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Increasing remote appointment efficiency in primary care

Overview

A GP Practice in the South Yorkshire ICS shares how digital tools have enabled proactive diabetes management and treatment optimisation for an elderly diabetes patient with comorbidities and mobility issues. 

Using the mySugr® app* and the RocheDiabetes Care Platform has enabled remote monitoring and remote clinical interventions, increasing efficiency of telephone appointments and reducing the burden of travelling to appointments.

Challenge: Optimising remote diabetes care for a patient with reduced mobility

This patient is insulin-dependent, aged 81, and has high HbA1c levels and heart failure diagnosis. 

Diabetes patients with comorbidities require significantly more 20 minute face-to-face appointments annually than those without comorbidities, putting additional pressure on healthcare system capacity1. 

The patient lives in a rural location with no access to a smartphone, and relies on family members to drive them to appointments. 

Remote telephone appointments can compliment in-person appointments, however, a lack of accurate up-to-date blood glucose data can mean the nurse does not have all the information needed to optimise treatment remotely.

Results: 18 months after introducing the RocheDiabetes Care Platform

Patient-centred care

  • The patient with reduced mobility was able to access care through remote appointments
  • The caregiver used the mySugr app to share the patient’s blood glucose results with the practice nurse†, increasing the carer engagement

Capacity

  • The number of face-to-face appointments required was reduced
  • Due to the practice nurse having access to the data in advance, remote appointments were shortened from 10 minutes to 5 minutes

Efficiency

  • Increased confidence in patient blood glucose results enabled the nurse to confidently titrate insulin remotely

Elderly patient with limited access to the practice was successfully managed remotely

  • Prior to using the RocheDiabetes Care Platform, the patient’s remote appointments required blood glucose results to be read out over the phone, or for the family to take the results into the practice before the next appointment
  • The patient was added to RocheDiabetes Care Platform, and their family member installed the mySugr app to her own phone to sync with the patient’s Accu-Chek Instant meter regularly†
  • In the following 23 weeks the patient had seven insulin adjustments via eight remote appointments
  • Remote appointments reduced the travel burden on the patient and her family members
“Over the course of 6-7 months the patient was successfully managed remotely. With access to accurate blood glucose data I could confidently titrate her insulin, whilst avoiding unnecessary travel for the patient”

Practice Nurse

“Having access to the data has increased my confidence in making clinical interventions remotely”

Practice Nurse

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The lifestyle images included in this article are stock photos used for illustrative purposes only.

Quotations sourced from recorded interviews as part of a consultancy agreement with Roche Diabetes Care in 2023.

*The mySugr Bolus Calculator is licensed for people with diabetes over the age of 18 years. The mySugr logbook is licensed for people with diabetes over the age of 16 years.

†The caregiver has to register for mySugr in order to manage the account for the person with diabetes.

1. Stafford M, Thorlby R, Fisher R. Understanding the health care needs of people with multiple health conditions. November 2018. Available at: https://alumni.health.org.uk/publications/understanding-the- health-care-needs-of-people-with-multiple-health-conditions. Last accessed May 2023