From design to implementation - The Joint Asia Diabetes Evaluation (JADE) program: A descriptive report of an electronic web- based diabetes management program. Figure 1 summarizes the key features of the JADE e- portal as a Java application using the Apache web server, the my. SQL database and the Cocoon framework. The user input is validated both on the server- side and client- side, which is aligned with industry best coding practices. The validation technique prevents attackers from inserting potentially harmful syntax into the web application, which could then potentially be sent to the application server or backend database residing inside the network infrastructure. ![]() The system was developed in a secure manner and externally assessed by Cybertrust Inc. Through SQL injection, cross- site scripting and parameter manipulation, it was unable to gain session hijacking and authentication bypass. Figure 1. Logistics and components of the web- based electronic portal of the JADE Program. The JADE e- portal includes a validated risk engine for risk stratification based on data collected during the annual comprehensive assessment. Based on the patient's risk level, a care protocol is recommended with clinical decision and self management support. The e- portal also provides user- friendly templates to guide users to collect relevant clinical data during the annual comprehensive assessment visit including eye and foot examination, blood and urine tests, medications, major medical events and quality of life. The British National Formulary was used as a framework to classify medications for data capture and future analysis. Comprehensive risk assessments of diabetic patients from seven Asian countries: The Joint Asia Diabetes Evaluation (JADE) program. J Diabetes 2011 Jun;3(2). ![]() Joint asia diabetes evaluation (JADE) clerical staff at Merck. Location Vietnam Industry Pharmaceuticals. ![]() At each review visit, key parameters as recommended by international guidelines are captured to document clinical progress. These include BP, body weight, risk factor control (e. Hb. A1c, lipid, renal function, albuminuria), self care, hypoglycemia and admissions since last visit (Figure 2, showing the comprehensive assessment webpage). These data can be collected on line at point- of- care, or offline using paper format followed by date entry to the e- portal at a later stage, depending on the clinic set up and operation. All patients are given unique identification codes and each visit is dated to avoid double entry.
All data are locked 1. However, through request to the PSO with clear explanation, unlocking of the relevant data for editing or deletion is possible. The timing of 1. 2 weeks for data locking was selected since this was the average turnover time for return of laboratory results and data input in various Asian countries. Figure 2. The JADE electronic portal provides templates to guide users to collect relevant data during the annual comprehensive assessment. Based on results estimated by the JADE Risk Engine, the e- portal displays the 5- year probability of major clinical events which can be adjusted by changing values of modifiable risk factors to promote discussions between patients and care providers (Figure 3). Data collected at each review visit are displayed to show the trends of control of modifiable risk factors including BP, Hb. A1c, LDL- C and body weight. General recommendations can be triggered by predefined levels of risk factors to prompt care providers and patients to take appropriate actions. Printable reports showing risk predictions, trends of risk factor control and practice tips can be generated for care providers (in English) and patients (in 5 different Asian languages i. English, Thai, Korean, Malay and Chinese . Furthermore, the portal provides matrixes to help doctors monitor patients' levels of adherence to care processes (e. These targets can be modified depending on the evolution of international healthcare standards. Figure 3. The JADE Risk Engine estimates the 5- year probability of major clinical events. Figure 4. The JADE e- portal displays the risk level of the patients, supplemented by decision and self management support triggered by various risk factors which can be printed in 5 Asian languages. Up to 1st January 2. Hong Kong, Taiwan, Singapore, Thailand, Philippines, Korea, India and Brunei have joined the JADE Program. The Program is scheduled to be launched in Mainland China in mid 2.
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