Glycemic Management System of Tcvgh: Taichung Veterans General Hospital

Inadequate glycemic control in hospitalized patients with diabetes is associated with increased healthcare costs, higher complication rates, and worsened clinical outcomes. Improved glycemic management for hospitalized diabetic patients has been shown to significantly reduce healthcare expenditures and enhance clinical outcomes. In response to this challenge, we developed a dynamic dashboard integrated with a remote management system and assessed its impact on inpatient glycemic control.

This program tackled the issue by leveraging technological innovations and process improvements to optimize glycemic management. A dynamic, electronic medical record (EMR)-based dashboard and a virtual glucose management service were implemented to provide real-time analysis and continuous monitoring of glucose levels across the patient population. Key process enhancements included the integration of point-of-care (POC) testing data directly into the EMR, facilitating automated daily updates on patient glucose levels. Furthermore, endocrinologists delivered virtual glycemic management recommendations to ensure timely and effective interventions.

Implementing of these tools and process improvements resulted in substantial improvements in glycemic control. There was a 43% reduction in the proportion of patients with poor glycemic control, a 43% reduction in hyperglycemia (glucose > 300 mg/dL), a 50% reduction in hypoglycemia (glucose < 70 mg/dL), and a 57% reduction in severe hypoglycemia (glucose < 50 mg/dL). Additionally, the mean length of hospital stay (LOS) decreased by 40.4%, from 13.6 days to 8.1 days.

The adoption of a hospital-wide electronic remote glycemic management system led to significant improvements in glycemic control, reducing both hyperglycemia and hypoglycemia incidences, as well as shortening the length of hospital stay. These findings suggest that this approach may also reduce the cost of avoidable hospitalizations, underscoring the potential of integrating technology to enhance diabetes care in the hospital setting.