Goldberg Harold I, Ralston James D, Hirsch Irl B, Hoath James I, Ahmed Kazi I
University of Washington, Seattle, USA.
Jt Comm J Qual Saf. 2003 Sep;29(9):443-51. doi: 10.1016/s1549-3741(03)29053-5.
Web-based applications have the potential to support the ongoing care needs of patients with chronic disease. At the University of Washington, a diabetes care module was developed, and the feasibility of allowing patients with type 2 diabetes to comanage their disease from home was pilot tested.
The disease management module consisted of five Web sites that enabled patients to access their electronic medical records; upload blood glucose readings; enter medication, nutrition, and exercise data into an online diary; communicate with providers by using clinical e-mail; and browse an education site with endorsed content. All data could be viewed by patients and providers in online trended displays that a nurse practitioner case manager used to review cases weekly.
"Proof-of-concept" was demonstrated by the three pilot participants who were the module's most active users. For example, one newly diagnosed patient was started on an oral hypoglycemic, underwent two upward dose adjustments, and achieved control (glycohemoglobin [HbA1c] from 8.0% to 6.1%). His treatment was conducted by exchanging 14 e-mails based on the 231 glucose-meter readings sent from home without requiring in-person follow-up visits.
The Internet offers the opportunity to involve patients and providers in collaborative management of chronic diseases between office visits.
基于网络的应用程序有潜力满足慢性病患者持续的护理需求。华盛顿大学开发了一个糖尿病护理模块，并对允许2型糖尿病患者在家中共同管理其疾病的可行性进行了试点测试。
疾病管理模块由五个网站组成，患者可以通过这些网站访问他们的电子病历；上传血糖读数；将用药、营养和运动数据输入在线日记；通过临床电子邮件与医护人员沟通；浏览一个包含认可内容的教育网站。患者和医护人员都可以在在线趋势显示中查看所有数据，一名执业护士病例管理员每周会利用这些数据来审查病例。
三名试点参与者作为该模块最活跃的用户，证明了“概念验证”。例如，一名新诊断的患者开始服用口服降糖药，进行了两次剂量上调，并实现了病情控制（糖化血红蛋白[HbA1c]从8.0%降至6.1%）。他的治疗是通过基于从家中发送的231次血糖仪读数交换14封电子邮件来进行的，无需进行面对面的随访就诊。
互联网为患者和医护人员在门诊就诊期间共同管理慢性病提供了机会。
