PHR use supports closer patient-professional relationships in diabetes care
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Transcript of 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
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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.”
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500
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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!