A telehealth system based on the ontology design of a diabetes management pathway model in China: Development and evaluation (Preprint)

BACKGROUND Diabetes needs to be under control with management and intervention. Mobile health is a practical approach for diabetes management. However, most diabetes mobile health management systems did not meet expectations, which may be due to the lack of standardized management processes in the management systems and the lack of intervention implementation recommendations in the management knowledge base. OBJECTIVE The purpose of this study was as following: (1) to construct a diabetes management care pathway suitable for the actual situation in China; (2) to express the diabetes management care pathway using ontology; (3) to develop a diabetes closed-loop system based on the construction results of the diabetes management pathway and apply it practically. METHODS This study proposes a diabetes management care pathway model which divides the management process of diabetes is divided into nine management tasks and constructs the Diabetes Care Pathway Ontology (DCPO) is constructed to represent the knowledge contained in this pathway model. A telehealth system was designed and developed based on the DCPO, which can support the comprehensive management of diabetes patients while providing active intervention by physicians. A retrospective study was performed based on the data records extracted from the system to analyze usability, the treatment effect of DCPO. RESULTS The diabetes management pathway ontology constructed in this study contains 119 newly added classes, 28 object properties, 58 data properties, 81 individuals and 426 axioms, and 192 SWRL rules. The developed mobile medical system was applied to 272 diabetic patients. Within 3 months, the average fasting blood glucose of the patients decreased by 1.34mmol/L (P<0.01), and the average 2h postprandial blood glucose decreased by 2.63mmol/L (P<0.01), while the average systolic and diastolic blood pressure decreased by 11.86mmHg (P<0.5) and 8.8mmHg (P<0.5) respectively. CONCLUSIONS This study guides the timing and content of interactive interventions between physicians and patients and regulates physicians' medical service behavior. Different management plans are formulated for physicians and patients according to different characteristics, which can comprehensively manage various cardiovascular risk factors. The application of DCPO in the diabetes management system can provide effective and adequate management support for diabetic patients and diabetic patients with hypertension.