Case study: Jeffery is an 18-year old high school senior, living in a rural area
ID: 300294 • Letter: C
Question
Case study: Jeffery is an 18-year old high school senior, living in a rural area and is newly diagnosed with Type I diabetes following an acute hyperglycemic episode which required hospitalization. After four days he is medically stable and ready for discharge. He is able to measure his blood glucose and can safely administer the appropriate dose of insulin. The nurse notes that Jeffery sometimes has trouble calibrating the insulin dose to the blood glucose reading. She also notes that his father is short and impatient with Jeffery, expressing many concerns that Jeffery “may not be able to handle such a complex medical problem on his own”. A classmate tells Jeffery – “it’s too bad you have diabetes, all guys with diabetes become weak sooner or later”. Later that night, Jeffery goes on the Internet and tries to find out if his friend’s dire warning is true. Two weeks later Jeffery’s physician notes a slight but persistent rise in his blood glucose readings. He sends Jeffery a message on the Palm to schedule an appointment and review the medication administration strategy. Later realizing that Jeffery regularly tests his blood but doesn’t always record the insulin dosing, the physician and nurse set up a plan for Jeffery to message them at each dose administration point. They use this messaging to provide reassurance, encouragement and to insure that the medication is actually being taken. After Jeffrey misses two scheduled visits, the Diabetes Educator calls see what is the matter. Jeffery explains that it is a three hour drive from his home to the diabetes center and that his father had trouble taking time off from work to drive Jeffery. The Diabetes Educator notes that Jeffery lives in a rural area and is eligible to receive educational services via teleheath. She signs Jeffery up to receive a Home Telehealth Unit and schedules delivery. After the unit arrives, Jeffery rarely misses a video education session. At one visit, Jeffery complains that is father is always “on his case” about his injections. She schedules the next video visit during an evening when Jeffery’s father can attend. She also schedules Jeffery to have a video visit with the dietitian. Health Informatics Department HCI 314 3 This case study is adapted from Shortliffe E.H. (2009)
Discussion questions: 1. Diabetic patients, like Jeffery, typically meet with their physician every two to six months to review data and plan therapy changes. And off course Travel has costs. - From above case select an information system that is serving diabetic patient in managing their chronic disease and describe the advantage and disadvantage of using this system in public health?
2. Patients like Jeffery need quick, private access to accurate information that can calm fears and ensure direct access to currently accepted treatment for their illness. How can computer technology in the health fields help in providing such information?
Explanation / Answer
Diabetic patients need to chech their blood glucose level regularly. Hence many new point-of-care diagnostic tests are available that will help in monitering the blood sugar level at home. This is will a quick result and aviod visiting to the docter for blood test. The patient can check his/her sugar level at home and can visit the docter in emergency condition only.