Building a certificate-based secure and quick response telemedical health-care system for diabetic patients

The internet has begun to play a greater role in many health-care processes. To improve the quality of diabetes control while safeguarding and keeping the patient's information confidential, a certificate-based and quick response telemedical health-care system can be used to devise a program which allows patients with diabetes to transmit their self-monitored blood glucose data directly from their personal glucometer device to their diabetes care provider over the internet. The system can integrate the remotely transmitted glycemic data to a secure database for retrieval by physician to analyze at a later time. If unusual or alarming trends are detected by an intelligent agent (IA) system, both the physician and patient are notified of the occurrence. Patients are also allowed to access clinical data through web-based interface. We hope that this initiative can improve the quality of diabetic care. The aim of this study was to evaluate the effectiveness of a quick response telemedical health-care model to biomonitor type 2 diabetic patients attending the diabetic OPD of Mackay Memorial Hospital and Taipei Medical University Hospital. A total of 134 unrelated type 2 diabetic patients were included in a 6-month prospective study. They were categorized into either the experimental or the control group. The experimental group was monitored using our telemedical health-care system for 6 months. The control group received the usual outpatient management over the same period. We compared the differences in HbA1c and fasting plasma glucose levels before and at the end of the study, both in each group as well as between the experimental group and the control group. Initially, there is no significant difference in either fasting glucose levels or HbA1c between the experimental group and control group. At the end of the study (6 months later), there were significant changes in fasting plasma glucose when compared with the initial data, both in the experimental group (179±61 mg/dl vs. 241±77 mg/dl, p