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Computing and development of diabetes care
Martin Fahlen, Knut Fahlén, Sven-Gunnar Karlander and Anders Odén, Sweden.
A medical information system will reflect our attitudes toward the patient. We should ask how our
patient is are involved by our system. When economical labels is put into care the medical record
system is forced into a certain form. Doctors are also forced to work with laboratory investigations
and less with education. Inevitable a focus on cash flow will result in more non value activities. To
reverse this process we have to show that we can handle details.
This will simplify a move from abstract finances to concrete activities like education. We have
shown that it is possible to handle well structured and detailed information and continuously make
comparisons between clinics and primary care units. The result of educational activities and the
content of education can thus be demonstrated. The way in which our patient participates varies. A
basic information sheet is a questionaire with codes carried by the patient and is the starting point
while we write the medical record together. This sheet can also be used as a integration link between
primary care units and the hospital. In a future the patient card or a information on a diskette could
also be a crucial element in information flow. The attributed codes are saved to the document and
are used for production of readable records and for statistics. Free text is integrated with the
structured information in the medical record, making the final record tasteful for the reader.
Evaluation of graphs together with the patient is easily done. Evaluation is educational for the tutors
as well as for the patient. Results from interactive educational programs can also be a part of the
medical record like laboratory tests.
An important part of the information chain is the statistics, which are mandatory for quality
improvement. The statistics give the tools to refine methods and increase knowledge about
diagnostics and treatment consequences. A stronger platform is now maintained to put economical
labels on different treatments
So far we have used the system for half a year and are today monitoring 500 patients in the system.
Ten hospitals participate, serving the main heart surgery clinic at Sahlgren´s hospital. The main
objective is to give the surgeons and the health providers well structured, simplified and
comprehensive information about the patient. We have shown that it is possible to handle such
detailed information. Heart surgery is very expensive and care is patchy as far as priorities and
appropriateness. That is why we need disciplined shared care, continuously monitoring our results.
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