DigiBete App

Summary

DigiBete is a multi-award-winning digital web platform and app for the T1 diabetes community, co-designed by patients, parents and the Leeds Children’s Hospital Paediatric Diabetes Team. The DigiBete.org web platform, and the subsequent nationwide app launch in 2020, provide free access to clinically-approved education and training resources to support young patients with T1 diabetes, their families and communities. It has enabled rapid, direct digital communication between registered patients and individual teams during the pandemic. The app launched regionally in October 2019, and nationally in June 2020, in response to COVID-19, with funding from NHS England.

Innovation

The DigiBete website is established in paediatric practice as a clinically approved resource for patients, families, carers and NHS staff managing T1 diabetes. The DigiBete app launched in Yorkshire in October 2019 to provide personal access to age-appropriate self management education, help after diagnosis and for clinics to enhance communication and reduce paper use. In March 2020, when COVID-19 hit, the DigiBete app was funded by NHSE and launched nationwide in June 2020. Although children and young people (CYP) are less affected by COVID-19, effective diabetes management is paramount to prevent hospital admissions, avoid DKA episodes and maintain good health remotely without face-to-face appointments. Much of the app microlearning educational content is consistent across all services; each diabetes service can tailor messaging to an individual cohort. All content and functionality meets NHS standards.

Equality, Diversity and Variation

DigiBete.org is available, without cost or registration, to all. The app is free to all CYP attending a children’s diabetes clinic in England and Wales. Standardising care and reducing inequalities in diabetes services is at the core of DigiBete’s work. DigiBete resources comply with Web Content Accessibility Guidelines (WCAG) and employ Text Help and the ReachDeck Toolbar, to support web visitors in a way that suits their needs. Features include text-to-speech, reading with choice of text size and translation facilities to support up to 99 languages using Browsealoud technology. All resources are routinely subtitled. DigiBete has addressed inequality through World Diabetes Day videos and developed resources to address minority communities. An Equality and Health Inequality Impact Assessment (E&HIIA) document monitors and reviews representation from minority groups. A variety of ages, backgrounds and ethnicities are represented in the videos on the site/ app. A parallel site for young people with T2 diabetes is planned.

Results

The website and app have brought value and recognition to a community often neglected in the national diabetes agenda. In relative numbers, the young T1 community is small, but the impact of diagnosis is far-reaching in terms of physical and mental health. Providing timely, accessible, quality resources and support between structured clinic appointments with HCPs is essential. The app won two prestigious tech industry awards in 2020/21. Since June 2020, 95% of paediatric clinics across England and Wales have implemented the app, with 40% (12,000) of patients registered. There are approximately 20,000 users. Staff can evidence ongoing self-management education by patients. Patients and carers are using the app for enhancing knowledge and preventing potential emergency care. Realworld survey evidence supports this. Use of app instead of postal communications has enabled more frequent clinic communications at no extra cost, saving the NHS around £430,000 to date. Any DKA admission prevented by timely access to illness management saves £7,000. Individual plans and results can be stored in the app after clinic appointments in the MyT1D section. DigiBete (non NHS staff) delivered 190 sessions of free NHS staff training, plus template letters and photos for newsletters. DigiBete is working with the North West NHS Improvement programme to evaluate the app over two years.

Dissemination and Sustainability

All paediatric services in England and Wales have had access to the app since June 2020. The existing web platform has been used as a national resource since 2016 and is already established. It is centrally supported by NHSE and the Welsh Government as a recommended resource for young people with T1 diabetes. The app has been funded for a further two years by NHSE, promoted widely using the National CYP Diabetes Network, by social media and the Families with Diabetes Network for patients. DigiBete Champions assist engagement with the app locally and examples of good practice are shared via the Champions Network. Many services nationally have included the app as part of Quality Improvement initiatives for service improvement throughout 2021. With the benefi t of the experience of 150 families and the expertise of many clinical teams driving the development of DigiBete, the complexities of self-management of diabetes have been well understood. Using real patients and families brings authenticity and peer support. The website and app have undergone extensive development at considerable cost from a variety of private, commercial, charity and NHS sources. Fifteen young adult services are implementing the app and co-creating further relevant content. DigiBete is part of a NIHR-funded £800,000 project with IBM to develop a ‘ChatBot’ for young people moving from children’s to adult services.

User Feedback

As parents of young people with T1 diabetes, DigiBete staff are involved with national and local support groups and encourage feedback. Both the app and website have the facility for instant feedback or can respond to enquiries. Patients and families, both local and from further afi eld, and experts, are included in new content. A monitored Community Page enables contributions and shared patient experiences. Since 2016, DigiBete has co-created content with more than 150 families and 50 professionals in diabetes and education, with about 15% newly created or refreshed annually. This will increase with renewed NHS funding. The app design and development have been revised in response to patient and staff feedback.

User feedback for the app (HCPs and patients) was requested via an in-app survey, and a real-world evaluation carried out with independent researchers from the University of Leeds. Rapid communications from diabetes teams were welcomed throughout the pandemic. CYPF liked the app for its ‘bite-sized information’. Some CYPF wanted to know as much as possible, while others preferred not to be overloaded with information.

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QiC Diabetes Winner 2021
Type 1 Specialist Service
DigiBete App
by DigiBete and Leeds Children's Hospital Diabetes Team

Quality In Care Diabetes

QiC Diabetes is partnered by:
Supported by:
  • 2022 KEY DATES
  • Open for entry:
    Monday 28 March 2022
  • Entry Deadline:
    Friday 1 July 2022
  • Judging day:
    Tuesday 6 September 2022
  • Awards ceremony:
    Thursday 13 October 2022