Impact of a Computerized Guidelines on the Management of Hypertension and Diabetes

Diabetes Mellitus, Hypertension

Guideline based decision support system, Hypertension, Diabetes

The purpose is to determine wether an electronic decision support system based on national guidelines is effective to improve the follow-up and the treatment of two conditions: hypertension and diabetes, in primary care practices.

Existing computer-based ordering systems for physicians provide drug-centred checks but offer little assistance for optimizing the overall patient-centred treatment strategy. The ASTI project aims : 1. to design a guideline-based decision support system for diabetic and/or hypertensive patients, to help general practitioners : 1. to carry out procedures (clinical and biological tests) according to guidelines (the recommended procedure at the recommended moment), and to get a synthetic view of all the elements they need to follow-up the patient 2. to avoid prescription errors and to improve compliance with therapeutic guidelines. The critic mode operates as a background process and corrects the physician's prescription on the basis of automatically triggered elementary rules that account for isolated guideline recommendations. The guided mode directs the physician to the best treatment by browsing a comprehensive guideline knowledge base represented as a decision tree. 2. To measure the impact of ASTI when it is implemented with an electronic medical record system. We adopt a randomized design, with the practice as the unit of randomization.

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France