Knowledge-Based Personal Health System to empower outpatients of diabetes mellitus by means of P4 Medicine

Methods Mol Biol. 2015:1246:237-57. doi: 10.1007/978-1-4939-1985-7_15.

Abstract

Diabetes Mellitus (DM) affects hundreds of millions of people worldwide and it imposes a large economic burden on healthcare systems. We present a web patient empowering system (PHSP4) that ensures continuous monitoring and assessment of the health state of patients with DM (type I and II). PHSP4 is a Knowledge-Based Personal Health System (PHS) which follows the trend of P4 Medicine (Personalized, Predictive, Preventive, and Participative). It provides messages to outpatients and clinicians about the achievement of objectives, follow-up, and treatments adjusted to the patient condition. Additionally, it calculates a four-component risk vector of the associated pathologies with DM: Nephropathy, Diabetic retinopathy, Diabetic foot, and Cardiovascular event. The core of the system is a Rule-Based System which Knowledge Base is composed by a set of rules implementing the recommendations of the American Diabetes Association (ADA) (American Diabetes Association: http://www.diabetes.org/ ) clinical guideline. The PHSP4 is designed to be standardized and to facilitate its interoperability by means of terminologies (SNOMED-CT [The International Health Terminology Standards Development Organization: http://www.ihtsdo.org/snomed-ct/ ] and UCUM [The Unified Code for Units of Measure: http://unitsofmeasure.org/ ]), standardized clinical documents (HL7 CDA R2 [Health Level Seven International: http://www.hl7.org/index.cfm ]) for managing Electronic Health Record (EHR). We have evaluated the functionality of the system and its users' acceptance of the system using simulated and real data, and a questionnaire based in the Technology Acceptance Model methodology (TAM). Finally results show the reliability of the system and the high acceptance of clinicians.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / prevention & control*
  • Diabetes Mellitus / therapy*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Knowledge Bases*
  • Male
  • Middle Aged
  • Outpatients*
  • Patient Participation / methods*
  • Precision Medicine / methods*
  • Risk Assessment