In 1995, by changing workflow and using task delegation to implement an assessment protocol, the Hong Kong Diabetes Register (HKDR) was established as a data-driven quality improvement program to stratify risk and identify care gaps whilst the personalized data was used to empower self-management and inform early intervention. The incorporation of the HKDR protocol in the territory-wide electronic medical record system in Hong Kong and its digitalization to become the web-based Joint Asia Diabetes Evaluation (JADE) platform have benefited 800,000 people with diabetes with reduced event and death rates, and inspired similar data-driven care models in Asia.
The 30-year ongoing data collection of HKDR evolved to become the Chinese Diabetes Outcome Model (CDOM) which quantifies the impacts of intervention on a personalized level. The biobank accompanying the HKDR revealed marked heterogeneity of the causes, trajectories, and outcomes of diabetes with discovery of biogenetic markers which form the basis of a territory-wide Precision Prevention Program for Young-Onset Diabetes.