1. SCI-Diabetes and My Diabetes My Way: A Primary Care Focus
Dr Scott G Cunningham – Technical Consultant

2. Introduction SCI-Diabetes: shared diabetes record
Reporting and analytics
Research and evidence base
My Diabetes My Way
New technologies

3. 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

5. 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

6. 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

7. 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

17. National Retinal Screening Programme
Grading & Call / Recall
SCI-DC Network
NationalCHI

25. Audit Reports –MCN Quarterly Reports

26. Scottish Diabetes Survey
Chair: Johnny Mcknight 26

31. 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)

35. 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 35

38. 38

39. 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

62. 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

63. 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

64. Records Access – Current Status
12,868 people have accessed their records
~2500 in Lothian

65. New Technologies Virtual support Personal data
eLearning
Virtual consultations
Personal data
Internet of Things
Smartphone apps
Wearables
Medication compliance
Big Data and Data Science

66. Patient-recorded Data
Mobile: >1,300 diabetes apps!
Wearable technology: pumps, CGM, activity
Home monitoring: BG, BP, weight, CHO

67. Patient-recorded Data

73. 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

74. Quarterly Reporting

75. Quarterly Reporting

76. 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

77. 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

78. Dr Scott G Cunningham, Technical Consultant
@MyDiabetesMyWay