糖尿病病患照護品質資料庫建置

Using Web-based Database to Improve Quality in Diabetes Management

背景和目的：建立以糖尿病病患為中心的共同照護，提供糖尿病病患診察、檢驗、衛教及追蹤等完整服務，減少糖尿病患併發症與合併症發生，提昇醫療照護品質。方法：「糖尿病照護品質資料庫」整合醫院資訊系統(Hospital Information System, HIS)、實驗室資訊系統(Laboratory Information System, LIS)以及個案管理師人工紀錄之糖尿病病患照護相關資料。資料庫記載病患基本資料、相關疾病及家族史、急慢性併發症、藥物過敏或不良反應、過去及目前用藥紀錄、實驗室檢驗值、衛教紀錄、醫療處置、住院及急診就醫紀錄等糖尿病病患資訊，並每天自動更新資料。結果：資料庫管理功能讓個案管理師能有效管理追蹤本院糖尿病病患，提供高品質醫療服務；醫療專業人員即時取得及更新病患資料。資料庫分析功能的搜尋，能有效地搜尋病患照護相關資料，改善糖尿病病患照護品質，除此之外亦提高醫師看診、病患就醫滿意度以及簡化病患追蹤管理。結論：慢性疾病個案管理為未來醫療產業潮流，唯有整合病患照護資料，才能提升糖尿病患者整體性的照護品質。

Objectives: Disease management for chronic condition is evolving into a major entity of healthcare quality in an aging society. The issues regarding the care guideline compliance, long term follow-up, and complication prevention are becoming critical in diabetes management. Methods: A web-based diabetes management system is developed for automatic retrieving patient information from hospital information system (HIS), laboratory information system (LIS). Data available in medical records are provided by the healthcare case manager. Diabetes care information, including past history, co-morbidity, medication archive, current prescription, laboratory data, education records, procedure records, admission records, and incident reports data are imported from various data ports and are automatically updated on a daily basis. Results: The searchable, rational, and interactive database provides case manager to conduct performance measurements. The manager function allows care professionals to access, enter, and update patients' information on a real-time basis. The establishment of this database has also led to higher physician and patient satisfaction. Conclusion: A web-based database is an excellent option to continuously monitor, manage, and improve care for diabetes patients.