Role of information technology in managing chronic illnesses

We applied information and Internet technologies to help people living with congestive heart failure (CHF) and diabetes. We provided home monitoring technologies to older patients living with CHF and supported them with case managers who had access to their daily vital signs. For diabetes, we provided diabetic patients a web site where they could visualize their daily readings, communicate with their healthcare provider, and gain educational materials approved by their provider. Individuals with diabetes can electronically transfer their blood glucose readings from their meter to the Internet based diabetes management system, MyCareTeam, developed at Georgetown University. Both patients and their health care providers use MyCareTeam to review the readings and the automated analysis of them, to maintain logs of exercise, laboratory results and blood pressure readings, to make medication adjustments and to message each other. Patients learn about diabetes from their own blood sugar values as well as from the interactions with their providers and the educational material. MindMyHeart provided a blood pressure monitor, scale, and electronic question device to CHF patients to use daily to record their vital signs and answer questions about their basic health (fatigue, and shortness of breath). These values were automatically transferred to a centralized database where they were reviewed by a nurse case manager and acted on as appropriate. In studies with MyCareTeam, statistically significant improvements in blood sugar control was seen in as short as six-months. With MindmyHeart, a decrease in hospitalizations and emergency visits was observed. The information technology is becoming an essential tool for managing chronic illnesses, but it alone is not sufficient to achieve the improved clinical outcome.