D-WISE: Diabetes Web-Centric Information and Support Environment: Conceptual Specification and Proposed Evaluation

• Published in: Canadian journal of diabetes Vol. 38; no. 3; pp. 205 - 211
• Main Authors: Abidi, Samina, PhD, MBBS, MSc, Vallis, Michael, PhD, R Psych, Raza Abidi, Syed Sibte, PhD, MS, BE, Piccinini-Vallis, Helena, MD, MSc, CCFP, Imran, Syed Ali, MBBS, FRCP, FRCPC
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Inc 01-06-2014
• Subjects: Access to Information; aide à la décision clinique; behaviour change; Canada; changement du comportement; clinical decision support; Decision Support Techniques; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; diabetes self-management; Endocrinology & Metabolism; Evidence-Based Practice; Female; healthcare knowledge modeling; Humans; Internet - economics; Internet - utilization; Male; modélisation des connaissances en matière de soins de santé; Other; Patient Education as Topic - economics; Patient Education as Topic - organization & administration; prise en charge autonome du diabète; Risk Reduction Behavior; Self Care - economics; Self Care - psychology; Social Support; Software; Telemedicine - economics; Telemedicine - utilization; Canada; modélisation des connaissances en matière de soins de santé; changement du comportement; clinical decision support; healthcare knowledge modeling; behaviour change; diabetes self-management; prise en charge autonome du diabète; aide à la décision clinique
• ISSN: 1499-2671; 2352-3840
• DOI: 10.1016/j.jcjd.2014.03.006

Abstract Objective To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. Methods The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. Results We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. Conclusions D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control.