OBJECTIVES

• The general objective of the project is:
  
  
  • to build a common European infrastructure for standardized information exchange in diabetes care, for the purpose of monitoring, updating and disseminating evidence on the application and clinical effectiveness of best practice guidelines on a regular basis

• To fulfill the general objective, we propose a plan based on the following rationale:
  
  
  • adoption of a systems approach to make best use of different sources of information

• promotion of an efficient use of available resources, using systems already in place at the regional level

• implementation of technical solutions to build comprehensive reports on a range of outcomes

• These principles underpin our logic of “Best Information through Regional Outcomes” (B.I.R.O.).

• The general objective will be pursued through the realization of the following specific objectives:

• • identification of a set of clinical guidelines based on the scientific literature
  • selection of a European minimum dataset for international comparisons
  • adoption of common Health and Quality Indicators for routine monitoring of diabetes outcomes
  • finalisation of a concept and data dictionary for information exchange and data processing
  • definition of standardized statistical analyses, in the form of report templates
  • design and implementation of a relational data model
  • design and implementation of statistical methods for the production of health reports
  • validation of a secure protocol for international communication and shared data analysis
  • customisation and development of specialized software to be deployed in the public domain
  • linkage of the different components in a user-friendly reporting facility
  • dissemination of all results through a web portal and a specialized publication

• Each of these objectives relates to a specific workpackage, presented in detail in the methodological/workplan section. The different components together constitute a coherent system that will be progressively built through the project collaboration. 

• This system is defined as “Shared European Diabetes Information System”,hereafter referred to as “SEDIS”. SEDIS, once realized, will represent an efficient and sustainable solution to perform the following tasks:

• - analysis of longitudinal trends and average outcomes in a diabetic population
  - identification of patterns of care and prevention consistently showing positive results
  - identification of population strata and/or practices that do not show effective results
  - verification of the application/applicability of best practice guidelines
  - on-field testing of collaborative information systems in chronic diseases
  

• Outputs of this proposal will support improved information at both the micro and the macro levels: they will facilitate activities for planning and management of diabetes care in regional health systems, delivering European institutions information directly applicable at the Community level.

The project will exploit the following leverage points:

• • multidisciplinary collaboration
  • protection of data ownership
  • privacy protection
  • shared information infrastructure
  • high level database and statistical technology
  • software publicly available

• Disease management is frequently represented by a quality improvement cycle, which incorporates changes from emerging best practice through the adoption of a systematic and comprehensive evaluation model. State-of-the-art disease management programs are characterized by: 1) a population-based systems approach; 2) proactive contacts and reminders; 3) patient-centred care; 4) accurate follow-up; 5) multidisciplinary teams; 6) focus on outcomes and outcomes-related processes; and 7) clinical information systems to improve quality of care.

• The availability of a system that has the ability to conduct rapid disease management evaluation at the European level is a valuable opportunity that will be properly tested in a critical area for chronic diseases and risk prevention such as diabetes. It is fundamental that the adoption of the disease management scheme is accompanied by clear and robust procedures for data exchange, whose structure we wish to define with accuracy in this project. The system that we propose to build, SEDIS, will operate on top of databases already available, in a way that could provide users with reliable information relative to: a) common patient management strategies, as expressed by agreed clinical guidelines, b) current average for the target patient categories in the particular geographical and social context; and c) measures of ‘global variability' in diabetes care in Europe.

  LINKS TO PREVIOUS EU PROJECTS

  EXPECTED RESULTS OF THE B.I.R.O. COLLABORATION

  FUTURE USE OF THE SHARED INFORMATION SYSTEM

  REFERENCES