Digital and Technology Solutions in the Treatment and Management of Diabetes

WINNER

A technology-enabled service to optimise insulin management

by Hygieia Medical

The d-Nav Insulin Guidance Service is a technology-enabled managed service providing automated insulin dosage titration for patients using basal, premixed and basal-bolus insulin regimens with and without carb counting. When implemented in a Trust in Northern Ireland mean Hba1c decreased and patient satisfaction was high. Meanwhile, cost effectiveness analysis demonstrates that d-Nav is cheaper than the current standard of care.

Judges comment:

"The team targeted their most hard to reach patients in Northern Ireland and improved their self-management, with a great use of technology and appreciation for the current and emerging situation to support an ever increasing cohort of patients. They have already produced exceptional audit results."

HIGHLY COMMENDED

Type 2 Diabetes and Me – E-learning guide

by Diabetes UK, in partnership with Bupa

A Type 2 diabetes diagnosis can be overwhelming. There is so much information available, it can be difficult to take it all in. Diabetes UK’s free Type 2 Diabetes and Me online guide allows patients to get all the facts, at their own pace, in their own time. The online guide is for anyone who has recently received a Type 2 diabetes diagnosis and those living with or affected by Type 2 diabetes who want a refresher about their condition and the options available to support them.

Judges comment:

"This guide is changing lives and reaching out to a huge amount of people. It is scaleable, sustainable and replicable, with good data on the results. The scale is impressive and it is great to see such a good, free, simple, easy to use education tool for Type 2."

COMMENDED

Transforming Diabesity Care: Institution of an NHS Endobarrier Service

by Sandwell and West Birmingham Hospitals NHS Trust

Endobarrier is a 60cm intestinal liner inserted by mouth (endoscopy) to mimic weight-reducing and diabetes-improving gastric bypass surgery less invasively. Having acquired the practical skills for inserting and removing Endobarriers, Sandwell & West Birmingham Hospitals (SWBH) NHS Trust set out to establish an NHS Endobarrier service for selected patients with diabesity and ‘nowhere else to go’. A one-year service evaluation found it is working well and referrals are increasing from across primary care and multiple secondary care specialties. There is a large number of NHS patients with diabesity who have exhausted treatment options, which suggests that the service could be established widely in the NHS.

Judges comment:

"This is an interesting project, tackling a real problem and the outcomes are significant. Patient feedback was impressive."

COMMENDED

HeLP-Diabetes: a proven online solution for diabetes self-management support

by University College London

HeLP-Diabetes has around 800 users and is an evidence-based programme that takes a holistic view of self-management, focusing on medical, emotional and role management. It includes behaviour change support (with goal setting, action plans, reminders and feedback); emotional support (computerised cognitive behavioural therapy tools, mindfulness, online moderated forum); an online health record where patients can input their own information and set text/email reminders; and regular newsletters, emails and SMS alerts about new and specific (seasonally-relevant) content. Benefits for patients include reduced diabetes-related distress, improved glycaemic control, accessibility, convenience, privacy and access to clinically informed and trusted information. Developed as a research programme, it is now being rolled out nationally and has been adopted in four London CCGs.

Judges comment:

"This is a great project which focuses on self-management – a much neglected area of care – and has good user feedback."

COMMENDED

My Diabetes My Way: online support for diabetes self-management

by University of Dundee

NHS Scotland’s My Diabetes My Way (MDMW) website for people with diabetes and their carers offers multimedia resources aimed at improving self-management. MDMW also offers users access to their clinical data via its novel electronic personal health record (ePHR). The ePHR sources data from primary care, secondary care, specialist screening services and laboratory systems; including diagnostic information, demographics, process outcomes, screening results, medication and correspondence. These data provide a more complete overview of diabetes than is available from any single data source. Over 9,000 patients across Scotland have logged in and user evaluation shows that they find it a useful tool to aid self-management by improving knowledge and motivation to make positive changes.

Judges comment:

"This programme is “on the money” and is a good, modern approach to support self-management, linking traditional care models to information and ease of access for patients."

FINALIST

The Florence (FLO) telehealth texting system

by Derbyshire Community Health Services NHS Foundation Trust

Community diabetes nurses embraced the Florence (FLO) telehealth texting system to support patients they see with diabetes. The free service has been used for medication reminders and glucose results; improving patient outcomes and changing the way diabetes nurses are working. Over 250 type 1 and type 2 diabetes patients identified by the community team are using this technology, which allows specialist nurses to monitor patients remotely, set them individual target ranges and receive email alerts if the patient is out of an agreed individual target range. Patients have responded positively to this cost-effective system and it has reduced the number of face-to-face contacts required. Patients also report that they feel more supported.

Judges comment:

"A good project representing clear and realistic objectives. It had strong planning and implementation and considered the local impact with the results they were achieving."

FINALIST

Clinical Decision Support for Diabetes in Scotland

by NHS Tayside and University of Dundee

Clinician Decision Support Systems (CDSS) provide HCPs with automated advice about best practice patient care, and have been shown to effectively influence behaviour in terms of adherence to guidelines and avoidance of drug errors. The Evidence Based Medicine electronic Decision Support (EBMeDS) system is a CDSS that was developed in conjunction with health care providers and successfully implemented within SCI-Diabetes, the Scottish national electronic health record for diabetes. EBMeDS has been ‘live’ to users within NHS Tayside and NHS Lothian since December 2013: evaluation found that use of the EBMeDS system has resulted in a dramatic improvement in adherence to national guidelines, with modest improvements in glycaemic control.

Judges comment:

"This was a very professional submission and what this hospital have achieved is extremely hard to do and do successfully, especially the clinical algorithms. Great initial results, especially with the foot care reviews and it will beinteresting to see where this goes in the future."

FINALIST

An “IDEA” to deliver inpatient diabetes safety messages in bite-sized animations

by University Hospitals of Leicester

IIDEA (Inpatient Diabetes Education through Animation) is intended to improve inpatient diabetes care. A review of serious diabetes incidents and DATIX incidents was used to identify recurring safety themes. These were then incorporated into a suite of animations. The innovation is aimed at delivering key safety messages to healthcare professionals (HCPs) in memorable bite-sized animations. IDEA may be used to disseminate key learning messages to all HCPs who care for patients who have diabetes and are admitted to hospital. The videos focus on key areas identified where mistakes have been made, with the aim of learning from these experiences, improving care and patient experience. IDEA can be found on a variety of platforms to widely disseminate shared learning.

Judges comment:

"Great, simple idea and judges loved the fact that untoward incident data was used to focus on what mattered most. This is fresh, different and has potential."