JMIR Publications

ABSTRACT

Background:

Primary care physicians manage most type 2 diabetes (T2D) cases worldwide but face increasing workload pressures and limited infrastructure. To support consistent, guideline-based care, the Swiss Society of Endocrinology and Dia-betology (SSED) developed a quality monitoring tool known as the SSED score. The score evaluates whether essential care processes have been completed for each individual with T2D. These processes include HbA1c testing, blood pres-sure measurement, and screening for diabetes-related complications. By aggre-gating these elements, the SSED score provides a structured way to assess ad-herence to recommended standards of diabetes care. Although this approach shows promise for improving health outcomes, the score is currently mostly available in paper format and creates additional administrative burden for phy-sicians.

Objective:

This study explored challenges in T2D management in Swiss primary care, as-sessed the limitations of the SSED quality score, and identified strategies to ena-ble its adoption in routine practice.

Methods:

We conducted 38 semi-structured interviews following the COREQ guidelines with key stakeholders involved in T2D care in Switzerland: 12 healthcare pro-fessionals, 12 individuals with T2D, five health insurers, and nine healthcare software developers. Data were analyzed using thematic analysis.

Results:

Participants highlighted persistent challenges in T2D management, including time pressure for health care professionals, fragmented care, and lack of per-sonalized support. Barriers to digital quality monitoring included poor integra-tion with GP systems, misaligned incentives, and limited relevance to multi-morbidity. Suggested facilitators included embedding tools into workflows, en-abling task shifting for physicians, integrating patient-centered features and improving data sharing.

Conclusions:

A digital SSED score could support GPs by integrating patient-entered data, generating automated alerts, and enabling pharmacy-based follow-up. Success-ful adoption depends on GP workflow integration, system interoperability, and aligned incentives that promote engagement for individuals with T2D. Involv-ing stakeholders early is essential to ensure that new digital tools meet the needs of both individuals with T2D and GPs.