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Developing a Glucometry Alert System to Address Inpatient Dysglycemia

Seheult, Jansen N. MB, BCh, BAO, MSc; Kumar, Amit BSc; Gaffney, Peter MSc; Fogarty, Jane BSc; Boran, Gerard MB, BCh, BAO

Point of Care: The Journal of Near-Patient Testing & Technology: March 2016 - Volume 15 - Issue 1 - p 35–40
doi: 10.1097/POC.0000000000000081
Original Articles
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Background Poor inpatient glycemic control has a prevalence exceeding 30% and results in higher rates of hospital complications, increased length of stay and likelihood of readmission, and significantly higher inpatient mortality. Current networked point-of-care (POC) technology offers a novel way to address this problem. However, current technology provided by POC diagnostics companies is lacking in terms of data presentation and alerts.

Objective The aims of this study were to develop an automated system to process POC testing blood glucose results stored on our network server and to present the daily analysis in a user-friendly interface to the diabetes consult service.

Implementation and Results Microsoft Excel (Version 2013) Macros were developed for the processing of daily glucometry data downloaded from the Cobas IT database using Visual Basic. Reports were generated according to ward location and alerts were triggered for any value of less than 4 mmol/L (70 mg/dL, hypoglycemia) or greater than 15 mmol/L (270 mg/dL, moderate-severe hyperglycemia). The diabetes team provided a weekday consult service for all patients flagged on the daily reports. We describe a system for processing of inpatient glucometry data downloaded from a networked database. The Excel Macros were loaded onto a tablet with a Windows 8.1 OS for daily use by the diabetes consult team.

Conclusions An automated alert system that allowed the use of site-specific level- and time-based criteria for the identification of dysglycemic results and generation of alerts was successfully developed and deployed in our medium-large sized tertiary care facility.

From the *Clinical Chemistry Department, Adelaide and Meath Hospital, Tallaght, Dublin, Ireland; and †Indian Institute of Technology (IIT Delhi), Delhi, India.

Reprints: Jansen N. Seheult, MB, BCh, BAO, MSc, Clinical Chemistry Department, Adelaide and Meath Hospital, Cookstown Way, Tallaght, Dublin 24, Ireland. E-mail: seheultj@tcd.ie.

The authors declare no conflict of interest.

J.N.S. conceived of the study, participated in the development of the Macros, and drafted the manuscript. A.K. participated in development of the Macros. P.G. and J.F. provided technical laboratory support and data acquisition. G.B. supervised the project, provided clinical support, and assisted with manuscript preparation. All authors read and approved the final manuscript.

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