1. Tamara Poljičanin, MD, PhD Croatian Institute of Public Health
CHRODIS PLUS
Croatian pilot
Tamara Poljičanin, MD, PhD
Croatian Institute of Public Health
Zagreb, 26th-27th March 2019

2. Problem Description 304.408 diabetic persons
2300 general practitioners
7 diabetes centres
not all the patients with diabetes are being treated equally, by the same clinical standards and led through clinical pathways providing similar outcomes

3. Available knowledge
There is strong evidence that well established electronic patient registries improve quality indicators of diabetes control at population level.
Ref - Harris MF. et al 2002, Bu D. et al 2007, Han W. et al 2016, Shojania KG. et al in 2008, Peterson A. et al in 2014, Burry E. et al in 2018

4. MDS - minimum data set Croatian diabetes registry (CroDiab)
& „diabetes panel“ (to some extent aligned with international minimum common data set, but not completely)
non-consistent
quality (coverage, reliability, accuracy, transparency, timeliness and relevance)
MDS should be collected at least once a year and therefore can serve as a primary data source for diabetes registry.

5. Specific aims & strategic actions
improvement of collaborative use of MDS and diabetes registry
promotion of diabetes control check-list use
align MDS of diabetes panel, clearly define institutional responsibilities and mandates regarding eHealth and health information systems in Croatia - decision making level (MoH)
improve awareness of patients with diabetes on their potential benefits from CroDiab, and how participate within health care system organisation in order to improve health outcomes
improve awareness of GPs on potential benefits from MDS and CroDiab
improve the representation of diabetes clinical field within continuous education of health professionals - Croatian medical chamber
improve the quality of the feedback to data sources (GPs) in order to maintain data quality
improving the MDS tool that will allow better insight in patients’ health history and monitoring results
strategic actions - improvement Areas (strategic actions) selected in order to overcome identified Weaknesses and Threats
Kako mjeriti awareness GP-a i pacijenata

6. Study description
GROUP 1
GROUP 2
GROUP 3
analysis of indicators (HbA1C, lipids, albumin/creatinine ratio, systolic and diastolic blood pressure and fundoscopic examination)
5 urban and 5 rural-area teams
analysis of indicators (after 6 months)
interview
education on project and MDS/registry and feedback on their MDS performance
letter with information about project and their monitoring
no information

7. Improvement areas Improvement areas Priority score (1-3) Ranking
At decision making level align MDS with international standards and mutually between systems and clearly define institutional responsibilities and mandates regarding eHealth and health information systems in Croatia. 1
Improve the quality of the feedback to data sources GPs in order to maintain data quality. 2
Improving awareness of GPs on potential benefits from MDS and CroDiab, i.e. try to raise awareness of the importance of standardised clinical practice and health information systems 3
Improving awareness of patients with diabetes on their potential benefits from CroDiab and how to participate within health care system organisation in order to improve their health outcomes. 4
Improving the MDS tool that will allow better insight in patients’ health history and monitoring results 5
Through Croatian medical chamber improve the representation of diabetes clinical field within continuous education of health professionals 6

8. HVALA