Northwest Herts diabetic management system

The Diabetic Management System was set up in Hemel Hempstead within the Dac orum district (population 119 515 with 2176 registered patients with diabet es). The objective was to create a clinical management system for all patie nts with diabetes in a district using a computerised clinical base. To achi eve this a database of agreed clinical information was collected from all g eneral practitioners within the district. From the computerised data we can identify those patients who do not have data recorded and can recall them for review. Consultant advice can be given on patients with special or mult iple risks identified from interrogation of the database. The outcome has b een a higher percentage of patients with diabetes receiving clinical review and achieving optimal clinical targets within the reviews. We already have recorded data on 85% for retinal screening and 75% for comprehensive annua l reviews. Conclusions drawn from the Dacorum Diabetic Management System ar e that effective diabetic care to a population can be provided by a combina tion of hospital and primary care. Primary care needs to be supported by ad equate consultant advice with continued monitoring of the whole population to ensure standards are met. This system achieves this without increased ho spital referrals. (C) 2000 Elsevier Science Ireland Ltd. All rights reserve d.