The Main Idea of the Article
The main idea presented in the article by Fisher & Dickinson (2011) is the use of self-management support (SMS) in the provision of patient care for patients who are undergoing diabetes treatment. It presents the problem of the negligence of patients as a major factor that necessitates the implementation of SMS in order to improve the efficiency of provision of care to them and improve recovery. A number of SMS techniques are explained. These include telephone-based techniques of self-management and web-based methods. It explains the processes through which these technologies can be integrated into the health care systems . It also recommends the involvement of practitioners in the implementation of these programs and technologies in order to adequately achieve their objectives and goals.
The Research Findings from the Article
The analysis of the article resulted in the finding that the problem of patient negligence is the reason why there is the need to implement a technology for coordinating their treatment and obtaining feedback from them regarding their condition whenever necessary. According to the article, the main functions of technology-based interventions during treatment of diabetes include: assessment of health conditions of patients, determining the symptoms contributing to their health conditions, and determining whether they are adhering to medication procedures which are recommended to be followed to enable them to achieve full recovery ( Fisher & Dickinson, 2011).
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The analysis of the particular use of SMS technology is illustrated as the method of enabling communication between physicians and patients to determine whether the latter are recovering from diabetes or the actual state of their blood sugar status when there are limited opportunities for the former to be around. It also illustrates the relevance of the technology in facilitating monitoring of changes in glycemic control process in a patient.
The article also explains the patients who are mostly targeted by the use of SMS technology by illustrating those in the poorly controlled environment and those who are less likely to look around for treatment of their diabetic conditions. Patients who are at high risk of being neglected and not being monitored should be provided with this technology to promote their communication with the relevant care providers. Other patient characteristics that are recommended for use when determining the target patients include age, sex, ethnicity, the level of educational achievement, symptoms associated with a disorder, and the patient’s competence in the use of a particular technology ( Fisher & Dickinson, 2011).
The media characteristics that are recommended for use when using the technology is the interactive voice recognition (IVR) which enables monitoring of symptoms for comparative shorts and simple communications involving patients and physicians such as when there is the need to know the clinical status of the patient. The limitations attributed to IVR technology is that it is tedious to use and cannot enable monitoring complex tasks ( Hussein, Hasan & Jaradat, 2011). This article also recommends the use of web-based audio and visual cues in enabling engagement of patients for longer durations of time. The effectiveness of SMS technology is stated to be achievable when those involved in its use create a match between particular SMS program and the patients to be monitored. Nevertheless, the article recommends the use of the technology to monitor any patients due to its relevance in the performance of this function. The limitation of the high cost of automated SMS technology has been explained as one of the reasons why it has not been implemented in most patient care organizations to enable monitoring patients experiencing diabetic conditions. Cost reduction is achievable by the use of initial personal contact and decrease in overtime, based on the needs of the patient and the relationship with the program ( Liang et. al, 2011).
Further, the study explains the procedure through which the program can be integrated into the ongoing clinical care. This is achievable by providing training to diabetes physicians and patients on the working mechanism of the technology and the provision of coordinated and informed services in cooperation with the needs of patients and their preferences. This should be followed by linking the SMS based technology of diabetes monitoring to the wider structure of patient management to ensure that the patients and care-givers have the awareness about the SMS functionality and effectiveness in order to integrate and coordinate the process of providing care. It also states that the implementation of a particular SMS based technologies requires an understanding of work flow and the process through which information is obtained from the technology can be utilized, simplified and utilized in a clinical environment. The person in the workplace who will be responsible for monitoring the SMS technology is also stated as important since its operations are subject to breakdowns and the need to restore it to its working condition ( Fisher & Dickinson, 2011).
It was found that the process of SMS program development, its implementation, and integration into diabetes monitoring in any health care facility is subject to the incurrence of costs which any organization should be prepared to meet. Schillinger et. al. (2009 argues that while it is not illustrated who should be responsible for the costs, the stakeholders such as the clinical group should advocate for its relevance in use during monitoring of patients with diabetes as a measure of promoting its implementation in the care for patients.
The article concludes that SMS technology of monitoring patients with diabetes will be a major contribution to the effectiveness of monitoring tasks and should be implemented in any hospital setting where patients with diabetes have been admitted.
References
Fisher, L., & Dickinson, W. P. (2011). New Technologies to Advance Self-Management Support in Diabetes Not just a bunch of cool apps! Diabetes care , 34 (1), 240-243.
Hussein, W. I., Hasan, K., & Jaradat, A. A. (2011). The effectiveness of mobile phone short message service on diabetes mellitus management; the SMS-DM study. Diabetes research and clinical practice , 94 (1), e24-e26.
Liang, X., Wang, Q., Yang, X., Cao, J., Chen, J., Mo, X. ... & Gu, D. (2011). Effect of mobile phone intervention for diabetes on glycemic control: a meta‐analysis. Diabetic medicine , 28 (4), 455-463.
Schillinger, D., Handley, M., Wang, F., & Hammer, H. (2009). Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes. Diabetes Care , 32 (4), 559-566.
