Lim, Risa Ozaki, Wing-Yee So, Juliana C.N. Chan |
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| Rok vydání: | 2019 |
| Předmět: |
Diabetes risk
Quality management Endocrinology Diabetes and Metabolism media_common.quotation_subject Psychological intervention JADE (programming language) 030209 endocrinology & metabolism Risk Assessment 03 medical and health sciences 0302 clinical medicine Clinical Protocols Internal Medicine medicine Diabetes Mellitus Humans 030212 general & internal medicine Registries Program Development Empowerment computer.programming_language media_common Advanced and Specialized Nursing business.industry medicine.disease Triage Quality Improvement Integrated care Hong Kong Medical emergency Risk assessment business computer Algorithms Program Evaluation |
| Zdroj: | Diabetes care. 42(11) |
| ISSN: | 1935-5548 |
| Popis: | In 1995, the Hong Kong Diabetes Register (HKDR) was established by a doctor-nurse team at a university-affiliated, publicly funded, hospital-based diabetes center using a structured protocol for gathering data to stratify risk, triage care, empower patients, and individualize treatment. This research-driven quality improvement program has motivated the introduction of a territory-wide diabetes risk assessment and management program provided by 18 hospital-based diabetes centers since 2000. By linking the data-rich HKDR to the territory-wide electronic medical record, risk equations were developed and validated to predict clinical outcomes. In 2007, the HKDR protocol was digitalized to establish the web-based Joint Asia Diabetes Evaluation (JADE) Program complete with risk levels and algorithms for issuance of personalized reports to reduce clinical inertia and empower self-management. Through this technologically assisted, integrated diabetes care program, we have generated big data to track secular trends, identify unmet needs, and verify interventions in a naturalistic environment. In 2009, the JADE Program was adapted to form the Risk Assessment and Management Program for Diabetes Mellitus (RAMP-DM) in the publicly funded primary care clinics, which reduced all major events by 30–60% in patients without complications. Meanwhile, a JADE-assisted assessment and empowerment program provided by a university-affiliated, self-funded, nurse-coordinated diabetes center, aimed at complementing medical care in the community, also reduced all major events by 30–50% in patients with different risk levels. By combining universal health coverage, public-private partnerships, and data-driven integrated care, the Hong Kong experience provides a possible solution than can be adapted elsewhere to make quality diabetes care accessible, affordable, and sustainable. |
| Databáze: | OpenAIRE |
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