Diabetes Care and Treatment

The major goals of this continuing project are the establishment of a telemedicine system for comprehensive diabetes management and the assessment of diabetic retinopathy that provides increased access for diabetic patients to appropriate care, that centralizes the patients in the care process, that empowers the patient to better manage their disease, that can be performed in a cost effective manner, and that maintains the high standard of care required for the appropriate management of diabetic patients. The aim of this program of research will be to perform the appropriate clinical validation, cost efficiency, and risk benefit studies associated with the use of the recently developed Comprehensive Diabetes Management Program CDMP and the Joslin Vision Network JVN Eye Health Care Program that is now a module of the CDMP. These research studies and the implementation of CDMP were originally planned at Tripler Army Medical Center TAMC in Honolulu, HI. Because the decision was made at TAMC to accelerate the adoption of a new electronic medical record AHLTA, implementation of the CDMP was delayed indefinitely. Consequently, alternative sites were chosen for these research studies and the implementation of the CDMP Waianae Coast Community Health Center, Waianae, HI The Physicians Center at Mililani, Mililani, HI and the Molokai General Hospital, Kaunakakai, HI. Retinal imaging with a JVN system was implemented into an additional site, Koolauloa Community Health Center.