Audit-feedback web application supporting medical follow-up of patients with diabetes in primary care

Reflex-D is a web application that provides information on the management of patients with diabetes in a family medicine group (GMF) in a context of quality improvement. It is developed to demonstrate the usefulness of the Learning Health and Social Services Research Platform (PARS3) in real life.

As part of a quality improvement project, Reflex-D gives clinicians a view of their diabetic patients’ data and offers them two approaches to analyze their practice.

Filtering patients

The first step is to identify the group of patients you are interested in using various characteristics. For example, a clinician could be able to select a population of patients who did not receive metformin while currently receiving insulin.

Once the population is selected, the clinician can explore this population in two ways: comparative analysis and individual analysis.

Comparative analysis

This tool allows a clinician to compare one’s practice with the whole clinic.

The clinician will be able to see the percentage of patients who have had a glycated haemoglobin (HbA1c) result outside the treatment targets, as shown in the graph below.

The clinician will also be able to see the distribution of medication classes used in the context of diabetes management.

Individual analysis

This tool allows the clinician to analyze each one of his/her patients belonging to a population along various parameters, including INESSS indicators.

For each patient, the tool displays graphically the pharmaceutical history as well as the latest lab test results for creatinine and HbA1C.

Here is an example with Skylar Dean data, a fictional patient.

The graph below shows the evolution of the patient lab results (HbA1c and creatinine) over time in regard of the medication used. Other tables will show in a table format the latest laboratory test and active medication.

Finally, the clinician will be able, with the result of the latest glomerular filtration rate test, to find out if one of the patient’s active medications is contraindicated.

Screen capture video

 The following video shows in action how a clinician might choose to use the tool.