Novel strategies and incorporation of information systems were identified for development to improve overall patient care within the outpatient setting. One of the ways to improve the Diabetes service is via a diabetes medical information management system. This will allow facilitation and analyses of data by audit of practice and health assessments within the diabetes teams. In addition, routine uploading of glucometers and insulin pumps in outpatient clinic allows joint analyses between staff and patients of patient’s blood glucose trends.
Aims Within a dual-site integrated care organisation, we established the use of an electronic diabetes information management system (Twinkle.net) and routine uploading of glucometers and pumps (Diasend system) with an aim to improving outpatient paediatric diabetes care and education.
Methods The Diasend blood glucose monitoring system allowed patients to upload and view their own data and allowed the diabetes team within a clinic setting to download a patient’s blood glucose from as many as 15 different manufacturer’s glucometers or insulin pumps within less than 2 min. The electronic management system (Twinkle) allowed monthly audit which identified specific patients who had poor metabolic control and those with recurrent DNAs to clinic. These patients were identified for more intensive contact and education with the diabetes nurse specialists.
Results Metabolic outcome for diabetes (HbA1C) was compared in the period before and the period after the implementation of the electronic diabetes information management system and use of a routine uploading of patient’s blood glucometers and pumps. In 2012, average HbA1c was 8.6% and in 2013, average HbA1c was reduced to 8.4%. A patient satisfaction survey was also conducted within the outpatient setting with 79% positive feedback pertaining to the use of the new technology. Admission to hospital rate was 28% in 2012 and 19% in 2013 (p < 0.05). The median hospital length of stay for was 2.7 days in 2012 compared with 1.8 days in 2013 (p < 0.05).
Conclusions The data indicates that following the implementation of the technology within a clinic outpatient setting, overall HbA1c metabolic control, admission rates and patient satisfaction improved and the team found regular data analyses and audit submissions less time consuming and more cost-effective.
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