PHR use supports closer patient-professional relationships in diabetes care

CanPersonalHealthRecordshelpbuildcloserrelationshipswith

peoplewithType1Diabetes?

Dr PeteDavies

JanetKinson DiabetesCentre,Sandwell Hospital,SWBHNHSTrust

TimeforType1diabetes

• 10yearsoftransformation– “RightCare,RightHere”– Type2diabetescareclosertohome

• Helpedtocreatetime/spacetodeveloptype1diabetescare– BUTaskpeoplewithdiabetes– Appetiteforinnovation

• BirthofT1SWAS– T1SWBHTAdvice&Support Surveyautumn2014

Autumn2014:Voiceofthecustomer

WeaskedPWDtype1:• Whataretheirspecific

needs?

• Whichnewelementscouldaddvalue?

• Imagine… “noholdsbarred!”

PWDtype1toldus:• Access needs improving

– Greaterflexibility inthetiming andfrequency ofsupport

– Fasteraccesstosupport &advice

• “Mindthegap”– Peersupport– Emotional support– Psychological support

• Toolsthatallowclosercommunication– OpentoSkype, sms-support,

securemessaging, etc.

Spring2015,T1SWASlaunch:supportedwith"PatientsKnowBest™"

• PKBalreadyinuseourorganisation– Immunodeficiency– Behçettertiaryservice

• SWBHTwishedto'test'PKBonalargerscale

• Offers– Secure

messaging– Integration

withlaboratorytestresults

– Careplanning– Libraryoflinks

&documents– Skype

consultationsintegration

– Trackingofbiomedicalmeasurements

– Careplanning

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

ImplementingPatientsKnowBest• Eachpersoninvitedface-face inconsultation

– 1minutesign-up– PKBleafletstotakeaway,forthecurious– Cliniclettersentbysecuremessagewithin3businessdays

• Teammemberstrained&added,patient-by-patient

Plan

DoStudy

Act

v “Voice of customer” survey

v Improve accessv Greater breadthv Technology

enabled

v Implement PKBv Offer to PWDv Engage the

teamv training

v Determine what changes need to be made

v What was learned

Peoplewithdiabetes

Diabetes nurses

Dietitian

Doctors

Emotional supportteam

Peersupportteam

0

100

200

300

400

500

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0

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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

CumulativeSecuremessageNum

ber

PKBGrowthApril2015toFebruary2016

Messages

No.Patients

HL7

EvaluationSept 2015• Inuse5months• 221patientsusingPKB• 50:50type1diabetes&endocrine

• N=30(13.5%responserate)N

umbe

rsofpatients/HL7messagese

xchanged

EvaluatingPKB

EvaluationofPKB:September2015Use ofPKBbypeoplewithtype1diabetes:

Idonotowntherecord

IfeelIowntherecord

Thepotential thatpeoplewithtype1diabetesseeforPKB

EvaluationofPKB:September2015CostsavingImpactofPKBasperceivedbypeoplewithtype1diabetes:

0%

10%

20%

30%

40%

50%

60%

70%

Messages Bloodtests Clinicletters SkypeConsultation

Addingmeasurements

AddingWearables

ViewingDocumentsfromlibrary

SavingCost

DefinitelysavesMoney/cost Sometimesavemoney/cost Doesnotsavemoney/cost

Canhelpsupportabusiness casejustification toadoptPHR

Time-savingpotentialofPKB,asperceivedbypeoplewithtype1diabetes

Canhelpsupportabusiness casejustification toadoptPHR

ImpactofPKBondoctor/nurse-patientrelationshipperceivedbypeoplewithtype1diabetes

Canhelpsupportavalues-based justification toadoptPHR

Peoplewithdiabetessaid…“Usingthemessagingserviceputmymindatrest”

“IreceivedareplymuchfasterthanIwouldhaveexpectedthroughmoretraditionalmeans.”

“It’susefulthatcorrespondenceissavedformetolookbackover,soIcanprocesstheinformationatapacethatsuitsme” “PKBhelpedmetoconstruct

amoreconsideredanddetailed question thanIwouldhavemanagedverballywhilst feelingunwellandconfused”

“IfeelsafeintheknowledgethatIhaveexpertadviceattheclickofabutton.Excellent.”

“IliketousethispkbbecauseIdon'thavetokeepgoingtoappointmentsanditsavesmealotoftime”

“PKBhasenabledmetohavediscussionswithmyconsultantandtheteam- forwhichIamincrediblygrateful.”

“Ifinditveryreassuringthatyouareabletocontactyourconsultantveryquicklyandresolveanyconcernsorfearsyoumighthave”

“Ithinkthis isreallyusefulwhenyouareworriedorconcerned”

“IhavefoundPKBinvaluable,Ineededguidancewithanissue&thedoctorwasabletohelp,adviseandguidemethroughmytreatmentviathemessagingservice.”

Peoplewithdiabetessaid…“Usingthemessagingserviceputmymindatrest”

“IreceivedareplymuchfasterthanIwouldhaveexpectedthroughmoretraditionalmeans.”

“It’susefulthatcorrespondenceissavedformetolookbackover,soIcanprocesstheinformationatapacethatsuitsme” “PKBhelpedmetoconstruct

amoreconsideredanddetailedquestionthanIwouldhavemanagedverballywhilst feelingunwellandconfused”

“IfeelsafeintheknowledgethatIhaveexpertadviceattheclickofabutton.Excellent.”

“IliketousethisPKBbecauseIdon'thavetokeepgoingtoappointmentsanditsavesmealotoftime”

“PKBhasenabledmetohavediscussionswithmyconsultantandtheteam- forwhichIamincrediblygrateful.”

“Ifinditveryreassuringthatyouareabletocontactyourconsultantveryquickly andresolveanyconcernsorfearsyoumighthave”

“Ithinkthis isreallyusefulwhenyouareworriedorconcerned”

“IhavefoundPKBinvaluable,Ineededguidancewithanissue&thedoctorwasabletohelp,adviseandguidemethroughmytreatmentviathemessagingservice.”

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

CumulativeSecuremessageNum

ber

PKBGrowthApril2015toFebruary2016

Messages

No.Patients

HL7 Furtherevaluation:February2016•Inuse10months•346patientsusingPKB•Newfocus is• Value-added• PKBscapacitytoeliminate‘wastes’

Num

bersofpatients/HL7messagese

xchanged

NextStepswithPKB

Summary:Web-basedPersonalHealthRecords

• Areavailablenowtosupportdiabetescare

• Canbedeployedeffectivelyacrossteams

• Offergreatopportunitiestoaddvaluetodiabetescare&breakdowntraditionalboundaries

• Helpbuildcloserrelationshipsbetweenpeoplewithdiabetesandtheirhealthcareteam

Summary:Web-basedPersonalHealthRecords

• Areavailablenowtosupportdiabetescare

• Canbedeployedeffectivelyacrossteams

• Offergreatopportunitiestoaddvaluetodiabetescare&breakdowntraditionalboundaries

• Helpbuildcloserrelationshipsbetweenpeoplewithdiabetesandtheirhealthcareteam

Thepotentialof#ConnectedHealth

“Healthcareisarelationshipbasedontrust”

“Whenyouuse#ConnectedHealthatfirstitimprovesyour

relationship.Lateronitimprovestheperson’shealth”

Thankyou!