how an intelligent device can cut the mustard

HOW AN INTELLIGENT DEVICE CAN CUT THE MUSTARDDr 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 HBA1C 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 cost.

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 end-point 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 endpoint data helps identify patients earlier.

3. Integrated Care: Sharing the eHealthcard Secure online for

ease of access by: GPs Other HCPs Patients

3. Summary Reports Allows quick

overview of patient

Allows pre-diabetes 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 Regular Screening

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 Self-management

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

Innovation to

Implement

Prevention allowing ImprovedEfficiency

Improved Productiv

ity

Cost-Savings with reinvestmen

t