Proposal for Business Case Analysis for Diabetes Term Paper

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¶ … Business Case Analysis for Diabetes

Cleveland Clinic

Achieving the overall business plan of the organization

Diabetes Monitoring will Strengthen this Institution

Using it Tools will Strengthen Loyalty to the Clinic

Positive Partnering with the Patient and the Clinic's Staff

Patient Outcomes are Improved


Staff is Competent to Use the Technology

Organization is Ready to Employ this Technology

Improving Access and Service to Patients


The technology facilitates providing a safe workplace


The technology inter-interfaces with current IS systems in the organization

The technology can be utilized with minimal investment with other equipment (i.e. PCs, video cameras).

The organization has sufficient it staff to support the technology.

The software has been tested and demonstrates usability and viability.

The technology is consistent with the long -- "term IS plan of the organization.

The technology has strong user support.

The technology will assist in streamlining existing manual methods




This proposal concerns the introduction of a diabetes it program for the Cleveland Clinic, following on our successful eClinic initiative to involve patients in their heart care.

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The primary reasons for focusing on diabetes are the following:

Diabetes is one of the leading causes of death in the United States.

Much of diabetes care has to do with lifestyle, which is a community- as well as hospital-based set of strategies. That's why an it strategy would be particularly well-suited to this initiative.

Diabetes' co-morbidities are well-known, and can be reversed in this model.

Term Paper on Proposal for Business Case Analysis for Diabetes Assignment

There is a great deal of information which needs to be collected and analyzed, both by the patient and by the health care provider.

The product presented here is a home health care diabetes monitor which is web-based, but uses some of the digital download capabilities of common glucose testers (although such a liaison is not necessary for the program to work). Monitoring blood glucose levels and recording them on an internet interface allows both the patient and the healthcare providers to ensure that compliance is being monitored. By adding other indicators, including body weight and key diet variables, the patients give a way for their families and healthcare providers to ensure that the patient is on the right path. This paper will demonstrate that the patient's closer monitoring will result in better outcomes, and a better financial picture for the Cleveland Clinic.

Cleveland Clinic

From its founding to its current status as one of the leading healthcare institutions in the world, the Cleveland Clinic has been run by physicians who seek to improve patients' outcomes and quality of life. Towards this goal, the Cleveland Clinic has become the premier heart care center in the world, for heart surgery, heart interventions, vascular disease and on-going heart care (Saydah, 2004).

This diabetes initiative will build on the strengths of the Cleveland Clinic in the heart and vascular area, and attack a major cause of vascular disease. The treatment of Type II diabetes, which is related to obesity, lends itself particularly well to home- and community-based tracking and compliance. The treatment of Type I diabetes, in some ways more life-threatening, also lends itself well to regular monitoring of the patient, and can be built into a feedback loop which improves compliance, and therefore the outcome for the Type I diabetes patient.

Achieving the overall business plan of the organization

It has been established in the literature that better diabetes control results in improved patient outcomes (Dunning, 2006) (BCM, 2007). Better compliance means more accurate timing of insulin injections for insulin-dependent patients, better control of glucose, weight and diet. All those elements can be controlled by the family and the patient in a home setting, and can be demonstrated to improve patient outcomes.

Since the Cleveland Clinic has many patients on a capitated basis, the ability to reduce the side-effects of diabetes could result in a significant reduction of the sequelae from poor diabetes control. These can include fewer heart attacks, fewer problems related to obesity, improved eyesight and the reduction of other vascular disease consequences, including stroke and peripheral vascular disease (Thompson, 2006).

Diabetes Monitoring will Strengthen this Institution

Diabetes monitoring at home is a logical extension of the work done at the Cleveland Clinic. That is because our institution serves patients who are obese, who have vascular problems, and who have other results of diabetes. By reaching out to the community and helping diabetes sufferers, we offer both a continuation of their treatment in the Clinic, as well as an early-warning method which ties those patients to our institution.

By tending to those patients within our capitated health plan, we can assure better compliance, and therefore lower patient costs. Given that the greater Cleveland area is home to 1.1 million people, and the number of diabetics is estimated at 44,000 people. This means that the Cleveland Clinic can offer outpatient services using it which improve our overall market coverage and improves patient care.

Using it Tools will Strengthen Loyalty to the Clinic

As we have seen with the eClinic initiative, web-based tools have a broad appeal in the community. By enlisting the diabetes patient and his/her family, we are therefore able to improve self-monitoring, and point to problems before they result in symptoms which require hospitalization.

In addition, when the patient comes to a Cleveland Clinic-associated doctor's office, or to the Clinic itself, the treating physician and other healthcare professionals have access to that patient's compliance record, with such items as weight, glucose levels and diet monitored in a way that ensures that compliance is or is not an issue in the patient's presentation.

Positive Partnering with the Patient and the Clinic's Staff

One of the most difficult things to judge is the patient's self-reported history at the time of admission or doctor's office visit. There is some reason to question the accuracy of patient's self-declared compliance and glucose monitoring (MedScape, 2007). To the degree that the patient's recalled therapy compliance can be corroborated by additional information (weight, measured glucose levels -- including when taken and how often per day), the doctor's decision about the clinical course for the patient can be improved.

Patient Outcomes are Improved

In addition, there is a benefit to the patient in self-monitoring using it tools. The patient's review of his/her records at home gives an impetus to insure that the measurements are being taken accurately.

This also gives the patient's family a way to positively participate in their family member's care (Rosenstock, 1985). Research of the literature has found that self-monitoring improves not only patient compliance, but offers additional diagnostic evidence for the physicians concerned (Marks, 2005).


Staff is Competent to Use the Technology

Since the staff has now worked with the eClinic initiative for 5 years (Clinic, 2007), the patients and physicians are accustomed to having access to the patients' records using online resources, whether in the Clinic or outside it in an outpatient or doctor's office setting. For that reason, adding the diabetes monitoring tools will be a helpful addition to an already-known tool (Clinic, 2007).

There is a concern about the patients' use at home. While this may have been a concern 5 years ago, it is clear that most of our target market has internet access and a computer, and is able to perform the needed functions. Since many of the treated diabetes patients are older, it is reassuring to know that most Americans in that age group are likely to be friendly to such an approach; if not, their spouses and family can provide assistance (eMarketer, 2007).

Organization is Ready to Employ this Technology

Compliance is one of the biggest concerns expressed by physicians and other health care workers with diabetes patients. Although many can have their glucose and other conditions brought under control when they visit the hospital, there is nevertheless a significant problem. According to a 2000 JAMA article:

What's the hardest thing about taking care of people with diabetes? Many health professionals would answer that patients with diabetes do not do what they are told. It is common to hear them express frustration and sorrow that their patients just don't follow their diet or exercise plans, that they don't check their blood sugars or even take their medicines. (Funnell, 2000)

This proposal can therefore address one of the most difficult issues for our physicians and staff: the fact that patients come to our institutions many times due to lack of compliance to relatively straightforward regimens, including diet, exercise, glucose monitoring and taking the necessary medications.

Improving Access and Service to Patients

The overall goal of this program is threefold: increase patient health, improve patient outcomes, and enrich the patient-physician interaction when such a visit is called for. By following up in-hospital and in-office treatments with compliance monitoring, the physician can focus on the patients' compliance without necessarily requiring frequent visits.

Once the initial tools are put in place, it will then be possible to extend the service in two directions:

Provide the information to diabetes care nurses who can give fairly… [END OF PREVIEW] . . . READ MORE

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