Started off in February 1996, DiabCare Q-Net, as a three year initiative, forms part of the European Commission's Telematics Applications Programme. The project's goal is threefold and consists in the development of a European quality network for diabetes benchmarking, the improvement of diabetes care and prevention, and the application of telemedicine in the form of image and video information to detect retinopathy and to remotely examine foot and leg ulcers. For this purpose, a telemedicine demonstrator has been designed. The project partners hope to achieve on all national, regional and local levels within Europe, the efficient functioning of a service centres' network for the evaluation and optimization of diabetes care. Health providers will be able to access and link the latest guidelines to their own data.
Diabetes is a disorder of the metabolism, which if not properly taken care of, can lead to disability or even death. Normally, the pancreas automatically produces a sufficient amount of the insulin hormone to regulate the level of glucose within the blood. In patients suffering from diabetes, however, the pancreas either produces little or no insulin at all, or the produced insulin fails to help the glucose get into the body cells. As a result, too much glucose builds up in the blood and is secreted by the body without having passed its energy to the cells. Patients develop a range of typical symptoms, such as increased thirst and urination, constant hunger, loss of weight, blurred vision, great tiredness, frequent infections, and slow healing of sores. If the patient neglects these signals, the disease might cause blindness, heart strokes, kidney failure, gangrene or nerve damage.
The core of the DiabCare Q-Net system constitutes the Basic Information Sheet (BIS) and the data entry and feedback software, which exists in two forms, the DiabCare Data for Windows and the DiabCare Fax System. By means of these tools, general practitioners (GPs), nurses and physicians are able to transmit anonymized patient data to regional and national servers all over Europe for automatic calculation performance. Every year, each diabetes patient should have a BIS filled in. After a number of BIS documents have been collected, it is possible to let the central node calculate benchmark indicators for comparison of care performance at several treatment sites. The assessment criteria are based on the Saint Vincent Declaration, a set of recommendations for diabetes care control, established in October 1989 in Italy by the National Health Departments, the World Health Organization, and the International Diabetes Federation.
The DiabCare Fax System has been successfully implemented in Italy and Germany as an additional tool for diabetes data collection and evaluation. Data sets are sent on a BIS fax form to a central server, which calculates and communicates the accumulated own and the anonymized data sets from other GPs or clinics, maintaining the same health care level. For security reasons, special key cards are introduced to enable legitimation, by creating a unique key, which is linked to the requester's record. The monitoring and feedback network has been developed in five languages, which are English, German, Portuguese, Spanish and Catalan. Currently, plans exist to extend the software to other chronic disorders, such as hypertension, asthma, migraine, and thyroid diseases. Comprehensive information on diabetes research, prevention and benchmarking is to be found on the DiabCare Q-Net Web site.