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DSS GDM final presentation pp (4)
- 1. Teri Carlson, RN FinalProject 2010 MMI 406
- 2. This project is focusedon the creation of a Gestational Diabetes Clinical Decision Support System.
- 3. What is GestationalDiabetes ? The American Diabetes Association defines Gestational diabetes mellitus (GDM) as any degree of glucose intolerance with onset or first recognition during pregnancy. It generally occurs between the 24-28 week of pregnancy. It is reported that up to 7% of all pregnancies are complicated by GDM.
- 4. Mother Fetus Maternal/Fetal Dyad Gestational Diabetes Preeclampsia C-section Type 2 DM biomedme.com/.../01/gestational-diabetes.jpg Perinatalmortality Macrosomia Birth trauma Hyperbilirubinemia Neonatal Hypoglycemia
- 5. Cost of GDMto the Nation In 2007 it cost of GDM was $636 million for the 180,000 pregnancies where gestational diabetes was diagnosed. Maternal $596 million Neonatal $40 million Total $636 million The Cost of Gestational Diabetes to the United States in 2007 Medicaid • $230 million • 36% Insurance • $355 million • 56% Self-pay • $51 million • 8%
- 6. The Keys toSuccessful Management of GDM preventing extra healthcare costs and negative outcomes for the mother / infant “Early Identification” All women will be screened for risk and possible pre-existing diabetes that they were unaware of Patient education Monitoring and if necessary pharmacological treatment The Ob-gyn Practice will use a diabetic dashboard as a tool. The clinicians can use to screen, identify and monitor all the pregnant women who come to their practice Using nationally established GDM best practice recommendations
- 7. Care provided byOb-gyn Practice Best Clinical Practice Disease Management Patient Education Remote Monitoring Prepared Proactive Providers Informed Motivated Patients Quality Care…..Lower Costs…..Better Outcomes Components Outcomes Management Participants GDM Registryhttp://ww.delphihealth.com/sol_overview.html The Registry decision support information is based on the American Diabetes Association best clinical practices for Gestational Diabetes
- 8. GDM Dashboard Decision Tree Allmoms undergo a GDM screening at the first visit in the first trimester Not at Risk At Risk Second screening occurs in the 2nd at trimester 24-26wks Not Treat for GDM Treat for GDM Wireless Home Monitoring - BG reading is done at home - The results are sent wireless to the Ob-gyn practice Dashboard - Built in alerts will show when the mother is not in the desired BG range - The real time data - leads to real time interventions - versus waiting for the next office visit. The cost benefit of this is a value add, because early treatment equals less long run complications to both mother and infant. Third Screening at 32-34 weeks Not Treat for GDM Treat for GDM
- 9. Decision Tree forPharmacological Treatment of GDM http://spectrum.diabetesjournals.org/content/20/2/101/F1.expansion.html
- 10. Obgyn GDM Dashboard Patientswith Remote Blood Glucose Monitoring Patients Referred to Perinatologyg
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- 12. Significance of theTechnology in Disease Management Technology Provides A new way of healthcare delivery, one that decreases healthcare costs An avenue to find the best practice interventions and solutions A real time monitoring and treatment of GDM resulting in a decrease of the associated diabetic co-morbidities