Glucose control as a model for implementation of a clinical decision support system

Glucose control in acute cardiac disease is difficult to achieve and may improve patient outcome. Because glucose levels were high at the Intensive Cardiac Care Unit, and adherence to a paper protocol was low, a web based decision support system for glucose control was developed. A board view of the currently admitted patients is provided; new glucose values are retrieved along with insulin infusion rates and patient data from the Patient Data Management System. For each new glucose value a pop-up is generated with the protocol advised action for insulin dosage and time for the next glucose measurement. Temporal trends in glucose and insulin values are displayed as an additional aid. An evaluation database is included in the design to provide feedback to the users on protocol compliance and glucose control. These data will also be used to improve the protocol.