Plenary Conference: Data management. The bridge between biology and technology

Abstract

In Chile, the prevalence of type 2 diabetes mellitus is of a 12.3%. The public system monitors 920,219 patients, of which a 19% has HbA1c levels higher than 9%, with a 26.8% of insulinization, with an actualized 36.4% of ocular fundus, and, reaching the triple-goal (LDL/AP/HbA1c), only a 20%. Knowing this data has led us to propose a different working method. To be able to obtain better results locally, we have implemented different strategies, such as telemedicine, a platform where the healthcare specialist can be of assistance, modifying the basic pharmacological kit to suite patients with greater cardiovascular risk. This last implementation has resulted in an improvement in the indicators of the service of our cardiovascular program within 6 month of it being applied. This has allowed us to calculate the number of incidents prevented annually and the cost associated that the health system has been able to spare. Nevertheless, it is quite complex to attribute this improvement in diabetes control to one particular measure. After 2 years of work, we have observed that the lack of adherence from the patients, the therapeutic inertia of the healthcare team, the failure in keeping a strict monitoring of the patient via electronic registers, and the lack of a suitable pharmacologic monitoring, connected to social adverse determiners affecting the people in control, may lead to the non-obtainment of health goals, with an important increase in the economic cost of attention. That is without considering the effects this may have over the morbidity and mortality of this particular group of patients. Data recollection and evaluation has led us to reconsider the caring strategies, diagnosing their weaknesses, evaluating the application of probabilistic and precision to have a greater cost-effectiveness ratio, in an attempt to get it implemented at a national scale.