Abstract:
Introduction: The rising prevalence of gestational diabetes mellitus (GDM) continues to be a major issue in the efficient and timely provision of diabetes care at our maternity facilities. Mater Mothers’ Hospital (MMH) is a large quaternary maternity centre servicing a culturally and linguistically diverse population. Local GDM frequency is approximately 16% of maternities, amounting to over 1000 women with GDM per annum. We present elements of the steps and outcomes of an iterative process for redesigning GDM care using novel strategies. This incorporates a digital solution in trial at MMH since June 2020, removing the traditional “GDM schedule” in favour of a streamlined digital review schedule.
Method: MMH, in collaboration with CSIRO, have implemented a smartphone app with Bluetooth transfer of BGLs from the woman’s home glucose meter and real time BGL transmission to a clinician-facing web portal. Text messaging is used for feedback and insulin titration. The larger and more complex component of the project includes the associated model of care changes required to make the digital interface time and resource efficient.
Results: Over 1000 women have received care through the novel GDM model of care. Initial informal feedback reveals: far greater visibility of the patient cohort and early recognition of patients with highest care needs. Improved staff satisfaction for work flow, reduced requirement for initiation of insulin (40% to 30%) and improved patient satisfaction and experience. App use compliance increased from 60% to 97% in the first 6 months. Clinical outcome data is under evaluation.
Conclusion: A mobile health solution integrated into a radical model of care change demonstrates positive initial feedback and outcome data.
Keywords
GDM, Smartphone App, digital, mHealth, model of care
The authors have presented 3 inter linked abstracts for consideration;
GRANT: ADIPS- Clinical Education Research (2019)