What are the data from your meters worth if you can't analyze more than the immediate reading? Most modern meters have the ability to upload their readings to software programs that reside on Windows-based computers. A few meter companies and third-party software developers have programs that work on Macintosh or Linux operating systems as well, but they are generally in the minority. Since I've not yet put together or acquired a Vista system, the following observations are based on installation to Windows XP, service pack 3.
Picking up where I left off, the meters under test are the Advocate Duo (combined blood pressure and blood glucose monitor), Accu-Chek Aviva, Freestyle Lite, Freestyle Flash (my main meter), One Touch Ultra2, One Touch UltraMini, One Touch Ultra Smart, and Wavesense Keynote. For a number of reasons, I did not acquire the proprietary infrared cable and serial-to-USB converter for the Aviva. Other than that, I either had, or purchased, connection cables for the Advocate, Freestyle, Wavesense, and One Touch meters, and either purchased or downloaded the meter manufacturer's software for these meters.
Following are my impressions on the installation, usability, and utility of these systems.
Name: ADVOCATE Health Care System (manufacturer's capitalization)
The software and drivers for this system need to be downloaded from the Internet; the cable needs to be purchased from a vendor
- Plug-n-Play detected the cable, but could not find driver and did not want to use the driver that had been saved to disk.
- Manual installation of driver worked and was very rapid.
- The initial executable file unarchives a Crystal Reports folder and a setup file.
- Clicking the setup icon results in a slow Internet-based download of Crystal Reports and .NET framework.
- It seems to take a long time to load the program
- The initial setup requires basic information (user ID, user name, birthdate, and preferred units)
As all of the software under test, the ADVOCATE Health Care System supports multiple users
- Data download from the device requires a separate autodetect routine each time one tries to download (extra step!)
- The user has to manually select how many readings to download each time s/he downloads (extra step, easy to forget and not get all the readings)
- Manual input: double-clicking on a reading brings up a pop-up dialog box which allows a note to be attached to a reading. No other manual input is available.
- Only the most simplistic of reports are generated:
- log, with pre-set time-of-day readings (forget it if you do shift work!)
- percentage of readings in range
- There are options to view histogram by date, day of week, time, or level
Reports may be printed, but there is no way to save reports or to collate information across multiple devices, or to e-mail the results to one's clinicians
- All necessary files are on the CD that comes with the connection cable
- An autorun file on the CD brings you directly to installation
- The connection cable is automatically detected when the CD is read
- The entire installation and setup is very fast
- Not only does the software support multiple users, but it also has a "Professional Mode" which a clinician can use to access specified reports for all patients from the application home screen.
- Any individual user can set his meter's preferences for target range, hypo OR hyper alert, and times for meal blocks, from the Zero-Click interface. These can then be uploaded to the meter.
- User Profiles (in Microsoft Access format) may be imported or exported from the application home page
- Zero-Click runs as both a System Tray utility and a Start Menu application
- Because of this, once you connect the meter to the computer, the agent will recognize the meter, download any new data, and launch Zero-Click
- Manual input: Glucose readings can be added manually, and comments can be added. In logbook-report view, any reading can be clicked on and comments added.
- The data are backed up as an MSAccess database, but the file is locked to access through any method other than the Zero-Click software.
The following report types are available:
- target analysis
- glucose trend
Reports can be exported using the "E-mail Reports" option from the file menu
- Individual reports can be exported to e-mail as .PDF files
- Basic data (initial information with patient and target goals, followed by a table of date, time, reading, comments) can be exported to e-mail as a .csv file
One Touch: Ultra2, Ultra Mini, Ultra Smart
Name: One Touch Software
- Instructions with device say to install the USB driver first. I installed the general USB driver; as it turned out, I had to install a second USB driver (for the UltraMini) separately, after installing the main software.
- The initial driver required license approval (click to agree to the terms). While this is standard for most software, I don't recall encountering it for the Freestyle meters, and I definitely did not encounter it for either the Advocate Management System or Zero-Click.
Again, this required license approval (click to agree to the terms). Otherwise, pretty straightforward.
The initial menu provides four large icons: download readings, view reports, manually enter data, and setup. This menu comes up every time one invokes the program.
- Initial setup options include "Home" and "Clinic" options. Once you choose "Home", "Clinic" is disabled.
- Patient Setup includes space for one's doctor, CDE, and insurance information, as well as the ability to customize meal periods, set a second schedule for non-working days, and add the information for one's medical diabetes management (medications, diet-and-exercise, and whether or not you are on a pump). The medication list can be customized to include medications not on the initial list. Other tabs allow customized insulin regimens and a check-off list of common complications of diabetes.
- The printed instructions state that you need to have the USB cable attached before starting the program. It doesn't say whether or not the meter needs to be "on" or not. Depending on the specific meter, you may need to manually turn on the meter after attaching it to the USB cable before it will communicate with the computer.
- The list of which meters require you to turn them on, and which ones do not, can be found in the "Meter Settings" area of the Setup menu.
- You must manually install the USB driver for the UltraMini before it shows up in the list of meters.
- The meter serial number appears when the meter is downloaded; patient confirmation is required by default (but can be dismissed) before readings will be downloaded.
- The software automatically detects duplicate readings.
- Manual input: Both glucose and general health information can be manually entered by clicking on an icon. The interface is straightforward, and all tabs accept input of free-text comments. That said, the Food tab asks only for totals of macronutrients, and the Exercise tab asks only for intensity and duration, not type of exercise or calories burned.
- Except for the free-text comments, these fields may manually recorded to a OneTouch Ultra and automatically uploaded to the computer.
The following report types are available:
- Data List
- Glucose Trend
- Pie Chart
- Standard Day
- Average Readings
- Health Checks
Reports may be e-mailed or FAXed as .tif files. Records may be archived in MS Access format (locked file) or exported in .csv format. The .csv export appears to include all recorded fields, but it is not obvious which column reports which datum.
Abbott/Therasense: Freestyle Flash, Freestyle Lite
Name: Co-PilotSince the Freestyle Flash is my primary meter, the software and cable were installed on my system well before the start of the review. As a result, my recall of the initial installation may be a bit hazy.
I don't remember drivers coming with the DB-9 cable I got years ago. I do recall a driver CD coming with the USB cable. There is a license agreement with the installation.
I remember having to register to be able to download the Co-Pilot software installer; the application itself downloaded from the Web as part of the install.
- The first time you select "Read Device" from the default/home menu, the device will ask you what user you wish to associate with the meter.
- If you have not yet entered user information, you will need to set up an initial user as well. As with most meter connectivity software, Co-Pilot supports multiple users. The basic user profile includes a name, a user number, an e-mail address, and a password.
- The Health Profile tab allows you to specify height, weight, diabetes type, diagnosis date, and any other conditions (and their treatment). A list of common complications is provided, but you can add in your own.
- The Data Entry Preferences tab allows you to enter preferred exercise regimens (for example, a 1 hour Pilates class) as well as medications and their dosages.
- The Glucose Targets tab allows you to specify both high/low/hypo/hyper targets and time periods for your daily schedule.
- Options allows you to set which data entry options you wish to enable, which report types you prefer, and what you want displayed on those reports.
- The software also supports multiple Freestyle devices.
- The USB cable associates with a specific USB port. If I connect the USB cable to the other USB port on my system, Co-Pilot will not find the meter.
- The software supports multiple users, insulin use, insulin pumps, and manually-indicated oral medications
- Each user can specify what information to display, or not display, on list-format reports.
- Manual input:
- Some of these readings may have been part of the standard download from the Freestyle Tracker electronic logbook; they may also be downloadable from the Navigator.
- Individual glucose readings can be modified from the software interface to indicate reading site (forearm, palm, abdomen, calf, etc.) and hours since last meal.
- Meals entry is restricted to the internal database; the serving sizes are not flexible. Only the grams of carbohydrate are tracked.
- The Exercise tab allows for a few basic types of exercise, duration in 10-minute intervals, and intensity.
- State of Health has a handful of options (infection, tired, fever, menses, sore throat, allergy, stress, flu, dizzy), mostly similar to those in the One Touch software, but you can type in your own option.
- Meds allows you to customize the set of all medications you take, their doses, and their frequency. You then choose from the dropdown list when adding entries.
- Exam allows you to enter the type of exam, doctor name, and comments.
- Lab includes a dropdown list of the most common laboratory tests, but allows you to add in your own, including reference ranges and comments.
- There is also a Notes tab to write in any other comments.
The following report types are available:
- Diary List
- Glucose Modal Day
- Pie Chart
- Lab & Exam
- Glucose Line
- Glucose Average
- Daily Combination
- Glucose Histogram
- Weekly Pump
- Reports may be exported as either XML files or comma separated values, or e-mailed in .pdf format.
- Abbott also offers synchronization to their own servers to facilitate sharing data with one's healthcare providers.