Cunningham My Diabetes - knowledge.scot.nhs.uk · My Diabetes My Way Scott Cunningham – Technical...
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My Diabetes My WayMy Diabetes My Way
Scott Cunningham Scott Cunningham –– Technical ConsultantTechnical Consultant
BCS Health Informatics Conference, BCS Health Informatics Conference,
Edinburgh, 12Edinburgh, 12thth September 2011September 2011
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IntroductionIntroduction
�� Diabetes in ScotlandDiabetes in Scotland
�� My Diabetes My WayMy Diabetes My Way
�� Patient expectations of record accessPatient expectations of record access
�� Record access systemRecord access system
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Diabetes in ScotlandDiabetes in Scotland
�� ScotlandScotland’’s diabetes prevalences diabetes prevalence
–– 2002: 103,835 (2%) 2002: 103,835 (2%)
–– 2010: 237,468 (4.6%)2010: 237,468 (4.6%)
�� Type 1: 12%; Type 2Type 1: 12%; Type 2: : 88%88%
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Diabetes in ScotlandDiabetes in Scotland
�� Increasing at a rate of 4.9% per yearIncreasing at a rate of 4.9% per year
�� People with diabetes at increased risk of:People with diabetes at increased risk of:
–– Eye diseaseEye disease
–– Lower limb amputationLower limb amputation
–– Renal failureRenal failure
–– Cardiovascular diseaseCardiovascular disease
�� Diabetes accounts for 10% of NHS Diabetes accounts for 10% of NHS
expenditureexpenditure
�� SelfSelf--management is a strategic objectivemanagement is a strategic objective
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My Diabetes My WayMy Diabetes My Way
�� Website for patients and carersWebsite for patients and carers
�� Information leafletsInformation leaflets
�� Interactive contentInteractive content
–– VideosVideos
–– AnimationsAnimations
–– Patient JourneysPatient Journeys
�� Validated internal/external contentValidated internal/external content
�� Live since October 2008Live since October 2008
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Patient SurveyPatient Survey
�� Identify patient Identify patient expectationsexpectations
�� Current online Current online activityactivity
�� Perceived Perceived benefitsbenefits
�� ConcernsConcerns
�� 144 (81.8%) 144 (81.8%) submittedsubmitted
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Patient SurveyPatient Survey�� GenderGender
–– MaleMale: : 56.6%56.6%
–– Female: Female: 43.4%43.4%
�� AgeAge
–– 1616--25: 25: 4.9%4.9%
–– 2626--35:35: 8.5%8.5%
–– 3636--45:45: 21.1%21.1%
–– 4646--55:55: 26.8%26.8%
–– 5656--65: 65: 28.2%28.2%
–– 6666--75: 75: 9.2%9.2%
–– Over 75:Over 75: 1.4%1.4%0.00
10.00
20.00
30.00
40.00
50.00
60.00
16-45 46-65 66+
Age Range
%
MDMW
Scotland
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Patient SurveyPatient Survey
�� 99.3% wanted to check their diabetes 99.3% wanted to check their diabetes
controlcontrol
�� 83% wanted medication reminders83% wanted medication reminders
�� 95.1% wanted to check accuracy, make 95.1% wanted to check accuracy, make
corrections and ask questionscorrections and ask questions
�� 94.4% believed it would improve knowledge 94.4% believed it would improve knowledge
�� 93.7% believed the system would help 93.7% believed the system would help
meet goalsmeet goals
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Patient SurveyPatient Survey
�� Respondents wished to use the system to:Respondents wished to use the system to:
–– support a healthy lifestylesupport a healthy lifestyle
–– monitor HbA1cmonitor HbA1c
–– to remind themselves of information discussed to remind themselves of information discussed
at consultationsat consultations
�� Main motives:Main motives:
–– peace of mindpeace of mind
–– ability to manage disease betterability to manage disease better
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UK Internet AccessUK Internet Access
�� 77% of households have Internet access77% of households have Internet access
–– 93% broadband93% broadband
�� 8% have Internet access elsewhere8% have Internet access elsewhere
�� 30 million access the Internet each day30 million access the Internet each day
Office for National Statistics (August 2011):Office for National Statistics (August 2011):
http://www.ons.gov.uk/ons/publications/rehttp://www.ons.gov.uk/ons/publications/re--referencereference--
tables.html?edition=tcm%3A77tables.html?edition=tcm%3A77--226727226727
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Record Access Building BlocksRecord Access Building Blocks
�� My Diabetes My WayMy Diabetes My Way
�� SCI Diabetes CollaborationSCI Diabetes Collaboration
�� Citizen AccountCitizen Account
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SCI Diabetes CollaborationSCI Diabetes Collaboration
�� National diabetes information systemNational diabetes information system
�� Shared electronic record Shared electronic record –– data from:data from:
–– Primary CarePrimary Care
–– Secondary CareSecondary Care
–– LaboratoriesLaboratories
–– Specialist screening servicesSpecialist screening services
�� Covering all 14 health boards since 2006Covering all 14 health boards since 2006
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Citizen AccountCitizen Account
�� Scottish Government National Infrastructure Scottish Government National Infrastructure subsub--programmeprogramme
�� Allows citizenAllows citizen’’ access to public servicesaccess to public services
�� Diabetes demonstrator first in NHSDiabetes demonstrator first in NHS
�� Authentication using Authentication using OneScotlandOneScotland portal portal
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Enrolment ProcessEnrolment Process
�� Patient registers on the website and is sent Patient registers on the website and is sent
and enrolment packand enrolment pack
�� Patient completes an enrolment (consent) Patient completes an enrolment (consent)
form which is verified by a clinician to form which is verified by a clinician to
confirm the patientconfirm the patient’’s identitys identity
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Enrolment ProcessEnrolment Process
�� Authentication details created and sent to Authentication details created and sent to
the patientthe patient
�� Data is transferred securely from SCIData is transferred securely from SCI--DC to DC to
My Diabetes My WayMy Diabetes My Way
�� Patient uses authentication details received Patient uses authentication details received
to access personal informationto access personal information
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Patient AccessPatient Access
�� Limited to key diabetes data initiallyLimited to key diabetes data initially
�� Information to explain clinical Information to explain clinical
measurementsmeasurements
�� Feedback mechanism to report errorsFeedback mechanism to report errors
–– ClinicalClinical
–– Technical: Errors and password issuesTechnical: Errors and password issues
�� Full user audit trailFull user audit trail
�� Pilot available in all Health BoardsPilot available in all Health Boards
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Patient Access Patient Access –– StatusStatus
�� Live: 15Live: 15thth December 2010December 2010
�� 262 registered users262 registered users
�� 174 completed the enrolment process174 completed the enrolment process
�� 120 active users120 active users
�� 13/14 health boards represented13/14 health boards represented
�� Aim to reach 5000 patients in Aim to reach 5000 patients in three yearsthree years
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Patient Access Patient Access –– FeedbackFeedback
�� This is superb This is superb …… I'm so impressed by the I'm so impressed by the information and how it is presentedinformation and how it is presented
�� The knowledge provided helps me The knowledge provided helps me understand the normal parameters and understand the normal parameters and where I stand/can improvewhere I stand/can improve
�� I find that, especially with Diabetes, more I find that, especially with Diabetes, more information available to me means I can information available to me means I can play a more positive role in my treatment play a more positive role in my treatment ……I am extremely pleased with this initiative.I am extremely pleased with this initiative.
�� Just a quick note to say what a fantastic Just a quick note to say what a fantastic site this is!!site this is!!
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Thank you!Thank you!
www.mydiabetesmyway.scot.nhs.ukwww.mydiabetesmyway.scot.nhs.uk