Diabetes Mellitus, Type 2 Clinical Trial
Official title:
Cyber Disease Management: Using the World Wide Web to Share the Medical Record With Patients at Home
This is a 12-month randomized, controlled trial of a Web-based diabetes co-management module among type 2 patients at the University of Washington's Roosevelt General Internal Medicine Clinic.
We will conduct a randomized controlled trial to determine whether a fully computerized,
diabetes mellitus (DM) disease-management module (known as Cyber-DM) can improve the quality
of adult diabetes care. The module will be Web-based, include a graphical HTML “front end”
user interface, and will be incorporated into each patient's existing Web-based electronic
medical record --the Medical Information Networked Database (MIND) repository at the
University of Washington Academic Medical Centers. This Web site will include five
components that will enable patients to interact asynchronously from their homes with their
clinic-based providers:
1. An integrated view of their actual medical record as it relates to diabetes care that
can generate customized patient education materials.
2. Real-time clinical reminders of the need to obtain preventive services such as HbA1c,
urine-protein and cholesterol determinations, and retinal examinations.
3. An electronic version of the SDMTM diabetes-care algorithms indicating where on the
"road-map" to adequate control they currently stand treatment-wise.
4. The ability to download glucometer readings and medication-use information from home
directly into the MIND repository.
5. Secure email communication between patients, their primary care physicians, and clinic
staff.
A total of 80-85 diabetic patients who are regular utilizers of the UW's General Internal
Medicine Clinic and who have home Internet access will be randomized to the experimental and
control arms of the trial. Control subjects will receive usual care. We hypothesize that use
of Cyber-DM will increase compliance with guideline-indicated care processes, improve
glycemic control, and reduce utilization costs. A trial this size would have the statistical
power to detect a change in HbA1c of 0.50%. Secure Socket Layer technology, session specific
"cookie" files, and a custom database application that manages logins/passwords and audits
all accesses to the system will provide security for this information tool.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Educational/Counseling/Training
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