PHR use supports closer patient-professional relationships in diabetes care
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Overview of progress & evaluation using a personal health record 'Patients Know Best' to help & support people with type 1 diabetes
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PHR use supports closer patient-professional relationships in diabetes care
- 1. Can Personal Health Records help build closer relationships with people with Type 1 Diabetes? Dr Pete Davies Janet Kinson Diabetes Centre, Sandwell Hospital, SWBH NHS Trust
- 2. Time for Type 1 diabetes • 10 years of transformation – “Right Care, Right Here” – Type 2 diabetes care closer to home • Helped to create time/space to develop type 1 diabetes care – BUT ask people with diabetes – Appetite for innovation • Birth of T1SWAS – T1 SWBHT Advice & Support Survey autumn 2014
- 3. Autumn 2014: Voice of the customer We asked PWD type 1: • What are their specific needs? • Which new elements could add value? • Imagine… “no holds barred!” PWD type 1 told us: • Access needs improving – Greater flexibility in the timing and frequency of support – Faster access to support & advice • “Mind the gap” – Peer support – Emotional support – Psychological support • Tools that allow closer communication – Open to Skype, sms-support, secure messaging, etc.
- 4. Spring 2015, T1SWAS launch: supported with "Patients Know Best™" • PKB already in use our organisation – Immunodeficiency – Behçet tertiary service • SWBHT wished to 'test' PKB on a larger scale • Offers – Secure messaging – Integration with laboratory test results – Care planning – Library of links & documents – Skype consultations integration – Tracking of biomedical measurements – Care planning Plan DoStudy Act v “Voice of customer” survey v Improve access v Greater breadth v Technology enabled v PKB “the vehicle” v Carry out the plan v Determine what changes need to be made v What was learned
- 5. Implementing Patients Know Best • Each person invited face-facein consultation – 1 minute sign-up – PKB leaflets to take away, for the curious – Clinic letter sent by secure message within 3 business days • Team members trained & added, patient-by-patient Plan DoStudy Act v “Voice of customer” survey v Improve access v Greater breadth v Technology enabled v Implement PKB v Offer to PWD v Engage the team v training v Determine what changes need to be made v What was learned People with diabetes Diabetes nurses Dietitian Doctors Emotional support team Peer support team
- 6. 0 100 200 300 400 500 600 0 500 1000 1500 2000 2500 02-Apr 02-May 02-Jun 02-Jul 02-Aug 02-Sep 02-Oct 02-Nov 02-Dec 02-Jan 02-Feb Cumulative Secure message Number PKB Growth April 2015 to February 2016 Messages No. Patients HL7 Evaluation Sept 2015 • In use 5 months • 221 patients using PKB • 50:50 type 1 diabetes & endocrine • N = 30 (13.5% response rate) Numbers of patients / HL7 messages exchanged Evaluating PKB
- 9. Evaluation of PKB: September 2015 Cost saving Impact of PKB as perceived by people with type 1 diabetes: 0% 10% 20% 30% 40% 50% 60% 70% Messages Blood tests Clinic letters Skype Consultation Adding measurements Adding Wearables Viewing Documents from library Saving Cost Definitely saves Money / cost Sometime save money / cost Doesnot save money / cost Can help support a business case justification to adopt PHR
- 13. People with diabetes said… “Using the messaging service put my mind at rest” “I received a reply much faster than I would have expected through more traditional means.” “It’s useful that correspondence is saved for me to look back over, so I can process the information at a pace that suits me” “PKB helped me to construct a more considered and detailed question than I would have managed verbally whilst feeling unwell and confused” “I feel safe in the knowledge that I have expert advice at the click of a button. Excellent.” “I like to use this PKB because I don't have to keep going to appointments and it saves me a lot of time” “PKB has enabled me to have discussions with my consultant and the team - for which I am incredibly grateful.” “I find it very reassuring that you are able to contact your consultant very quickly and resolve any concerns or fears you might have” “I think this is really useful when you are worried or concerned” “I have found PKB invaluable, I needed guidance with an issue & the doctor was able to help, advise and guide me through my treatment via the messaging service.”
- 14. 0 100 200 300 400 500 600 0 500 1000 1500 2000 2500 02-Apr 02-May 02-Jun 02-Jul 02-Aug 02-Sep 02-Oct 02-Nov 02-Dec 02-Jan 02-Feb Cumulative Secure message Number PKB Growth April 2015 to February 2016 Messages No. Patients HL7 Further evaluation: February 2016 •In use 10 months •346 patients using PKB •New focus is • Value-added • PKBs capacity to eliminate ‘wastes’ Numbers of patients / HL7 messages exchanged Next Steps with PKB
- 15. Summary: Web-based Personal Health Records • Are available now to support diabetes care • Can be deployed effectively across teams • Offer great opportunities to add value to diabetes care & break down traditional boundaries • Help build closer relationships between people with diabetes and their healthcare team
- 16. Summary: Web-based Personal Health Records • Are available now to support diabetes care • Can be deployed effectively across teams • Offer great opportunities to add value to diabetes care & break down traditional boundaries • Help build closer relationships between people with diabetes and their healthcare team The potential of #ConnectedHealth “Healthcare is a relationship based on trust” “When you use #ConnectedHealth at first it improves your relationship. Later on it improves the person’s health”
- 17. Thank you!