Skip to main content

Optimising a patient pathway and outcomes using the RocheDiabetes Care Platform

Profile

A Community Specialist Diabetes Service in the Lancashire and South Cumbria Foundation Trust has used the RocheDiabetes Care Platform to make timely and effective clinical interventions remotely.

The Specialist Diabetes Service has a caseload of over 1,000 patients. The service runs 15 clinics per week for its patients, who are above their target blood glucose range and need additional, specialist support. The service offers home visits and supports district nurses.

Challenge: Prioritise and manage high-risk patients remotely in between appointments

Before using the RocheDiabetes Care Platform, patients would have their first 1-hour appointment, followed by an appointment every 8-9 weeks, with no review for medication titration or clinical intervention in between.

The lack of timely and accurate blood glucose data made it difficult for the Diabetes Specialist Service Team Lead and her colleagues to monitor patients in-between appointments, and made clinical interventions sub-optimal. This delayed the time it took to achieve optimal diabetes management, often leading to patients staying in the service longer than necessary.

“The 9-week wait between appointments is too long. We rely on patients to self manage during this time. Patients don’t often feel confident, and want our support”

Diabetes Specialist Service Team Lead

Results: Improvement in remote management of patients after using the RocheDiabetes Care Platform

With access to accurate, real-time diabetes data on the RocheDiabetes Care Platform, members of the Diabetes Specialist Service Team were able to make timely and effective clinical interventions remotely.

The team were also able to better risk-stratify patients, using the Platform to highlight patients with the highest need, enabling early remote intervention.

One patient in the service, after the Service Team identified them as high-risk using the RocheDiabetes Care Platform, was able to be intensively managed with four in-person and remote appointments within an 11 week period. The patient demonstrated an improvement in the percentage of blood glucose values in range from 14% to 71% in five months.

After eight weeks, and following medication adjustments, 30% of the patient’s blood glucose values were in range and their HbA1c levels decreased from 80 to 69 mmol/mol. Previously, the patient would not have been seen during this eight week period.

The patient pathway above illustrates how the healthcare professional intensively managed this patient using the RocheDiabetes Care Platform

“Having access to the patient’s blood glucose data was key to being able to identify his needs and intervene to make a positive change to his health between appointments”

Diabetes Specialist Service Team Lead

With access to accurate, real-time diabetes data on the RocheDiabetes Care Platform, members of the Diabetes Specialist Service Team were able to make timely and effective clinical interventions remotely.

The team were also able to better risk-stratify patients, using the Platform to highlight patients with the highest need, enabling early remote intervention.

One patient in the service, after the Service Team identified them as high-risk using the RocheDiabetes Care Platform, was able to be intensively managed with four in-person and remote appointments within an 11 week period. The patient demonstrated an improvement in the percentage of blood glucose values in range from 14% to 71% in five months.

After eight weeks, and following medication adjustments, 30% of the patient’s blood glucose values were in range and their HbA1c levels decreased from 80 to 69 mmol/mol. Previously, the patient would not have been seen during this eight week period.

“The healthcare professional has been able to review my data more frequently behind the scenes, she has made more changes to medication more often. I have had three medication changes within 6 weeks, previously I would have had to wait about three months between each medication increase”

Patient

Overall, implementing the RocheDiabetes Care Platform has resulted in healthcare professionals in the Community Specialist Diabetes Service being able to identify high risk patients, and provide these patients with timely and effective remote clinical interventions. This has led to patients being discharged from the service sooner.

If you would like to learn more about the RocheDiabetes Care Platform and how it could support your healthcare setting, fill in the form below to request a demo.

Status message

Sorry… This form is closed to new submissions.

The lifestyle images included in this article is a stock photo used for illustrative purposes only.

Quotations sourced from a recorded interview with a Diabetes Specialist Team Lead as part of a consultancy agreement with Roche Diabetes Care in 2022.