Thank You! | eGlycemic Management System Video Overview

Transcript 

Introduction

Thank you for taking a look at Glytec's, eGlycemic Management System. We are revolutionizing glycemic management by uniting teams around patient safety.

Glytec's eGMS centers on Glucommander, the only cloud-based, FDA cleared software, able to personalize IV and SubQ insulin dosing support for patients with and without diabetes.

Introduction to eGMS 

eGlycemic Management System, also known as eGMS, is an EHR integrated cloud-based software solution that supports safe and effective glycemic management and insulin dosing.

eGMS offers personalized insulin dosing decision support at the point of care. Unlike paper protocols, sliding scale methods and digital insulin calculators, eGMS uses an evidence-based FDA cleared algorithm, Glucommander. 

Glucommander leverages real time and historical data to personalize insulin dosing by learning each patient's insulin sensitivity and anticipating future need

The result? Patients experiencing glycemic management challenges get into target range faster, stay within tighter parameters and experience fewer insulin related adverse drug effects compared with patients treated with other protocols. 

In addition to dosing support eGMS offers tools for doctors, nurses, pharmacists, diabetes, educators, hospital leadership, and others to optimize insulin management.

These tools include advanced glycemic management analytics, continuous surveillance of blood glucose levels across the entire patient population, dynamically adjusted timing for blood glucose checks with automated reminders, and dashboards to support coordination of care.

Glucommander provides insulin dosing decision support and is FDA cleared for use with adult and pediatric patients ages two and above. 

Glucommander is available in three different treatment modules that support patients and providers across the continuum of care.

Healthcare facilities can decide to implement one or more Glucommander treatment modules based on the units and care settings at their facilities.

 In the inpatient setting, Glucommander IV supports IV insulin regimens and transitions to SubQ. Glucommander SubQ supports basal bolus regimens and Hospital to Home discharge considerations. In the outpatient setting, Glucommander Outpatient supports adaptive long-term insulin dosing. 

Every treatment module includes the full suite of eGMS modules alongside insulin dosing decision support, including GlucoSurveillance, GlucoView, and GlucoMetrics.

We'll go into more detail on these modules with a special focus on inpatient care over the course of this video. But first let's cover the status quo of glycemic management in the inpatient setting to explain why there's a better, safer way to manage glycemic management.

Status Quo

The glycemic management status quo is unsustainable. Our research indicates that about 90% of US hospitals still treat glycemic issues with confusing ineffective, one size fits all methodologies. Simplified protocols seek to ease provider burden, but can't provide personalized care. Meanwhile, more complex protocols that are dependent on manual calculations are prone to dangerous errors. 

Sliding scale and other one size fits all protocols are outdated and dangerous, resulting in higher rates of hyperglycemia and hypoglycemia compared to Glytec's, personalized algorithm driven solution. Reliance on protocols that don't dynamically adjust based on patient needs is strongly discouraged by the American Diabetes Association.

Insulin dosing in the inpatient setting has remained largely unchanged for half a century. What the status quo methodologies have in common is that they're not safe and they're not the current state standard of care. 

In many hospitals, glycemic management teams and data are siloed. Glycemic management cuts across every hospital unit and every disease state, so cross team communication and data sharing is critical to optimize patient safety. 

In addition, traditional paper protocols and most digital insulin dosing calculators provide no data for further analysis and lack safety guardrails to prevent errors in treatment. 

59% of reporting us hospitals do not have the automated ability to extract and analyze glucose data.

Improving glycemic management in the hospital is becoming increasingly urgent. One in three Americans has glycemic control issues such as diabetes or pre-diabetes, and that means more patients in the hospital are coming in with known glycemic management needs. 

And it's not just people living with diabetes who require insulin in the hospital. Stress hyperglycemia is often found with patients who are undergoing surgery or who are critically ill.

38% of inpatients require insulin therapy during their hospital stay. However, these patients are often not given insulin therapy that has been proven to improve their outcomes because status quo methodologies don't have a way of identifying them. 

The cost of treating patients with glycemic control issues tends to be higher. One study showed Americans with diabetes have 2.3 times greater healthcare costs compared to those without diabetes. 

And while insulin therapy is incredibly effective and lifesaving when used appropriately, safe dosing protocols are necessary to prevent adverse drug effects, which can occur with misuse. Insulin is involved in 16.3% of medication error reports for high alert medications, more than any other single medication type. 

  Considered alongside the increasing prevalence of diabetes in the US and the outsized impact patients with glycemic issues have on the healthcare system, reliance on the status quo is a recipe for disaster.

Medicine has changed. It's time for a new way to think about glycemic management. 

Reimagining Glycemic Management

Glytec's eGMS is glycemic management re-imagined.

Ineffective glycemic management has consequences that reach far beyond the patient bed and stakeholders throughout the hospital have a role to play in ensuring the safe and effective treatment of patients with glycemic issues. 

That's why Glytec developed eGMS as a holistic solution for improving glycemic management throughout the healthcare system. 

Glytec's eGMS doesn't just support insulin dosing. It also focuses on supporting and uniting clinicians and stakeholders across the continuum of care. 

Our cloud-based, EHR integrated technology, unites doctors, nurses, pharmacists, quality teams, hospital leadership, and others around a common goal: better safer care.

eGMS is EHR agnostic, meaning it can be integrated with a variety of EHRs from the most common like Epic and Cerner, to less commonly use EHRs. Let's review the suite of modules within theGlycemic Management System.

Glucommander provides personalized insulin dosing decision support at the point of care. Later in this video, we'll cover how Glucommander works and the safety guardrails that support clinicians. 

GlucoMetrics is the analytics and reporting module. You've heard the saying that you can't improve what you can't measure.

We believe a critical aspect of improving patient safety is having the data to understand the problem and the tools available to easily analyze results.

GlucoView is a dashboard with workflow alerts for blood glucose checks and patient monitoring. It supports team nursing and coordinated care. 

GlucoSurveillance is a module that helps clinicians easily identify at risk patients by surfacing patients experiencing hyperglycemia. We'll share details on each of these modules later in the video.

By equipping all stakeholders with the tools and data they need to make better decisions, eGMS has been repeatedly proven to enhance patient safety, improve quality of care and decrease costs compared to the status quo. There are over 90 studies published in leading journals, such as Diabetes Care, Journal of Diabetes, Science and Technology, and more that show the efficacy of Glytec's eGMS and the dosing module Glucommander in hospitals across the country. Studies show improvements in reduction of severe hypoglycemia, cost savings, time savings for nurses, readmission and length of stay reductions, and reductions in preventable adverse drug effects.

So how does it work? Let's explore Glucommander.

Glucommander

Glucommander is the insulin dosing decision support module of eGMS. 

Our algorithm driven insulin dosing software is the heart of eGMS. Glucommander provides insulin dosing decision support at the point of care. 

In this introduction to Glucommander, we'll cover the settings in which Glucommander is used and walk through a sample workflow.

Glucommander is FDA cleared and indicated for use with patients two and above in the inpatient and outpatient setting. There are three treatment modules. Glucommander IV and Glucommander SubQ are used in the inpatient setting. In the outpatient setting, Glucommander outpatient supports adaptive long-term insulin dosing. 

Glucommander supports insulin dosing throughout the continuum of care and supports transitions between treatment modules, including hospital to home discharge considerations. Healthcare facilities can decide to implement one or more Glucommander treatment modules based on the units and care settings at their facilities.

The full suite of eGMS modules is included alongside Glucommander. 

Let's walk through an example of a Glucommander IV workflow. A provider, pharmacist, and point of care nurse will each play a role in this workflow. 

Glucommander is a provider-driven application. To initiate Glucommander, a provider must first determine that a patient requires IV insulin therapy.

The provider chooses a Glucommander insulin order set in the EHR. Order sets are customized during implementation to align with the unique patient populations that are most relevant to a unit or hospital site. 

The order is routed to pharmacy and a pharmacist verifies the order and dispenses the insulin.

At the same time the bedside nurse receives the order in the EHR. The nurse can open Glucommander directly from the EHR. Using the SmartClick button, the nurse is automatically signed in using single sign-on and is able to open Glucommander directly within the EHR window. No need to open another application or leave the EHR.

The nurse views and confirms patient details, which are pulled over through the ADT integration. The lab results integration has also pulled over the patient's A1C. 

The initial order set details have also been populated in Glucommander via the order set integration. All the nurse has to do is confirm the order set by clicking the save button. The nurse can also edit the order if necessary. 

Next, the nurse enters the patient's current blood glucose. If a recent value is available via the lab results integration, it will be populated already. The nurse can choose to clear the value and enter a new blood glucose if necessary.

The Meter Max safety feature can be activated on the blood glucose entry screen. If a patient's blood glucose is over the hospital's configured, readable meter limit, the nurse would select the Meter Max button rather than adding the meter max value. 

This often occurs when a patient is admitted with DKA or HHS. The Meter Max feature allows the nurse to immediately begin treatment, without waiting for an exact value from the lab, as timely treatment is critical for these patients. 

We'll cover the Meter Max feature in more detail in the safety guardrails chapter. 

Once the nurse enters the patient's current blood glucose value or uses the Meter Max feature, Glucommander will provide a recommended dose. The nurse adjusts the insulin infusion pump, and confirms that the dose has been administered in Glucommander. 

Next Glucommander will set a timer for the next adjustment. Glucommander's algorithm tracks, glucose velocity to determine appropriate timing for the next blood glucose check. When the patient's situation improves and stabilizes blood glucose checks are required less often. 

Time elapses as the nurse performs other duties and works with other patients.

Glucommander counts down to the next blood glucose check and the nurse is reminded via a visible and audible alert when the next blood glucose check is due. The nurse then repeats the process of entering the current blood glucose value, receiving a new recommended dose and adjusting the insulin pump as necessary. 

Glucommander's non-linear algorithm learns each patient's insulin sensitivity and adjusts the dose recommendations. No need to call the provider to make adjustments. 

Glucommander's algorithm personalizes insulin dosing recommendations for each unique patient using real time and historical data, not just the most recent value. 

Glucommander targets the midpoint of a patient's target range, which was determined in the provider's initial order set. The algorithm is designed to bring patients into range safely and efficiently without dropping too quickly or dropping below target range. 

Glucommander dynamically adjusts the timing between blood glucose checks based on patient trends and current blood glucose values.

Patients in crisis will often require more frequent checks compared to those who are stable in target blood glucose range. 

Safety Guardrails

 Glucommander includes an array of safety features to guide best practice insulin dosing methodology, and to improve patient safety and outcomes. 

Glucommander's safety guardrails supplement clinician decision-making by leveraging available data to draw attention to potentially dangerous situations. 

The glucose velocity warning alerts nurses about sudden drops in patient blood glucose and prompts a blood glucose recheck sooner to ensure that patients achieve target range safely. This feature is designed to prevent hypoglycemia and side effects like cerebral edema that are caused by rapid decrease in blood glucose. 

The Meter Max feature allows nurses to leverage the algorithms ability to recommend insulin doses when blood glucose values are above the glucose meter limit without waiting for lab values. This feature is designed to prevent large drops in blood glucose values so the patient achieves target range as soon as safely possible.

The Anion Gap Warning alerts nurses to high anion gaps to prevent premature discontinuation of treatment before resolution of DKA. 

Integrations & Access

Accurate data is critical to calculating a personalized, safe, and effective insulin dose.

Next I'll cover eGMS integrations and access tools that enable streamlined workflows for users.

eGMS utilizes secure integrations with health systems EHRs to capture relevant data that already exists and to close the data loop with minimal data entry, which improves patient safety and reduces workflow friction for clinicians. 

SmartClick enables single sign on and access to eGMS from within the EHR. Glucommander opens within the EHR window, which enables easy access for users.

The ADT integration imports patient information like demographics, height, and weight. 

The lab results, integration imports lab results like A1C, blood glucose, and anion gap . 

The order integration sends initial parameters as ordered by the provider and displays this information in Glucommander when the nurse starts treatment. 

When the nurse saves the order, the parameters are then leveraged by the algorithm to determine appropriate treatment recommendations.

The charting integration charts Glucommander data on the EHR flowsheet to display all patient care history in a single location without needing to double document. 

 Medication administration confirmation sends dose confirmation back to Glucommander once a medication is charted on the medication administration record. The interface sends dose confirmation back to Glucommander to close the data loop without manual effort. Recommended doses in Glucommander are visually unique from confirmed doses. For example, basal doses are highlighted in amber prior to confirmation, and return to the normal gray shading once confirmed.

GlucoView

Now let's talk about GlucoView, a module that displays glycemic status and alerts. 

GlucoView is a dashboard of glycemic status indicators for all patients in a unit, supporting team nursing and coordination of care, especially during shift changes. 

 GlucoView allows nursing teams to see next blood glucose due for all patients in one view so they can proactively plan and prioritize patient care. Many hospitals add GlucoView to a monitor at the nurses station so that all nurses can monitor upcoming blood glucose checks for patients in their unit. This ensures timely blood glucose checks, which are an important aspect of optimal glycemic management.

GlucoSurveillance

GlucoSurveillance is the at-risk patient identification module of eGMS. 

The GlucoSurveillance dashboard notifies the designated clinician about patients with hyperglycemia who are at risk for adverse effects. 

eGMS interfaces with the hospital's laboratory information system to continuously analyze the blood glucose values of all patients for whom data is available, not just those with Glucommander orders, to proactively identify patients with hyperglycemia. 

The GlucoSurveillance dashboard notifies the designated clinician about patients with hyperglycemia who are at risk for adverse effects. Using GlucoSurveillance providers can treat patients needing insulin therapy sooner, which improves patient safety.

GlucoSurveillance can be used by individual providers to monitor their patients, but is also a tool used by diabetes educator teams, glycemic management teams, or designated clinical teams to identify and recommend treatment. 

Let's walk through an example use case, which is based on our experience with current partners whose diabetes educator teams leverage GlucoSurveillance as part of their duties. 

In this example, Michelle is a diabetes educator who reviews the GlucoSurveillance dashboard multiple times during her shift as part of her assigned responsibilities.

Using GlucoSurveillance, michelle sees that Dee Fifty, a patient recovering from surgery, has had multiple blood glucose values over 180 milligrams per deciliter in the last 24 hours, and her latest blood glucose reading is very high. Michelle believes Dee would benefit from insulin therapy.

Michelle sends a message to Dee Fifty's provider, Dr. Smith, letting him know about Dee's hyperglycemia and recommending he ordered Glucommander for Dee. 

Dr. Smith reviews, Dee's chart and agrees with Michelle's recommendation. He orders the appropriate Glucommander order set for Dee's clinical situation. By addressing Dee's hyperglycemia, she recovers from surgery faster and with fewer complications. 

GlucoMetrics

GlucoMetrics is the glucose data analytics and reporting module.

GlucoMetrics and Glytec's other reporting capabilities provide insight into organizational glycemic management performance. Measuring and tracking glycemic management performance is critical to long-term success. 

Glytec's out of the box reporting enables hospital leadership, quality teams and providers to identify areas of opportunity in the current program, set actionable goals and track progress without needing to configure reports or manage spreadsheets. 

eGMS includes a variety of ready-made reports with the opportunity to drill down further by time period, patient history of diabetes, patient location, treatment type, renal status, BMI, diagnosis, admission glucose, and other factors.

System-level metrics are particularly helpful for data analysts and glycemic management committees. 

KPI tracking like incidents of hyperglycemia and hypoglycemia, and time to target blood glucose can be found on dashboards tailored for executives. 

Outcomes and performance are represented in data visualizations and also display trends and benchmarks from all Glytec customers.

It's also important to monitor best practice adherence. Utilization reports and blood glucose check timeliness reports show performance over time, as well as a peer benchmark showing how well your facility is performing compared to other Glytec customers.

Implementation, Training, Support

Now that you've seen what eGMS can do. You might be wondering about implementation, support, and training. 

Glytec has a proven process for change management and we'll guide you every step of the way before, during and after implementation. 

Glytec's streamlined post-purchase process ensures all stakeholders have exactly what they need to achieve great results. 

Our cloud-based technology enables remote implementation and upgrades and reduces reliance on your technical resources to maintain the software.  

Your dedicated Glytec implementation team guides you through the change management process. Expect to develop close relationships with your project manager, clinical project lead, technical project lead, customer success manager, and clinical practice executive.

You'll maintain a relationship with your customer success manager and a clinical practice executive after implementation as they are partners in your ongoing relationship. 

Glytec's clinical experts add value to the implementation process. We also help providers understand the why of the algorithm's recommendations by providing analytics and case by case analysis during implementation.

IV implementation for a whole hospital with a full suite of integrations takes as little as 12 weeks. Our tried and true implementation process includes detailed milestones, weekly meetings, and regular progress reports. We also standardize our technical integrations to make work as easy as possible for your IT team, and our cloud-based technology allows us to implement and update remotely. 

We offer a comprehensive training program that supports the initial eGMS rollout and user adoption, continual onboarding of new employees, and long-term optimization. 

Our training resources enable all of your users, providers, and stakeholders to successfully leverage the power of eGMS.

Our super-user training program develops local Glucommander expertise at your hospital system. And on demand computer-based learning will be accessed by users via your own learning management system.

During implementation, our team will work with you to customize workflows and order sets to leverage best practice and customize for your needs. Tip sheets, pocket cards, and other just-in-time training resources will also be provided.

We share your goals. At Glytec, our mission is to improve the lives of patients managing glycemic issues, and those who administer their care by optimizing insulin therapy. To us, that vision goes beyond the edges of our eGlycemic Management System. Our relationship with hospitals doesn't stop at implementation and training. We are long-term partners in your ongoing success. 

Post-implementation, we'll continue to support you and your team. All of our training and on-demand support is unlimited and a hundred percent included in your annual licensing fee.

Our customer support team provides 24/7/365 clinical and technical support. Ongoing training is available, which is especially important as new team members join your system. 

Your dedicated customer success manager will provide ongoing engagement to make sure you have the support you need to use eGMS and develop your glycemic management program. Our clinical practice team will also work with you after implementation to optimize your implementation and workflows and provide best practice guidance and other clinical expertise.

Partner Results 

When you choose to partner with Glytec, you're not just choosing insulin management software. You're choosing a partner for long-term success. 

We're proud to share the results that our partners have achieved using our technology. With over 90 published studies to choose from there's more than enough evidence that eGMS is effective.

We believe the evidence shows eGMS isn't just a nice to have, it's a must have. 

eGMS has been implemented at over 300 hospitals across the United States. And Glytec has a customer retention rate over 95% showing that our partners value our relationship. 

Learn More

Are you ready to optimize your glycemic management program? Get in touch to learn how Glytec can help your hospital or healthcare system.

Take the first step toward revolutionizing how your team approaches glycemic management and overall patient safety. Contact Glytec to schedule a demo or discuss options. We are looking forward to hearing from you and showing all that eGMS can do. We can provide consultation on how eGMS can help your healthcare system achieve your glycemic management goals.

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