SCI-Diabetes and My Diabetes My Way: A Primary Care Focus Dr Scott G Cunningham – Technical Consultant www.mydiabetesmyway.scot.nhs.uk
Introduction SCI-Diabetes: shared diabetes record Reporting and analytics Research and evidence base My Diabetes My Way New technologies www.mydiabetesmyway.scot.nhs.uk
Diabetes in Scotland Scotland’s diabetes prevalence 2002: 103,835 (2%) 2016: 291,981 (5.5%) Type 1: 10%; Type 2: 89%; Other types: 1% 153,028 (15.6%) aged 65 and over www.mydiabetesmyway.scot.nhs.uk
SCI-Diabetes Web-based access to the shared record Data captured from multiple sources Approx 1000 GP practices, labs, screening services, direct data entry Clinically relevant tools and views on data Support for specialty groups Diabetes Specialist Nursing; Dietetics; Paediatrics; Podiatry www.mydiabetesmyway.scot.nhs.uk
SCI-Diabetes Real-time data-entry and update Supporting single data-entry Continuous clinical audit Ease of cross-boundary movement 1 diabetes system for NHS Scotland Clinically led and driven National coverage since 2006 www.mydiabetesmyway.scot.nhs.uk
SCI-Diabetes Data Flows Audit & Reporting Laboratory Results Master Patient Index Retinopathy Screening Primary Care Systems Patient Access Clinical Portal Scottish Diabetes Research Network Inpatient Linkage Electronic Document Transfer Digital Dictation Ambulance Service Point of Care Blood Glucose Testing
National Retinal Screening Programme Grading & Call / Recall SCI-DC Network NationalCHI www.mydiabetesmyway.scot.nhs.uk
Audit Reports –MCN Quarterly Reports
Scottish Diabetes Survey www.mydiabetesmyway.scot.nhs.uk Chair: Johnny Mcknight 26
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SCI-Diabetes Secondary Use Health boards monitoring their patients Views filter data by health board (and the other NHS boards) 2. Data for health board users GPs The ‘Audit’ set of databases Researchers investigating diabetes Hospitals Live system Scottish Diabetes Research Network (SDRN) Clean, pseudonymise and encrypt Clinics Patient data Data replicated 1. Data for researchers UNIVERSITY OF DUNDEE (and other projects)
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My Diabetes My Way Website for patients and carers Information leaflets Interactive content Videos / Patient Testimonials / Interactive tools Validated internal/external content Overseen by multidisciplinary group Patients / HCPs / IT professionals Live since October 2008 www.mydiabetesmyway.scot.nhs.uk 35
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MDMW Personal Health Record Limited to key diabetes data Information to explain clinical measurements Feedback processes to report errors Full system audit trail Live since December 2010 Available to anyone with diabetes in Scotland www.mydiabetesmyway.scot.nhs.uk
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Anecdotal Feedback The knowledge provided helps me understand the normal parameters and where I stand/can improve… more information available to me means I can play a more positive role in my treatment… Great site and like having the long term history available to put current results in perspective… It is great to be able to view all of my results so that I can be more in charge of my diabetes… What a fab resource, wish we had this in @NHSEngland
Evaluation Survey – opinions following system use: 87% - reminders of information discussed 89.6% - better use of consultation time 94.2% - improved understanding 95.9% - helped to monitor changes over time 88.2% - helped manage diabetes better Significant improvements in outcomes: HbA1c (p < 0.001) 1.53 mmol/mol Total cholesterol (p=0.002); HDL (p=0.012); LDL (p=0.001); Diastolic BP (p=0.007); weight (p=0.003) 63
Records Access – Current Status 12,868 people have accessed their records ~2500 in Lothian www.mydiabetesmyway.scot.nhs.uk
New Technologies Virtual support Personal data eLearning Virtual consultations Personal data Internet of Things Smartphone apps Wearables Medication compliance Big Data and Data Science
Patient-recorded Data Mobile: >1,300 diabetes apps! Wearable technology: pumps, CGM, activity Home monitoring: BG, BP, weight, CHO
Patient-recorded Data
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Quarterly Reporting Regional reports with practice breakdown Circulated to Diabetes MCN Numbers of registrants and active users Comparisons with peers in local area Comparisons with other health boards
Quarterly Reporting
Quarterly Reporting
Raising Awareness Primary Care Mailout List of unregistered patients supplied Review to exclude inappropriate patients Letter sent out on practice headed paper All postage and stationery paid by MDMW
Conclusion SCI-Diabetes - a genuinely shared record MDMW assists diabetes self-management Unique covering a full national population Clinical audit and reporting Contributing to the evidence-base Internet of things and Big Data offer significant opportunities the future
Dr Scott G Cunningham, Technical Consultant scott.cunningham@nhs.net www.sci-diabetes.scot.nhs.uk www.mydiabetesmyway.scot.nhs.uk @MyDiabetesMyWay www.facebook.com/mydiabetesmyway