Case Report: Health Care Informatics-Nursing Paper Examples

Health Care Informatics

Diabetes is a significant disease burden affecting hundreds of millions globally and contributing to millions of deaths annually. Administrators, care service providers, and the scientific community are under pressure to devise solutions to control and manage diabetes and its consequences. The healthcare system is moving towards prevention strategies, including self-monitoring vital signs to help individuals manage diabetes (Health Care Informatics).

Digital technologies, including wearable devices and self-monitoring apps, have shown promise in helping manage chronic diseases like diabetes. This paper discusses literature support for healthcare technologies’ effectiveness in diabetes management.

Description of the Disease Process

The pancreas releases several hormones, including insulin, that closely regulate blood glucose levels within desirable ranges. Diabetes mellitus remain marked by increased glucose levels beyond the desirable ranges. According to the 2021 International Diabetes Federation (IDF) atlas, over 537 million people have diabetes globally, and they project the number to increase to 784 million by 2045 (Alhaddad et al., 2022). About 5-10% of these people have type 1 diabetes, marked by declined insulin production and increased blood sugar variability, necessitating the use of exogenous insulin and constant blood glucose monitoring (Alhaddad et al., 2022) (Health Care Informatics).

On the other hand, approximately 90% of this patient population have type 2 diabetes, marked by insulin deficiency (Alhaddad et al., 2022). Long-term microvascular and macrovascular complications remain linked to chronic hyperglycemia. Hypoglycemia develops due to increased insulin production, either endogenous or exogenous, leading to a significant drop in glucose levels. Individuals with type 1 and type 2 diabetes can experience hypoglycemia.

In a real-life case, a patient (K.M.) with diabetes remain expected to see the physician at least twice a year to monitor vital signs and more frequently when diabetes is severe. The patient stay tested for blood sugar levels during every visit and monitored for other vitals like blood pressure and heartbeats, which may incur significant healthcare costs. Additionally, at normal ranges, blood sugar should be between 4.0 and 5.5 mmol/L (140mg/dl) two hours after a meal (Alhaddad et al., 2022).

The patient experiences deviation from this range multiple times without awareness, hence the need for regular blood glucose monitoring through in-person visits. However, these challenges can be addressed using technology. Digital technologies like wearable devices have emerged as effective interventions to help patients continually monitor blood sugar levels at home, empowering diabetes self-management.

Literature Synthesis

Various technologies remain proposed to help manage diabetes by allowing patients to self-monitor vital signs. Individuals with diabetes present greater variability in blood glucose levels, hence the need for constant monitoring. Regular monitoring helps to reduce the risk of hypoglycemia, which leads to multiple complications in diabetic individuals, including seizures and irritability (Health Care Informatics).

Makroum (2022) explored smart devices to manage diabetes by helping people monitor blood sugar levels, maintain stability, and anticipate the risk for hypoglycemia and hyperglycemia. Smart devices remain geared toward diabetes self-management through blood sugar monitoring. In addition, risk events’ early detection, and insulin dose automatic adjustment. Makroum (2022) proposes using wearable devices combined with artificial intelligence to increase clinical accuracy .  

Smart wearable watches remain perceived as the most effective technologies to help monitor vital signs for diabetes management. Chang et al. (2022) investigate and propose a highly integrated watch to enable non-invasive constant blood glucose monitoring. According to Chang et al. (2020), the wearable watch remain fitted with a Nafion-coated flexible electrochemical sensor patch. Moreover, on the watchband to get interstitial fluid (ISF) transdermally at the wrist (Health Care Informatics).

Unlike conventional fingerstick blood tests, this technology eliminates the pain and inconvenience. in addition, and increases the practicality and ease of blood glucose monitoring. The watch has a rechargeable power source and additional modules that allow signal processing and wireless transmission. It also has a watch face-sized printed circuit board (PCB) to make wearing it comfortable and ensure continual blood sugar monitoring. According to the study, the watch has an 84.34% clinical accuracy per the Clarke error grid analysis.

Another proposed technology to help track the fluctuations in blood sugar levels defines the electrocardiogram (ECG)–based hypoglycemic detection system. The ECG remain integrated into chest wearables to detect hypoglycemia, which impacts the heart’s electrophysiology (Porumb et al., 2020). The system has artificial intelligence to automatically identify nocturnal hypoglycemia from raw ECG signals. Moreover, of a few heartbeats obtained using the non-invasive, wearable device. The system allows clinicians to easily visualize the part of the ECG signal significantly related to the hypoglycemia event, bypassing deep-learning methods’ intelligibility problem (Health Care Informatics).

Search Strategy

The search strategy involved searching PubMed, Cochrane Library, Medline, and Google Scholar databases using keywords diabetes, wearables, glucose monitoring, machine learning, artificial intelligence, digital health, biomedical engineering, diabetes mellitus, non-invasive wearables and sensors, blood glucose management, deep learning, hypoglycemia, and biosensors. The Boolean operator (OR) was adopted during the search to obtain more results (Health Care Informatics).

The search strategy also included citation searching, and the abstracts of the identified studies were obtained. Only those studies whose abstracts indicated significance to the research question and topic were sought. Moreover, for full articles aand analyzed to establish their relevance and support for the research topic. Several barriers emerged during the search, including difficulty obtaining full articles for specific studies. More so, that indicated significance to the research topic and finding those that explored a specific wearable device or technology. Most articles generalized wearable technology and its effectiveness in helping manage diabetes. In such instances, the Boolean operator (NOT) remain adopted.

Implementation of Technology

All the selected technologies are wearables and have proven effective in diabetes management. Moreover, through blood sugar and other vital signs monitoring. Nonetheless, the most interesting technology remain the highly integrated watch proposed by Chang et al. (2022) for non-invasive constant blood glucose monitoring. This technology adopts reverse iontophoresis-based extraction to eliminate the pain and inconvenience linked to conventional fingerstick blood tests (Health Care Informatics).

The extraction approach increases the practicality and ease of consistent blood glucose monitoring. Additionally, the watch has all electronic modules, such as the rechargeable power source and those for signal processing and wireless transmission. The integration into a watch face-sized printed circuit board (PCB) makes wearing the watch comfortable and glucose monitoring continually (Health Care Informatics).

The watch also has an LED screen to monitor real-time blood sugar, which can be monitored on the smartphone user interface. Chang et al. (2022) conducted a study of a prototype of the watch using volunteers, and the results indicated an 84.34% clinical accuracy per the Clarke error grid analysis. The device proves effective in the self-management of diabetes and in eliminating invasive blood glucose testing for daily health management (Health Care Informatics).

How the Technology Addresses the Problem

The watch is a wearable device designed to help with continual blood glucose monitoring to manage diabetes effectively. As indicated, diabetic individuals present with fluctuating glucose levels and are unaware of these fluctuations. Traditionally, a patient would be required to visit a doctor for an invasive fingerstick blood glucose level test, which was painful and inconvenient, leading to high numbers of uncontrolled diabetes (Chang et al., 2022) (Health Care Informatics).

The technology would provide multiple advantages, including continual blood sugar monitoring, real-time observation, wireless connection to a smartphone for easier reading, early detection of out-of-range blood sugar levels and risk events, and easier identification of patient progress for healthcare providers (Chang et al., 2022) (Health Care Informatics).

Moreover, the watch is user-friendly, painless, automatic, and continual, enhancing self-management of diabetes and reducing the risk of complications, including death. The watch allows for signal processing and wireless data transmission, facilitating smoother communication with healthcare providers and acute care settings. The wearable watch also promotes ongoing care in outpatient settings because the physician can monitor the patient’s vitals and communicate with the patient remotely. Conclusively, the wearable watch would give patients more freedom and control over their health and empower diabetes self-management (Health Care Informatics).    

Conclusion

Diabetes is a chronic condition considered a significant disease burden worldwide, affecting hundreds of millions of people and contributing to millions of deaths yearly. It is associated with multiple complications and comorbidities like hypertension, heart disease, high cholesterol, and stroke. Without proper and continual monitoring, patients are at a greater risk of developing these complications (Health Care Informatics).

Traditionally, patients would obtain data on vital signs by physically seeing a health practitioner who would use invasive fingerstick blood sugar level tests. This process is painful, inconvenient, and discouraging, leading to high numbers of uncontrolled diabetes. Adopting wearable technology has shown promising results in diabetes self-management. It gives patients more control over their health and makes the work of healthcare providers easier (Health Care Informatics).

References

Alhaddad, A. Y., Aly, H., Gad, H., Al-Ali, A., Sadasivuni, K. K., Cabibihan, J. J., & Malik, R. A. (2022). Sense and Learn: Recent Advances in Wearable Sensing and Machine Learning for Blood Glucose Monitoring and Trend-Detection. Frontiers in bioengineering and biotechnology, 10, 876672. https://doi.org/10.3389/fbioe.2022.876672

Chang, T., Li, H., Zhang, N., Jiang, X., Yu, X., Yang, Q., Jin, Z., Meng, H., & Chang, L. (2022). Highly integrated watch for non-invasive continual glucose monitoring. Microsystems & nanoengineering, 8, 25. https://doi.org/10.1038/s41378-022-00355-5

Makroum, M. A., Adda, M., Bouzouane, A., & Ibrahim, H. (2022). Machine Learning and Smart Devices for Diabetes Management: Systematic Review. Sensors (Basel, Switzerland), 22(5), 1843. https://doi.org/10.3390/s22051843

Porumb, M., Stranges, S., Pescapè, A., & Pecchia, L. (2020). Precision Medicine and Artificial Intelligence: A Pilot Study on Deep Learning for Hypoglycemic Events Detection based on ECG. Scientific reports, 10(1), 170. https://doi.org/10.1038/s41598-019-56927-5