The Regional Collaboration System for Treating Diabetes Mellitus Using the Community Liaison Critical Pathway: Wakayama Style

摘要

Aiming to create a high quality and effective community liaison system for treating diabetes mellitus using ashared healthcare tool, Wakayama City Medical Association developed the Wakayama Liaison Critical Pathwaythrough mutual discussions with hub hospitals in the region. The Pathway was launched in the region afterdefining the outcomes as (1) good blood glucose control with HbA1 c of 6.5% or less, (2) no onset or progressionof complications, and (3) coping well with the stress of diabetes. In this community healthcare collaboration based on the "two attending physicians" system, patients receiveroutine cares from their family physician and periodically visit specialized medical institutions to receive medicalguidance, following the liaison critical pathway for diabetes mellitus of the Wakayama City. This system, calledthe Wakayama Community Liaison System for Diabetes Mellitus, has surpassed the conventional hospital-cliniccollaboration that was limited to the collaboration between a hub hospital and adjacent medical institutions. It hasbecome the mean for wide-area medical collaboration system and is now used in multiple secondary-caremedical service areas in Wakayama Prefecture.