Most persons with diabetes mellitus in the USA are considered healthy. Consequently, they receive standard, primary care without major concern for their diabetes 'condition'. However, all are at risk of joining a small number who together draw a disproportionate share of all health resources for their acute and long-term medical care because they develop complications. This number is growing. Scientifically, it is now proven that expert medical intervention can significantly alter the rate of these long-term complications and therefore slow the growth in this number. The hypothesis is that the added costs of improved care for all members with diabetes can be met by confluent reductions in their acute care needs, given that this occurs in a managed care setting and is done through existing primary care resources empowered with information technology. Specifically, a computer system (HumaLinkTm) developed for and tested by medical experts is to be adapted to the needs of primary practitioners and applied to support their care of patients. The computer is on-line, voice interactive and assists the patient in daily control of their own blood glucose levels. Costs, savings and times spent are to be calculated. Metabolic outcomes will be measured before and after one year. For comparison a control group will include matched sites practicing similar care objectives manually, ie., without this computer support. PROPOSED COMMERCIAL APPLICATION: Computer-assisted home management of diabetes offers a significant commercial opportunity as systems for this purpose will potentially be needed in all managed care centers.
