HOW AN INTELLIGENT DEVICE CAN CUT THE MUSTARD

HOW AN INTELLIGENT DEVICE CAN CUT THE MUSTARD Dr Julian Brown

What Was Meant by This? Succeed Come up to Expectations Provide High Quality

Obviously I must Have Been Good ? 2006 +201%

The Story 2006: I became our PCT Prescribing Lead. My Surgery was highlighted as having significantly high admissions for diabetes. My Surgery was terrible. They sent me to Chicago. I decided to create an IT solution www. diabetesmanager. org. uk

The Result Went from one of the worst to the best in 1 year. No insulin initiations. Reduced Admissions. Reduced overall spend Best HBA 1 C control 2009

Graph of glycaemic control achieved from 2009 QOF data.

What Had We Done? Performance Tracking Risk Stratification Integrated Care Self-Management Plans Patient Access

Performance Tracking Accurate Benchmarking of how the surgery and PCT is performing on clinical markers. NICE � QOF � How we were performing in terms of outcome data. How we were performing in terms of

6. Track Overall Cost-effectiveness at surgery level

2. Risk Stratification: Identification of High Risk Patients Six types of High Risk Patients 1. Those that have poor endpoint data. 2. Those that have deteriorating end point data. 3. Those that fail to have screening 4. Those who are not on or not collecting appropriate medications 5. Those that are on inappropriate medications.

2. High Risk Patients: a. Poor End Point Data The System will automatically create weekly league tables by each parameter.

2. High Risk Patients: b. Deteriorating Scores Looking at flux of endpoi nt data helps identify patients earlier.

3. Integrated Care: Sharing the e. Healthcard Secure online for ease of access by: � GPs � Other HCPs � Patients

3. Summary Reports Allows quick overview of patient Allows prediabetes clinics Allows remote clinics Allows compliance issues to be identified.

7. Liaising With Specialists

7. Liaising with Specialists

3. Patient Self Management Plan 7 essential steps for diabetes perfection. � Blood Pressure Control � Blood Sugar Control � Cholesterol Control � Weight Control � Healthy Lifestyle � Medication Compliance

Self-Management Plans Encourage Patients. Educate Patients. Essential in achieving long-term diabetes control. Reduce complications. Reduce costs. Makes the Patients Happy

How did diabetesmanager work? � � � Web based application. Automated Data Extraction from GP systems Remote performance tracking of all diabetes patients. Automated self-management plans for every patient. Allows online access for patients Allows online education and remote specialist clinics.

Why Not Apply the Same Logic to Medicines Management 7% all emergency admissions medicine induced 60% of these preventable Each one costing average £ 5000

The Process

The Result is Complete Safety Monitoring

The System Allows True Integrated Care

Surgery Portal Identifies at risk patients Updated Weekly Confidentiality Maintained Surgery Has Control

Preventing Emergencies Identifies the Patients who don’t come to see us. The ones that manage to get themselves on drugs that are dangerous for them. The ones that aren’t taking their protective medications. QOF!

Better Integration Patients Practice Diabetes Nurses GPs Specialist Nurses Podiatrists GPs specialist interest Consultants Commissioning Leads Medicines Management online, webinars , emails, reports Communication!

The Future Better outcome for patients Better education of patients (autotranslation etc) Increasing Selfmanagement Reduced need for medications. Easy patient alerts Easy patient tracking Better outcomes for HCPs. Reduced Emergencies. Reduced Admissions Better project and formulary compliance. Better use of services. Identification of GP Surgeries needing extra resources. Better education Online referrals

This can become a thing of the past! � Microvascular Neuropathy Retinopathy Renal Disease Diabetic ulcers � Macrovascular Heart Attacks Strokes Peripheral Ischaemia Diabetic Ulcers

And more importantly – it transforms Patients Janet She used her selfmanagement plans & diabetesmanager. org. uk for 12 months

To this one! Same patient after 12 months using her self-management guide www. diabetesmanager. org. uk Time for live demo

Does this Cut The Mustard? 2009 QIPP arrived Quality Innovation Prevention Productivity The Future of the NHS £ 20 billion Savings

How Would It Work? Quality Cost-Savings with reinvestment Improved Productivity Innovation to Implement Prevention allowing Improved Efficiency