S. Sethu Reddy, MD, MBA, FPCPC, MACE, discussed how cloud-based records could be key to improving diabetes control in the hospital during Wednesday’s “Inpatient Endocrinology Part 1: Diabetes and Nutrition” seminar.
As moderator of the session, Dr. Reddy, who is Chief of the Adult Diabetes Section at Joslin Diabetes Center, Boston, kicked off the program with a lecture titled “Inpatient Glycemic Management: From Bedside to the Cloud.”
Dr. Reddy said having access to patient diabetes management data online allows endocrinologists to oversee patient care from anywhere — addressing both individual patient needs as well as accessing global, population-health patterns. This could offer hospitals an opportunity to see how their performance compares to other hospitals as well as seeing how each department is performing.
“Rather than managing only individual patients, hopefully all of you, as leaders of the diabetes team in the hospital will be the manager of diabetes control in the hospital,” he said. “You will be overseeing what’s happening to all of the blood sugars and insulin management in the ICU, the orthopedic ward, etc. You’ll be able to sit at your console and send a message to the orthopedic ward to alert them when there’s an increase in hypoglycemic events and tell them it’s time to retrain the nursing staff.
“Essentially, this is population health being applied to a hospital setting in real time… A cell working individually is not a great thing. It can’t do much. It’s only when it connects with others that it can do great things. When a whole bunch of cells get together as an organization, they can do great things.”
Dr. Reddy said it’s time for endocrinologists to take a holistic view. The future endocrinologist will be looking not only at sugars, but also fitness, activity, glucose patterns, insulin patterns, nutrition and more.
“All the data will be connected together for us to see,” he said. “And you’ll be able to see it from anywhere.”
A quick poll of the room showed only 20 percent of attendees worked in hospitals where glucose monitoring was connected to electronic medical record systems. However, Dr. Reddy said this will be the way of the future and hospitals must move that way.
All major glucose-monitoring systems have the ability to connect to the cloud or hospital infrastructure.
One of the ways this will help improve inpatient glucose control is by motivating hospital staff to improve. Dr. Reddy reviewed data that showed reports demonstrating management data stimulate behavior modification.
“We, as individuals seeing a patient, may not have a view of what is happening across the unit or across the hospital,” he said. “For example, hypoglycemia should be a recordable event, and you’d like to see that once a protocol has been implemented, you’ve been able to reduce the hypoglycemia rate.”
He showed examples of graphs reporting incidents of hyperglycemia and hypoglycemia that allow hospitals to see at a glance how different units are performing.
“You don’t drive forward by looking back, but that’s what we do in diabetes” Dr. Reddy said. “We need better predictors, better trend analysis, and real-time data for better glycemic management.”
As part of his talk, Dr. Reddy reviewed recent literature on other considerations related to inpatient glycemic management. The data addressed issues such as enteral nutrition, transplant surgery, steroid use, and glucose monitor reliability.
Other speakers during the morning workshop delved into detail about glycemic management in the hospital ICU, in transitioning patients from ICU to floor to home and the value of improved inpatient glucose management. The afternoon session focused on issues related to surgery in both thyroid and parathyroid surgery patients and pituitary and adrenal surgery patients.