2. This project is
focused on the
creation of a
Gestational
Diabetes Clinical
Decision Support
System.
3. What is Gestational Diabetes ?
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.
5. Cost of GDM to 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 to Successful 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 by Ob-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
All moms 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 for Pharmacological
Treatment of GDM
http://spectrum.diabetesjournals.org/content/20/2/101/F1.expansion.html
12. Significance of the Technology 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
