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