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How an intelligent device can cut the mustard

How an intelligent device can cut the mustard. Dr Julian Brown. What Was Meant by This ?. Succeed Come up to Expectations Provide High Quality. Obviously I must Have Been Good ?. 2006 +201% . The Story. 2006: I became our PCT Prescribing Lead.

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How an intelligent device can cut the mustard

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  1. How an intelligent device can cut the mustard Dr Julian Brown

  2. What Was Meant by This? • Succeed • Come up to Expectations • Provide High Quality

  3. Obviously I must Have Been Good ? • 2006 • +201% • 

  4. The Story • 2006: I became our PCT Prescribing Lead. • My Surgery was highlighted as having significantly high admissions for diabetes. • My Surgery was terrible. • They sent me to Chicago. • I decided to create an IT solution • www.diabetesmanager.org.uk

  5. The Result • Went from one of the worst to the best in 1 year. • No insulin initiations. • Reduced Admissions. • Reduced overall spend • Best HBA1C control 2009

  6. Graph of glycaemic control achieved from 2009 QOF data.

  7. What Had We Done? • Performance Tracking • Risk Stratification • Integrated Care • Self-Management Plans • Patient Access

  8. Performance Tracking • Accurate Benchmarking of how the surgery and PCT is performing on clinical markers. • NICE • QOF • How we were performing in terms of outcome data. • How we were performing in terms of cost.

  9. 6. Track Overall Cost-effectiveness at surgery level

  10. 2. Risk Stratification:Identification of High Risk Patients Six types of High Risk Patients • 1. Those that have poor end-point data. • 2. Those that have deteriorating end point data. • 3. Those that fail to have screening • 4. Those who are not on or not collecting appropriate medications • 5. Those that are on inappropriate medications.

  11. 2.High Risk Patients:a. Poor End Point Data • The System will automatically create weekly league tables by each parameter.

  12. 2.High Risk Patients:b. Deteriorating Scores • Looking at flux of endpoint data helps identify patients earlier.

  13. 3. Integrated Care: Sharing the eHealthcard • Secure online for ease of access by: • GPs • Other HCPs • Patients

  14. 3. Summary Reports • Allows quick overview of patient • Allows pre-diabetes clinics • Allows remote clinics • Allows compliance issues to be identified.

  15. 7. Liaising With Specialists

  16. 7. Liaising with Specialists

  17. 3. Patient Self Management Plan 7 essential steps for diabetes perfection. • Blood Pressure Control • Blood Sugar Control • Cholesterol Control • Weight Control • Healthy Lifestyle • Medication Compliance • Regular Screening

  18. Self-Management Plans • Encourage Patients. • Educate Patients. • Essential in achieving long-term diabetes control. • Reduce complications. • Reduce costs. • Makes the Patients Happy

  19. How did diabetesmanager work? • Web based application. • Automated Data Extraction from GP systems • Remote performance tracking of all diabetes patients. • Automated self-management plans for every patient. • Allows online access for patients • Allows online education and remote specialist clinics.

  20. Why Not Apply the Same Logic to Medicines Management • 7% all emergency admissions medicine induced • 60% of these preventable • Each one costing average £5000

  21. The Process

  22. The Result is Complete Safety Monitoring

  23. The System Allows True Integrated Care

  24. Surgery Portal • Identifies at risk patients • Updated Weekly • Confidentiality Maintained • Surgery Has Control

  25. Preventing Emergencies • Identifies the Patients who don’t come to see us. • The ones that manage to get themselves on drugs that are dangerous for them. • The ones that aren’t taking their protective medications. • QOF!

  26. Better Integration • Patients • Practice Diabetes Nurses • GPs • Specialist Nurses • Podiatrists • GPs specialist interest • Consultants • Commissioning Leads • Medicines Management • online, webinars , emails, reports • Communication!

  27. The Future • Better outcome for patients • Better education of patients (autotranslationetc) • Increasing Self-management • Reduced need for medications. • Easy patient alerts • Easy patient tracking • Better outcomes for HCPs. • Reduced Emergencies. • Reduced Admissions • Better project and formulary compliance. • Better use of services. • Identification of GP Surgeries needing extra resources. • Better education • Online referrals

  28. This can become a thing of the past! • Microvascular • Neuropathy • Retinopathy • Renal Disease • Diabetic ulcers • Macrovascular • Heart Attacks • Strokes • Peripheral Ischaemia • Diabetic Ulcers

  29. And more importantly – it transforms Patients • Janet • She used her selfmanagement plans & diabetesmanager.org.uk for 12 months

  30. To this one! • Same patient after 12 months using her self-management guide • www.diabetesmanager.org.uk • Time for live demo

  31. Does this Cut The Mustard? • 2009 QIPP arrived • Quality • Innovation • Prevention • Productivity • The Future of the NHS • £20 billion Savings

  32. How Would It Work?

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