Glucose software eases R.Ph.s' workload

September 4, 2006

MD Scientific LLC has received approval from the Food & Drug Administration to market a computer software program that calculates insulin dosages for critically ill patients. Company officials predict the technology will help reduce the workload of hospital pharmacists.

MD Scientific LLC has received approval from the Food & Drug Administration to market a computer software program that calculates insulin dosages for critically ill patients. Company officials predict the technology will help reduce the workload of hospital pharmacists.

"From a pharmacy standpoint, EndoTool cuts down on some of the work," said Robert Rittase, a pharmacist at Carolinas Medical Center in Charlotte, N.C. "The sliding scale orders are generated by the computer. I don't have to enter and reenter the orders-it does save some time."

EndoTool also saves pharmacists from agonizing over the mathematical calculations associated with insulin doses. "This really changes the life of a pharmacist," said Shade Mecum, president of MD Scientific, a North Carolina-based company founded in 2003. "The medical director writes an order to put an ICU patient on the EndoTool management system. From pharmacists' standpoint, they love it. They get an electronic record of what the doses were and when the doses were given. There's no math involved for the pharmacist or the nurse."

And there's very little work involved for the pharmacists, either. All they have to do is fill a doctor's order to put a patient on the EndoTool Glucose Management System. The rest is taken care of by the software program. "The only order pharmacists get is an order for the EndoTool," said Patrick Burgess, M.D., chief medical officer for MD Scientific and former chief of staff at Carolinas Medical Center, where the EndoTool system has been used for the past three years. "EndoTool has reduced pharmacists' workload, and they seem to love it," he said.

The EndoTool system has been in development for nearly four years and has been used mostly at Carolinas Medical Center. The software system was developed by Burgess, who was looking for a way to reduce renal failure in critically ill cardiac patients.

Various studies have shown that mortality and hospital infection rates increase in critically ill patients with high blood sugar levels. In his quest to reduce renal failure in cardiac patients, Burgess discovered that controlling blood glucose levels led to quicker recoveries, a reduced risk of infection, and shorter hospital stays.

The EndoTool Glucose Management System has been used in 13 intensive care units and operating rooms, producing more than 100,000 insulin dose calculations annually. The software has a hypoglycemia incidence of less than 0.1% of the total calculated doses administered.

Mecum said EndoTool is designed for patients in critical care who receive insulin intravenously. Most patients have Type 1 or Type 2 diabetes, but all have blood glucose levels above 130. "These are sick people, and this is one of the big opportunities hospitals have to reduce hospital-acquired infections," he explained. "This is certainly one of the things that has us inspired. The question in health care today is not why you should control glucose levels, but how to do it. That is the challenge."

Having met that challenge, Burgess and Mecum are now anxious to market the EndoTool Glucose Management System and share the technology with hospitals throughout the nation. The software program, licensed by MD Scientific, is run on computers or servers with Windows 2000 or higher operating systems. The license fee for the software includes on-site installation, service, and 24-hour technical support.

Rittase said the software is easy to use. "From the feedback I've gotten from nurses, it's really very simple," he said.