iCoDE June 22, 2022 Steering Committee Meeting Summary Report

Self Cite

Integration of insulin dosing data into the electronic health record (EHR), combined with other patient-generated health care data, would facilitate the use of wirelessly connected insulin delivery systems, including smart insulin pens, insulin pumps, and advanced hybrid closed-loop systems. In 2022, Diabetes Technology Society developed the Integration of Continuous Glucose Monitoring Data into the EHR (iCoDE) Project, which is the first consensus standard for integrating data from a wearable device into the EHR. The iCoDE Standard is a comprehensive guide for any health care delivery organization or hospital for automatically integrating continuous glucose monitoring data into the EHR. Diabetes Technology Society is following iCoDE with the Integration of Connected Diabetes Device Data into the EHR (iCoDE-2) Project, to similarly provide guidance for integrating insulin delivery data into the EHR alongside continuous glucose monitoring data.

Section: The Icode Project: a Repeatable And Scalable Methodologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Need for Data Standards and Implementation Policies to Integrate Insulin Delivery Data Into the Electronic Health Record

Espinoza

Yeung

Huang

et al. 2023

Self Cite

“…While recent standards (the Integration of Continuous Glucose Monitoring Data into the Electronic Health Record) 20 have been released for documenting CGM data in hospital electronic records, a single universal interface is yet to be developed that connects all available CGM devices to any hospital electronic record.…”

Section: Session 11 Accuracy Of Cgms/comparison With Poc Bg Testingmentioning

confidence: 99%

Use of Continuous Glucose Monitors in the Hospital: The Diabetes Technology Society Hospital Meeting Report 2023

Tian,

Aaron,

Yeung

et al. 2023

Self Cite

The annual Virtual Hospital Diabetes Meeting was hosted by the Diabetes Technology Society on April 14 and 15, 2023, with the goal of reviewing the progress made in the hospital use of continuous glucose monitors (CGMs). Meeting topics included (1) Nursing Issues, Protocols, Order Sets, and Staff Education for Using CGMs, (2) Implementing CGM Programs for Use in the Wards, (3) Quality Metrics and Financial Implications of CGMs in the Hospital, (4) CGMs in the Critical Care Setting, (5) Special Situations: Labor/Delivery and Hemodialysis, (6) Research Session on CGMs in the Hospital, (7) Starting a CGM on Hospitalized Patients, (8) Automated Insulin Delivery Systems in the Hospital, (9) CGMs in Children, (10) Data Integration of CGMs for Inpatient Use and Telemetry, (11) Accuracy of CGMs/Comparison with Point-of-care Blood Glucose Testing, and (12) Discharge Planning with CGMs. Outcome data as well as shared collective real-life experiences were reviewed, and expert recommendations for CGM implementation were formulated.

“…The integration of Continuous Glucose Monitoring Data into the Electronic Health Record (iCoDE) Project aims to facilitate integration of CGM data and provides standards towards supporting this. 27,28 Generating automated clinical insights to support optimal usage of this technology, may potentially reduce workload of health care professionals (accompanying Flanagan et al paper available • Capillary blood glucose should be checked 1 to 2 hours after CSII restarted at https://doi.org/10.1177/1932296819849478). Data acquisition processes will need to be compliant with regulatory privacy rules and cybersecurity policies.…”

Section: Hybrid Closed Loop In Surgerymentioning

confidence: 99%

Insulin Pumps and Hybrid Close Loop Systems Within Hospital: A Scoping Review and Practical Guidance From the Joint British Diabetes Societies for Inpatient Care

Avari

Lumb

Flanagan³

et al. 2022

This article is the second of a two-part series providing a scoping review and summary of the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) guidelines on the use of diabetes technology in people with diabetes admitted to hospital. The first part reviewed the use of continuous glucose monitoring (CGM) in hospital. In this article, we focus on the use of continuous subcutaneous insulin infusion (CSII; insulin pumps) and hybrid closed-loop systems in hospital. JBDS-IP advocates enabling people who can self-manage and are willing and capable of using CSII to continue doing so as they would do out of hospital. CSII should be discontinued if the individual is critically ill or hemodynamically unstable. For individuals on hybrid closed-loop systems, the system should be discontinued from auto-mode, and may be used individually (as CGM only or CSII only, if criteria are met). Continuing in closed-loop mode may only be done so under specialist guidance from the Diabetes Team, where the diabetes teams are comfortable and knowledgeable about the specific devices used. Health care organizations need to have clear local policies and guidance to support individuals using these wearable technologies, and ensure the relevant workforce is capable and skilled enough to ensure their safe use within the hospital setting.