Comparing glycaemic outcomes of digital and paper-based hospitals (GOOD study).

Abstract

Background: Digital technologies in healthcare are seen as mechanisms to improve and optimise management of health conditions.

Aim: To assess the impact of digitisation on clinical outcomes and medication errors for patients with diabetes.

Methods: This repeated cross-sectional study used data collected from the Queensland Inpatient Diabetes Survey (QuIDS), which was conducted in 2019 and 2021 at digital and paper-based hospitals in Queensland. Relevant data were collected from patients with diabetes admitted to participating hospitals during a single day of the study week. Outcomes and error rates of patients who were admitted to digital versus paper-based hospitals were compared. Regression determined the factors that contributed to 'good diabetes days' and 'no hypoglycaemic days'. Prescribing and management errors were compared.

Results: Data on 1942 patient admissions (6977 patient bed days) were collected. Of these, 1076 patient admissions (55%) were at a digital hospital, while 866 patient admissions (45%) were at a paper-based hospital. Using regression, it was found that being admitted to a digital hospital increased the odds of a 'good diabetes day' by 45% (P < 0.001), but there was no change in 'no hypoglycaemic days' (P = 0.183). There was a reduction in the proportion of patients with at least one error type across all error categories amongst those admitted to a digital hospital (P < 0.001).

Conclusion: Admission to a digital hospital improves the odds of experiencing a good diabetes day but does not change the occurrence of hypoglycaemia. There are potential quality and safety considerations for those hospitals still delivering paper-based diabetes care.