Patent Publication Number: US-2012046962-A1

Title: System and method for glucose monitoring and analysis

Description:
CROSS REFERENCE TO RELATED PATENT APPLICATION 
     This application claims the benefit of U.S. Provisional Application No. 61/375,420 filed Aug. 20, 2010, hereby incorporated herein by reference in its entirety. 
    
    
     BACKGROUND 
     In recent years it has become known that controlling the glucose levels of patients in hospitals results in reduced morbidity and mortality rates. For many years healthcare practitioners have been more concerned about low glucose levels rather than high glucose levels. A glucose level that is too low for a short period of time can result in death. Due to these concerns, a patient&#39;s glucose levels were maintained on the high side of normal or somewhat elevated. It was thought that these higher than normal levels were not hazardous to the patient during the short time the patient was in the hospital. 
     It has been discovered that high glucose levels can also be hazardous to the patient. High glucose levels can negatively affect the patient&#39;s immune system and limit the patient&#39;s ability to fight infections. It has also been discovered that better control of the patient&#39;s glucose levels also results in fewer low events. Accordingly, a number of national organizations including The Institute of Healthcare Improvement are recommending better management of glucose levels for patients. 
     To date, conventional glucose level collection has been largely manual, requiring a registered nurse (an expensive and limited resource) to review individual patient records. Accordingly, there is a need for analyzing glucose readings from a plurality of glucometers. 
     One of the chief obstacles to managing glucose readings has been the inability to monitor the success or failure of improvement initiatives, such as the introduction of protocols designed to better manage glucose levels. Thus, there is a need to analyze glucose measurements to identify patterns of performance relating to healthcare providers, healthcare provider units, personnel, personnel staffing schedules, time of day, and day of the week. There is also a need to incentivize glucose management by adjusting the amount of money paid to healthcare providers based on the glucose levels of their patients. Similarly, there is a need to addresses these and other deficiencies while allowing healthcare providers to continue using conventional glucometers. 
     SUMMARY 
     The problems identified above can be addressed by the methods, systems, and computer program products (hereinafter “method” or “methods” for convenience) according to the present disclosure. As used herein and as understood by one of ordinary skill in the art, “healthcare provider” can comprise any entity, or any combination of entities, that directly or indirectly provides healthcare services, such as doctors, nurses, medical technicians, hospitals, laboratories, emergency medical services, clinics, imaging centers, therapy centers, chiropractic centers, ambulatory care centers, and the like. 
     Methods are described for analyzing glucose levels. In an aspect, provided are methods comprising, receiving, using a computer, a plurality of glucose levels; selecting, using the computer, a subset of glucose levels from among the plurality of received glucose levels that is associated with at least a first healthcare unit of a first healthcare provider; and analyzing, using the computer, the selected subset of glucose levels. 
     In another aspect, provided are methods comprising, receiving, using a computer, a plurality of glucose levels from at least a first healthcare provider; selecting, using the computer, a subset of glucose levels from among the plurality of glucose levels that is associated with at least a first healthcare unit of the first healthcare provider; comparing, using the computer, the selected subset of glucose levels to a reference; and adjusting, using the computer, an amount of insurance money to be paid for services that have or will be performed by the first healthcare provider based upon the comparison of the selected subset of glucose levels to the reference. 
     In a further aspect, provided are methods comprising, receiving, using a computer, a first plurality of glucose levels from at least a first healthcare provider at a first time; receiving, using the computer, a second plurality of glucose levels from at least the first healthcare provider at a second time; and comparing, using the computer, the received first plurality of glucose levels to the received second plurality of glucose levels to determine a difference in glucose levels. 
     Additional advantages will be set forth in part in the description which follows or may be learned by practice. The advantages will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims. It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive, as claimed. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments and together with the description, serve to explain the principles of the methods and systems: 
         FIG. 1  shows a logical overview of a computer system; 
         FIG. 2  illustrates an exemplary method for analyzing glucose levels. 
         FIG. 3  illustrates an exemplary method for analyzing glucose levels. 
         FIG. 4  illustrates an exemplary method for analyzing glucose levels. 
         FIG. 5  illustrates an exemplary feedback presented to a user; 
         FIG. 6  illustrates an exemplary feedback presented to a user; 
         FIG. 7  illustrates an exemplary feedback presented to a user; 
         FIG. 8  illustrates an exemplary feedback presented to a user; 
         FIG. 9  illustrates an exemplary feedback presented to a user; 
         FIG. 10  illustrates an exemplary feedback presented to a user; 
         FIG. 11  illustrates an exemplary feedback presented to a user; 
         FIG. 12  illustrates an exemplary feedback presented to a user; 
         FIG. 13  illustrates an exemplary feedback presented to a user; 
         FIG. 14  illustrates an exemplary feedback presented to a user; 
         FIG. 15  illustrates an exemplary feedback presented to a user; and 
         FIG. 16  illustrates an exemplary feedback presented to a user. 
     
    
    
     DETAILED DESCRIPTION 
     Before the present methods and systems are disclosed and described, it is to be understood that the methods and systems are not limited to specific methods, specific components, or to particular compositions. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. 
     As used in the specification and the appended claims, the singular forms “a,” “an” and “the” include plural referents unless the context clearly dictates otherwise. Ranges may be expressed herein as from “about” one particular value, and/or to “about” another particular value. When such a range is expressed, another embodiment includes   from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. 
     “Optional” or “optionally” means that the subsequently described event or circumstance may or may not occur, and that the description includes instances where said event or circumstance occurs and instances where it does not. 
     Throughout the description and claims of this specification, the word “comprise” and variations of the word, such as “comprising” and “comprises,” means “including but not limited to,” and is not intended to exclude, for example, other additives, components, integers or steps. “Exemplary” means “an example of” and is not intended to convey an indication of a preferred or ideal embodiment. “Such as” is not used in a restrictive sense, but for explanatory purposes. 
     Disclosed are components that can be used to perform the disclosed methods and systems. These and other components are disclosed herein, and it is understood that when combinations, subsets, interactions, groups, etc. of these components are disclosed that while specific reference of each various individual and collective combinations and permutation of these may not be explicitly disclosed, each is specifically contemplated and described herein, for all methods and systems. This applies to all aspects of this application including, but not limited to, steps in disclosed methods. Thus, if there are a variety of additional steps that can be performed it is understood that each of these additional steps can be performed with any specific embodiment or combination of embodiments of the disclosed methods. 
     The present methods and systems may be understood more readily by reference to the following detailed description of preferred embodiments and the examples included therein and to the Figures and their previous and following description. 
     As will be appreciated by one skilled in the art, the methods and systems may take the form of an entirely hardware embodiment, an entirely software embodiment, or an embodiment combining software and hardware aspects. Furthermore, the methods and systems may take the form of a computer program product on a computer-readable storage medium having computer-readable program instructions (e.g., computer software) embodied in the storage medium. More particularly, the present methods and systems may take the form of web-implemented computer software. Any suitable computer-readable storage medium may be utilized including hard disks, CD-ROMs, optical storage devices, or magnetic storage devices. 
     Embodiments of the methods and systems are described below with reference to block diagrams and flowchart illustrations of methods, systems, apparatuses and computer program products. It will be understood that each block of the block diagrams and flowchart illustrations, and combinations of blocks in the block diagrams and flowchart illustrations, respectively, can be implemented by computer program instructions. These computer program instructions may be loaded onto a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions which execute on the computer or other programmable data processing apparatus create a means for implementing the functions specified in the flowchart block or blocks. 
     These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including computer-readable instructions for implementing the function specified in the flowchart block or blocks. The computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer-implemented process such that the instructions that execute on the computer or other programmable apparatus provide steps for implementing the functions specified in the flowchart block or blocks. 
     Accordingly, blocks of the block diagrams and flowchart illustrations support combinations of means for performing the specified functions, combinations of steps for performing the specified functions and program instruction means for performing the specified functions. It will also be understood that each block of the block diagrams and flowchart illustrations, and combinations of blocks in the block diagrams and flowchart illustrations, can be implemented by special purpose hardware-based computer systems that perform the specified functions or steps, or combinations of special purpose hardware and computer instructions. 
     The present disclosure relates to systems and methods for monitoring and analyzing glucose levels. The methods disclosed herein can be carried out using a processor or processors.  FIG. 1  is a block diagram illustrating an exemplary operating environment for performing the disclosed methods. The exemplary operating environment illustrated in  FIG. 1  is an example of an operating environment and is not intended to suggest any limitation as to the scope of use or functionality of operating environment architectures. Neither should the operating environment be interpreted as having any dependency or requirement relating to any one or combination of components illustrated in the exemplary operating environment. 
     The methods of the present disclosure can be operational with numerous other general purpose or special purpose computing system environments or configurations. Examples of well known computing systems, environments, and/or configurations that may be suitable for use with the methods include, but are not limited to, personal computers, server computers, laptop devices, and multiprocessor systems. Additional examples include programmable consumer electronics, network PCs, minicomputers, mainframe computers, distributed computing environments that include any of the above systems or devices, and the like. 
     The methods may be described in the general context of computer instructions, such as program modules, being executed by a computer. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types. The methods may also be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules may be located in both local and remote computer storage media including memory storage devices. 
     The methods, systems, and computer program products disclosed herein can be implemented, in whole or in part, using a general-purpose computing device in the form of a computer  101 . The components of the computer  101  can include, but are not limited to, one or more processors or processing units  103 , a system memory  112 , and a system bus  113  that couples various system components including the processor  103  to the system memory  112 . 
     The processor  103  in  FIG. 1  can be an x-86 compatible processor, including a PENTIUM, manufactured by Intel Corporation, a CORE, manufactured by Intel Corporation, or an ATHLON 64 processor, manufactured by Advanced Micro Devices Corporation, for example. Processors utilizing other instruction sets may also be used, including those manufactured by Apple, IBM, or NEC, for example. 
     The system bus  113  can represent one or more of several possible types of bus structures, including a memory bus or memory controller, a peripheral bus, an accelerated graphics port, and a processor or local bus using any of a variety of bus architectures. By way of example, such architectures can include an Industry Standard Architecture (ISA) bus, a Micro Channel Architecture (MCA) bus, an Enhanced ISA (EISA) bus, a Video Electronics Standards Association (VESA) local bus, and a Peripheral Component Interconnects (PCI) bus also known as a Mezzanine bus. This bus, and all buses specified in this description can also be implemented over a wired or wireless network connection. The bus  113 , and all buses specified in this description can also be implemented over a wired or wireless network connection and each of the subsystems, including the processor  103 , a mass storage device  104 , an operating system  105 , application software  106 , data  107 , a network adapter  108 , system memory  112 , an Input/Output Interface  110 , a display adapter  109 , a display device  111 , and a human machine interface  102 , can be contained within one or more remote computing devices  114   a,b,c  at physically separate locations, connected through buses of this form, in effect implementing a fully distributed system. 
     The operating system  105  in  FIG. 1  can comprise operating systems such as MICROSOFT WINDOWS operating systems, REDHAT LINUX, FREE BSD, or SUN MICROSYSTEMS SOLARIS. Additionally, the application software  106  may include web browsing software, such as MICROSOFT INTERNET EXPLORER or MOZILLA FIREFOX, enabling a user to view HTML, SGML, XML, or any other suitably constructed document language on the display device  111 . Other operating systems and web browsing software can be used. 
     The computer  101  can comprise a variety of computer readable media. Such media can be any available media that can be accessible by the computer  101  and includes both volatile and non-volatile media, removable and non-removable media. The system memory  112  includes computer readable media in the form of volatile memory, such as random access memory (RAM), and/or non-volatile memory, such as read only memory (ROM). The system memory  112  can contain data such as data  107  and/or program modules such as operating system  105  and application software  106  that are immediately accessible to and/or are presently operated on by the processing unit  103 . 
     The computer  101  can comprise other removable/non-removable, volatile/non-volatile computer storage media. By way of example,  FIG. 1  illustrates a mass storage device  104  which can provide non-volatile storage of computer code, computer readable instructions, data structures, program modules, and other data for the computer  101 . For example, a mass storage device  104  can be a hard disk, a removable magnetic disk, a removable optical disk, magnetic cassettes or other magnetic storage devices, flash memory cards, CD-ROM, digital versatile disks (DVD) or other optical storage, random access memories (RAM), read only memories (ROM), electrically erasable programmable read-only memory (EEPROM), and the like. 
     Any number of program modules can be stored on the mass storage device  104 , including by way of example, an operating system  105  and application software  106 . Each of the operating system  105  and application software  106  (or some combination thereof) may include elements of the programming and the application software  106 . Data  107  can also be stored on the mass storage device  104 . Data  104  can be stored in any of one or more databases known in the art. Examples of such databases include, DB2®, Microsoft® Access, Microsoft® SQL Server, Oracle®, mySQL, PostgreSQL, and the like. The databases can be centralized or distributed across multiple systems. 
     A user can enter commands and information into the computer  101  via an input device (not shown). Examples of such input devices include, but are not limited to, a keyboard, pointing device (e.g., a “mouse”), a microphone, a joystick, a serial port, a scanner, and the like. These and other input devices can be connected to the processing unit  103  via a human machine interface  102  that can be coupled to the system bus  113 , but may be connected by other interface and bus structures, such as a parallel port, serial port, game port, or a universal serial bus (USB). 
     A display device  111  can also be connected to the system bus  113  via an interface, such as a display adapter  109 . For example, a display device can be a cathode ray tube (CRT) monitor or a Liquid Crystal Display (LCD). Other display devices can be used. In addition to the display device  111 , other output peripheral devices can include components such as speakers (not shown) and a printer (not shown) which can be connected to the computer  101  via Input/Output Interface  110 . 
     The computer  101  can operate in a networked environment using logical connections to one or more remote computing devices  114   a,b,c . By way of example, a remote computing device can be a personal computer, portable computer, a server, a router, a network computer, a peer device or other common network node, and so on. Logical connections between the computer  101  and a remote computing device  114   a,b,c  can be made via a local area network (LAN) and a general wide area network (WAN). Such network connections can be through a network adapter  108 . A network adapter  108  can be implemented in both wired and wireless environments. Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet/Web Server  115 . In an aspect, an Internet/Web server can house the main ASP.Net application and can connect to a SQL Server 2005 database to compute the necessary calculations and perform the methods describe herein to the glucose data submitted by the healthcare provider and provide access to the contained graphs and charts. 
     For purposes of illustration, application programs and other executable program components such as the operating system  105  are illustrated herein as discrete blocks, although it is recognized that such programs and components reside at various times in different storage components of the computing device  101 , and are executed by the data processor(s) of the computer. An implementation of application software  106  may be stored on or transmitted across some form of computer readable media. An implementation of the disclosed method may also be stored on or transmitted across some form of computer readable media. Computer readable media can be any available media that can be accessed by a computer. By way of example, and not limitation, computer readable media may comprise “computer storage media” and “communications media.” “Computer storage media” include volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules, or other data. Computer storage media includes, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVD) or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by a computer. 
     In an aspect, illustrated in  FIG. 2 , provided are methods for analyzing glucose levels. In step  201 , a plurality of glucose levels can be received. In step  202 , a subset of glucose levels can be selected from among the plurality of received glucose levels that can be associated with at least a first healthcare unit of a first healthcare provider. In step  203 , the selected subset of glucose levels can be analyzed. 
     In an aspect, the step of receiving a plurality of glucose levels can comprise receiving a plurality of glucose levels from one or more glucometers. As an example, conventional glucometers can be used, such as the GLUCOMANDER. Further, the plurality of glucose levels can be received from one or more glucometers over at least a first network. In an aspect, the first network can comprise at least one of a wired or wireless network as understood by one of skill in the art. 
     Receiving a plurality of glucose levels can comprise receiving a plurality of glucose levels by the healthcare provider, such as by receiving a plurality of glucose levels at a computer operated by the healthcare provider. As an example, the computer can be the computer  101  shown in  FIG. 1 , or the like. Receiving a plurality of glucose levels can also comprise receiving a plurality of glucose levels over a network at a computer operated by the healthcare provider. The network can comprise one or more of a LAN, WAN, or the Internet. Further, the format of the plurality of glucose levels can be changed from a received format to a format for processing. 
     The first healthcare unit of the first healthcare provider can comprise any type of healthcare unit as understood by one of skill in the art, such as an intensive care unit, open heart unit, emergency care unit, surgical unit, and the like. 
     In an aspect, the step of analyzing the selected subset of glucose levels can comprise analyzing the selected subset of glucose levels by determining if one or more glucose levels in the selected subset of glucose levels are above a reference level. The levels above the reference level can be reported. 
     Analyzing the selected subset of glucose levels can also comprise analyzing the selected subset of glucose levels by determining an average glucose level for one or more glucose levels in the selected subset of glucose levels. Similarly, analyzing the selected subset of glucose levels can comprise analyzing the selected subset of glucose levels by determining if one or more glucose levels in the selected subset of glucose levels is below a reference level. For example, it can be determined if one or more glucose levels in the selected subset of glucose levels is above and/or below a reference level for a time period. Any time period can be used, such as minute, hour, day, week, month, year, or any combination thereof. The glucose level can be used to generate a feedback to a user such as one and/or more reports or files, for example. 
     In an aspect, analyzing the selected subset of glucose levels can comprise analyzing the selected subset of glucose levels by determining if one or more glucose levels in the selected subset of glucose levels is above a first reference level and/or below a second reference level, or by determining if one or more glucose levels in the selected subset of glucose levels is above a first reference level and/or below a second reference level for a time period. Any time period can be used, such as minute, hour, day, week, month, year, or any combination thereof. 
     In an aspect, the first reference level and/or the second reference level can be determined based on medicine and research parameters, physician and organizational preferences, routine or accepted practices, and/or patient variability. As an example, the reference level(s) can be based on a historical value comparison, comparison to others in similar or different demographic based on location, race, sex, age, body type, and the like. Other parameters can be used in determining the reference levels. 
     In an aspect, data obtained from the glucometers can be based on calibrations and programming associated with a particular patient, practitioner, or treatment facility. As an example, a glocometer can be calibrated to provide data including a patient identifier or account number, date and time of test, test result, unit identifier, and the like. As a further example, the particular information provided by the glocometer can be calibrated based upon specific data requirements and demographic interests of the user. It is understood that the glucometer can be configured to provide other data. 
     In an aspect, an indicator of a problem or no problem (disease state/no disease state) can be generated based upon the analysis of the glucose levels. As an example, the indicator can be visually presented to a user. As a further example, the indicator can be an alert such as a visual alert, audio alert, or an alert communicated to a user associated with the patient. Other indicators can be used. 
     In an aspect, a treatment for a patient can be adjusted based on the analysis of the glucose levels. As an example, protocols, physician orders, sliding scales or other forms of glucose treatment can be used to treat hypo- or hyper glycemia based on blood glucose analyses or feedback. 
     By way of example, the methods of  FIG. 2  can comprise a computer program product encoded with computer-readable instructions for analyzing glucose levels by performing the steps of receiving a plurality of glucose levels, selecting a subset of glucose levels from among the plurality of received glucose levels that can be associated with at least a first healthcare unit of a first healthcare provider, and analyzing the selected subset of glucose levels. Similarly, the methods shown in  FIG. 3  and  FIG. 4 , and any related embodiments and aspects, can be claimed as computer program products. 
       FIG. 3  illustrates an exemplary method for analyzing glucose levels. In step  301 , a plurality of glucose levels can be received from at least a first healthcare provider. In step  302 , a subset of glucose levels can selected  302  from among the plurality of glucose levels that can be associated with at least a first healthcare unit of the first healthcare provider. In step  303 , the selected subset of glucose levels can be compared to a reference. In step  304 , the comparison can be used to adjust an amount of insurance money to be paid for services that have or will be performed by the first healthcare provider. 
     In an aspect, the reference can be determined based on medicine and research parameters, physician and organizational preferences, routine or accepted practices, and/or patient variability. As an example, the reference can be based on a historical value comparison, comparison to others in similar or different demographic based on location, race, sex, age, body type, and the like. Other parameters can be used in determining the reference. 
     In an aspect, comparing the selected subset of glucose levels to a reference can comprise comparing the selected subset of glucose levels to a reference by determining if one or more glucose levels in the selected subset of glucose levels is one of above or below a reference level, such as above or below a reference level for a time period. Similarly, comparing the selected subset of glucose levels to a reference can comprise comparing the selected subset of glucose levels to a reference by determining if one or more glucose levels in the selected subset of glucose levels is above a first reference level and/or below a second reference level, such as by, for example, determining if one or more glucose levels in the selected subset of glucose levels is above a first reference level and/or below a second reference level for a time period. Comparing the selected subset of glucose levels to a reference can also comprise comparing the selected subset of glucose levels to a reference by generating a value from the selected subset of glucose levels and comparing the generated value to a reference. A reference can comprise at least one of a mean, median, mode, binary value, numerical value, textual value, score, or a set of one or more such references. A score can comprise at least one of a binary, numerical, or textual value. 
     In an aspect, the step of using the comparison to adjust an amount of insurance money can comprise using the selected subset of glucose levels to adjust an amount of insurance money to be paid for services that have or will be performed by the first healthcare provider. Using the comparison to adjust an amount of insurance money can also comprise using the selected subset of glucose levels to adjust an amount of insurance money to be paid for services that have or will be performed by the first healthcare unit of the first healthcare provider, and/or using the selected subset of glucose levels to adjust an amount of insurance money to be paid for services that have or will be performed by a second healthcare provider. Similarly, using the comparison to adjust an amount of insurance money can comprise using the selected subset of glucose levels to adjust an amount of insurance money to be paid for services that have or will be performed by a second unit of a second healthcare provider, wherein the first unit and the second unit provide substantially the same type of healthcare service. 
     In an aspect, the method of  FIG. 3  can further comprise determining the reference using glucose levels received from a plurality of healthcare providers, or determining the reference using glucose levels previously received from at least the first healthcare provider. In an aspect, the method of  FIG. 3  can further comprise using the comparison to adjust a glucose administration policy of one or more healthcare providers. 
       FIG. 4  illustrates an exemplary method for analyzing glucose levels. In step  401 , a first plurality of glucose levels can be received from at least a first healthcare provider at a first time. In step  402 , a second plurality of glucose levels can be received from at least the first healthcare provider at a second time. In step  403 , the received first plurality of glucose levels can be compared to the received second plurality of glucose levels to determine a difference in glucose levels. 
     Receiving a plurality of glucose levels can comprise receiving a plurality of glucose levels from at least a first healthcare provider from one or more glucometers or receiving a plurality of glucose levels from at least a first healthcare provider from one or more glucometers over at least a first network. 
     Further, comparing the received first plurality of glucose levels to the received second plurality of glucose levels can comprise comparing the received first plurality of glucose levels to the received second plurality of glucose levels to determine a difference in glucose levels by comparing a first value generated from the received first plurality of glucose levels to a second value generated from the received second plurality of glucose levels. 
     The difference determined between the first and second plurality of glucose levels can be used to adjust an amount of insurance money to be paid for services that have or will be performed by at least the first healthcare provider, and/or the difference can be used to adjust an amount of insurance money to be paid for services that have or will be performed by at least a second healthcare provider. The difference can also be used to adjust at least one of a healthcare unit personnel or a healthcare unit personnel staffing schedule of one or more healthcare providers. The difference can also be used to generate a feedback such as one or more reports of files, for example. 
     In an aspect, an indicator of a problem or no problem (disease state/no disease state) can be generated based upon the analysis of the glucose levels. As an example, the indicator can be visually presented to a user. As a further example, the indicator can be an alert such as a visual alert, audio alert, or an alert communicated to a user associated with the patient. Other indicators can be used. 
     In an aspect, a treatment for a patient can be adjusted based on the analysis of the glucose levels. As an example, protocols, physician orders, sliding scales or other forms of glucose treatment can be used to treat hypo- or hyper glycemia based on blood glucose analyses or feedback. 
       FIGS. 5-16  illustrate aspects of a software implementing the methods of the present disclosure.  FIG. 5  illustrates an exemplary feedback  500  presented to a user. In an aspect, the feedback  500  is a visual feedback presented on a display. As an example, the feedback  500  can comprise a plurality of glucose readings records for a pre-determined time period. As an illustrative example, as shown in  FIG. 5 , the time period can be four weeks (from May 28, 2010 to Jul. 1, 2010) and the records can be associated with a particular healthcare provider. For each week, selected information fields can be presented to the user such as the total number of tests performed, the test average, the first standard deviation, the percent of glucose levels within the first standard deviation, as well as the number of glucose levels within certain ranges, for example. 
       FIG. 6  illustrates an exemplary feedback  600  presented to a user. In an aspect, the feedback  600  is a visual feedback presented on a display. As an example, the feedback  600  can comprise a plurality of gauges  602 ,  604 ,  606 ,  608 ,  610 ,  612 . As an illustrative example, as shown in  FIG. 6 , the gauges  602 ,  604 ,  606  can represent a percent of glucose readings within a pre-determined range, an average of the glucose readings received, a percent of the glucose readings over a pre-defined range, and a percent of the glucose readings under a pre-defined range. 
     In an aspect, the feedback  600  can be limited to a particular department, such as the intensive care unit (ICU). As an illustrative example, as shown in  FIG. 6 , the gauges  608 ,  610 ,  612  can represent a percent of glucose reading in an ICU within a pre-determined range, an average of the glucose readings received from an ICU, a percent of the glucose readings from an ICU over a pre-defined range, and a percent of the glucose readings from an ICU under a pre-defined range. 
       FIG. 7  illustrates an exemplary feedback  700  presented to a user. In an aspect, the feedback  700  is a visual feedback presented on a display. As an example, the feedback  700  can comprise a plurality of glucose readings records for a plurality of patients. As an example, each of the records can comprise fields such as patient account number, date and time, glucose measurement, and department from which the glucose measurements were received. In an aspect, the records can be presented for a select department in response to a user input  702 . 
       FIG. 8  illustrates an exemplary feedback  800  presented to a user. In an aspect, the feedback  800  is a visual feedback presented on a display. As an example, the feedback  800  can comprise weekly highest test results  802  for each week. As a further example, the feedback  800  can comprise weekly lowest test results  804 . In an aspect, additional details relating to the glucose readings received can be displayed in response to a user selection of at least one of a plurality of buttons  806 , or icons. As an example, the test results  802 ,  804  can be presented as graph. As a further example, the test results  802 ,  804  can be exported in various file formats, such as Microsoft Excel. Other formats can be used. 
       FIG. 9  illustrates an exemplary feedback  900  presented to a user. In an aspect, the feedback  900  is a visual feedback presented on a display. As an example, the feedback  900  can comprise a plurality of glucose readings records  902  that are over a pre-defined range or value, such as 180 mg/dL. Other ranges and values can be used. In an aspect, additional details relating to the glucose readings received can be displayed in response to a user selection of at least one of a plurality of buttons  904 , or icons. As an example, the readings can be presented as a graph. As a further example, the readings can be exported in various file formats, such as Microsoft Excel. Other formats can be used. 
       FIG. 10  illustrates an exemplary feedback  1000  presented to a user. In an aspect, the feedback  1000  is a visual feedback presented on a display. As an example, the feedback  1000  can comprise a plurality of glucose readings records  1002  that are under a pre-defined range or value, such as 80 mg/dL. Other ranges and values can be used. In an aspect, additional details relating to the glucose readings received can be displayed in response to a user selection of at least one of a plurality of buttons  1004 , or icons. As an example, the readings can be presented as a graph. As a further example, the readings can be exported in various file formats, such as Microsoft Excel. Other formats can be used. 
       FIG. 11  illustrates an exemplary feedback  1100  presented to a user. In an aspect, the feedback  1100  is a visual feedback presented on a display. As an example, the feedback  1100  can comprise a graph of an average of a plurality of glucose readings for a plurality of pre-define time periods. It is understood that any time period can be defined. 
       FIG. 12  illustrates an exemplary feedback  1200  presented to a user. In an aspect, the feedback  1200  is a visual feedback presented on a display. As an example, the feedback  1200  can comprise a scatter plot of a plurality of glucose readings for a plurality of pre-define time periods. It is understood that any time period can be defined. As an example, a minimum glucose reading  1202  and/or maximum glucose reading  1204  can be identified by the feedback  1200 . Other information and details relating to the glucose readings can be displayed. 
       FIG. 13  illustrates an exemplary feedback  1300  presented to a user. In an aspect, the feedback  1300  is a visual feedback presented on a display. As an example, the feedback  1300  can comprise a graph  1302  of a plurality of glucose readings for a plurality of work shifts. As a further example, the feedback  1300  can comprise a quick view  1304  of information relating the glucose readings. Other information and details relating to the glucose readings can be displayed. 
       FIG. 14  illustrates an exemplary feedback  1400  presented to a user. In an aspect, the feedback  1400  is a visual feedback presented on a display. As an example, the feedback  1400  can comprise a graph  1402  of a plurality of glucose readings sorted by date and meal (e.g. breakfast, lunch, dinner, etc.) As a further example, the feedback  1400  can comprise a quick view table  1404  of information relating the glucose readings. Other information and details relating to the glucose readings can be displayed. 
       FIG. 15  illustrates an exemplary feedback  1500  presented to a user. In an aspect, the feedback  1500  is a visual feedback presented on a display. As an example, the feedback  1500  can comprise a graph of a plurality of glucose readings for a particular patient over a pre-defined time period. Other information and details relating to the glucose readings can be displayed. 
       FIG. 16  illustrates an exemplary feedback  1600  presented to a user. In an aspect, the feedback  1600  is a visual feedback presented on a display. As an example, the feedback  1600  can comprise a scatter plot  1602  of a plurality of glucose readings for a particular patient. In an aspect, the feedback  1600  can include an identification of a minimum  1602  glucose reading and a maximum glucose reading  1604  for easy analysis by a user. As a further example, the feedback  1600  can comprise a quick view  1606  of information such as patient identifier, date, time, department, work shift, and meal at which the glucose reading was taken. Other information and details relating to the glucose readings can be displayed. 
     The systems and methods described herein can receive and process thousands of glucose reading in a time efficient manner. The glucose readings can be sorted and organized into a useful format to replace the tedious manual and error prone methods currently used. The methods described herein do not require any manual chart abstraction. 
     As an example, a hospital level analyzing can reveal the quality of glucose management. As a further example, a departmental analyzing compares unit performance. A patient level detail can trace patient&#39;s steps as they move through the system. The chronological data can reveal if there are opportunities in response time by the clinicians. The graphs generated reveal a quick snapshot of overall performance. Because all data generated can be exported into a spreadsheet format, the information can be linked to other databases that contain other patient history and outcomes. Because the data can be examined concurrently as well as retrospectively treatment can be altered quickly. The use of protocols can also be measured for effectiveness. The application can illustrate to physicians variations in practice patterns. 
     While the methods and systems have been described in connection with preferred embodiments and specific examples, it is not intended that the scope be limited to the particular embodiments set forth, as the embodiments herein are intended in all respects to be illustrative rather than restrictive. 
     Unless otherwise expressly stated, it is in no way intended that any method set forth herein be construed as requiring that its steps be performed in a specific order. Accordingly, where a method claim does not actually recite an order to be followed by its steps or it is not otherwise specifically stated in the claims or descriptions that the steps are to be limited to a specific order, it is no way intended that an order be inferred, in any respect. This holds for any possible non-express basis for interpretation, including: matters of logic with respect to arrangement of steps or operational flow; plain meaning derived from grammatical organization or punctuation; the number or type of embodiments described in the specification. 
     It will be apparent to those skilled in the art that various modifications and variations can be made without departing from the scope or spirit. Other embodiments will be apparent to those skilled in the art from consideration of the specification and practice disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit being indicated by the following claims.