M THer Innovative mobile technology to support the care of women - - PowerPoint PPT Presentation

Innovative mobile technology to support the care of women with gestational diabetes mellitus

Dr Mar arlie lien Var arnfie ield ld

M♡THer

CSIRO AEHRC

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

BIOMEDICAL INFORMATICS

Biostatistics, imaging and genomics based - clinical workflows

HEALTH INFORMATICS

Improving health system performance & productivity from electronic health data

HEALTH SERVICES

Improving access to services & management of chronic diseases

CVD

‘Cardihab’

CKD

PD-Buddy

COPD

M-COPD

Diabetes

• M♥THER
• Insulin Stab

Mental health Health-e Minds

mHealth projects

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

GDM - What is the problem?

• GDM is one of the most common medical complications of pregnancy
• Usually occurs around the 24th to 28th week of pregnancy
• Associated with short and long term risks for both mother and baby, especially if blood

glucose levels are not well controlled

• Incidence of GDM is increasing
• New diagnostic criteria for GDM were introduced in 2014
• At Redland Hospital, 16% of women engaged in Maternity Services diagnosed with GDM

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Challenges

Women with GDM

Midwife Obstetrician Endocrinologist Diabetes Educator Dietitian

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Key problems

Suboptimal Co-ordination

• f Care

Inconvenient Ineffective

Women with GDM carry a paper based blood glucose level diary Results not always available to the MDT team in a timely manner

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Our solution

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Our solution

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Redland Feasibility Study (n=40)

Primary outcomes:

• User adoption and user satisfaction

Secondary outcomes:

• Number of BGL clinical reviews
• Frequency of antenatal contact
• Occasions of service related to GDM attended by women
• Time to commencement of therapy

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Study Cohort

Inclusion criteria

• confirmed 1st OGTT diagnosis of GDM diagnosed between K24-28
• at least 16 years of age
• referred from general practitioner for antenatal care at Redland Hospital prior to K20
• wning and ability to use smart mobile phone (both Androids and Apple phones)
• ability (and willingness) to upload data either via WiFi or Mobile Data
• ability to speak and understand English

Exclusion criteria

• ther types of diabetes
• ther illnesses that would limit participation e.g. chronic kidney disease (stage3-4)
• a known history of major psychiatric illness

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Recruitment

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Study Outcomes

• Survey responses from the women showed the app is user friendly, convenient, and

continuation is highly recommended

• Treating clinicians reported improved communication with the women they treat and showed

an increase in multi-disciplinary co-ordination amongst themselves

• BGL clinical reviews were significantly higher with the introduction of M♡THer, as was

frequency of ante-natal contact. Time to treatment and ante-natal clinic visits were comparable

• 8 women were identified with elevated readings in the first week of using the app enabling

early intervention

• Due to elevated fasting BGL’s 12 were commenced on Metformin, 8 were commenced on

insulin

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Interest

• Health Round Table Winner, Category: “Improving self-care”, Brisbane, July 2017
• RN Breakfast Show interview, May 2018
• Media report, Essentialbaby, May 2018
• Presentation, Australian Diabetes Educators Association (ADEA) QLD State Conference, Gold

Coast, May 2018

• 2018 iAwards Nominee, Queensland Awards, Brisbane, Jun 2018
• Show cased at the Australasian Diabetes in Pregnancy (ADIPS) Conference, Adelaide, Aug

2018

• Metro South Health Board Chair’s Award, Winner in Category: “Innovation Through Digital

Technology”, Brisbane, Sep 2018

• International Hospital Federation, Gold Award Winner: “Excellence Award for Quality &

Safety and Patient Centred Care” Brisbane, Oct 2018

• Invited presentation, Australasian Diabetes Advancements and Technology Summit. Sydney,

Nov 2018

• Queensland Health Award of Excellence, Highly Recommended Dec 2018

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

• Funded for further implementation at all

MSH Antenatal Clinics

• Translating platform into different languages
• Offering MoTHer to all women diagnosed

with GDM

• FHIR enabled platform development
• Commencing July 2019

Implementation study MSH

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Real world…

Adapted from https://www.kingsfund.org.uk/projects/nhs-65/alternative-guide-new-nhs-england-2013

NDIS

GPs

PIR FD A

Marlien Varnfield, AEHRC, CSIRO

• Medical advances, emerging technologies, consumer choices and expectations
• Providing high assurance security measures to put patients' privacy and security first
• Managing digital security to reduce the risk of downtime and breaches
• Integration with clinical systems
• Lack of standardised terminology, system architecture, indexing and regulation
• Change management

Implementation challenges

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO

Acknowledgments

Principal Investigator:

Dr Wendy Dutton Divisional Director of Women’s and Children’s Services, Metro South Health (MSH)

Co-Investigators:

Dr Joel Iedema, Director of Medicine, Redland Hospital; Liesel Higgins, Redesign Manager, Transformation, Innovation, Collaborative Team, MSH Georgia Hellen, A/Project Manager Redesign, Transformation & Innovation Collaborative Planning Engagement Reform, MSH Naomi Scolari, Project Officer and Dietitian, Redland Hospital; Roisine Warwick, Diabetes Educator (Clinical nurse consultant), Redland Hospital; Janet Knowles, Nurse Unit Manager, Women and Birthing, Redland Hospital; Barbara Kleine, Senior Dietitian, Redland Hospital; Denis Morton, Chronic Disease Team Leader, Redland Hospital; Dr Rachel Stoney, Director Nutrition and Dietetics, Redland Hospital.

Dr Marlien Varnfield, AEHRC, Health & Biosecurity, CSIRO