eHealth Supported Diabetes Management

Electronic healthcare (eHealth) is a technology that can be used to support patients and healthcare professionals in the management of diabetes care. In this thesis we assess two eHealth applications that can be used in the management of diabetes. In the first part a diabetes patient portal was evaluated. The main barrier to portal use was unawareness. Furthermore, not all patients with a login were actual users, those who stopped using it had more trouble understanding portal content and found the portal not very useful. Different people have different wishes for improvements. A uniform patient portal is not fit for all and different types of patients need different types of portals. In the second part the effects of a prompt in the medical record was evaluated. This prompt alerts the healthcare professional if a patient with diabetes is not treated in the correct treatment setting according to a national agreement (LTA) between primary and secondary care. We found that over 50% of patients with type 2 diabetes were not treated in the setting stipulated by the LTA and alerting the health care professional does not change this situation. However, the alert led to a small improvement in quality of care. The content of the LTA needs to be discussed with the health care professionals and a more extensive agreement procedure is necessary to improve diabetes care