cunningham my diabetes - knowledge.scot.nhs.uk · my diabetes my way scott cunningham – technical...

My Diabetes My WayMy Diabetes My Way

Scott Cunningham Scott Cunningham –– Technical ConsultantTechnical Consultant

BCS Health Informatics Conference, BCS Health Informatics Conference,

Edinburgh, 12Edinburgh, 12thth September 2011September 2011

www.mydiabetesmyway.scot.nhs.uk

IntroductionIntroduction

�� Diabetes in ScotlandDiabetes in Scotland

�� My Diabetes My WayMy Diabetes My Way

�� Patient expectations of record accessPatient expectations of record access

�� Record access systemRecord access system


Diabetes in ScotlandDiabetes in Scotland

�� ScotlandScotland’’s diabetes prevalences diabetes prevalence

–– 2002: 103,835 (2%) 2002: 103,835 (2%)

–– 2010: 237,468 (4.6%)2010: 237,468 (4.6%)

�� Type 1: 12%; Type 2Type 1: 12%; Type 2: : 88%88%


Diabetes in ScotlandDiabetes in Scotland

�� Increasing at a rate of 4.9% per yearIncreasing at a rate of 4.9% per year

�� People with diabetes at increased risk of:People with diabetes at increased risk of:

–– Eye diseaseEye disease

–– Lower limb amputationLower limb amputation

–– Renal failureRenal failure

–– Cardiovascular diseaseCardiovascular disease

�� Diabetes accounts for 10% of NHS Diabetes accounts for 10% of NHS

expenditureexpenditure

�� SelfSelf--management is a strategic objectivemanagement is a strategic objective



�� Website for patients and carersWebsite for patients and carers

�� Information leafletsInformation leaflets

�� Interactive contentInteractive content

–– VideosVideos

–– AnimationsAnimations

–– Patient JourneysPatient Journeys

�� Validated internal/external contentValidated internal/external content

�� Live since October 2008Live since October 2008


Patient SurveyPatient Survey

�� Identify patient Identify patient expectationsexpectations

�� Current online Current online activityactivity

�� Perceived Perceived benefitsbenefits

�� ConcernsConcerns

�� 144 (81.8%) 144 (81.8%) submittedsubmitted


Patient SurveyPatient Survey�� GenderGender

–– MaleMale: : 56.6%56.6%

–– Female: Female: 43.4%43.4%

�� AgeAge

–– 1616--25: 25: 4.9%4.9%

–– 2626--35:35: 8.5%8.5%

–– 3636--45:45: 21.1%21.1%

–– 4646--55:55: 26.8%26.8%

–– 5656--65: 65: 28.2%28.2%

–– 6666--75: 75: 9.2%9.2%

–– Over 75:Over 75: 1.4%1.4%0.00

10.00

20.00

30.00

40.00

50.00

60.00

16-45 46-65 66+

Age Range

%

MDMW

Scotland



�� 99.3% wanted to check their diabetes 99.3% wanted to check their diabetes

controlcontrol

�� 83% wanted medication reminders83% wanted medication reminders

�� 95.1% wanted to check accuracy, make 95.1% wanted to check accuracy, make

corrections and ask questionscorrections and ask questions

�� 94.4% believed it would improve knowledge 94.4% believed it would improve knowledge

�� 93.7% believed the system would help 93.7% believed the system would help

meet goalsmeet goals



�� Respondents wished to use the system to:Respondents wished to use the system to:

–– support a healthy lifestylesupport a healthy lifestyle

–– monitor HbA1cmonitor HbA1c

–– to remind themselves of information discussed to remind themselves of information discussed

at consultationsat consultations

�� Main motives:Main motives:

–– peace of mindpeace of mind

–– ability to manage disease betterability to manage disease better


UK Internet AccessUK Internet Access

�� 77% of households have Internet access77% of households have Internet access

–– 93% broadband93% broadband

�� 8% have Internet access elsewhere8% have Internet access elsewhere

�� 30 million access the Internet each day30 million access the Internet each day

Office for National Statistics (August 2011):Office for National Statistics (August 2011):

http://www.ons.gov.uk/ons/publications/rehttp://www.ons.gov.uk/ons/publications/re--referencereference--

tables.html?edition=tcm%3A77tables.html?edition=tcm%3A77--226727226727


Record Access Building BlocksRecord Access Building Blocks

�� My Diabetes My WayMy Diabetes My Way

�� SCI Diabetes CollaborationSCI Diabetes Collaboration

�� Citizen AccountCitizen Account


SCI Diabetes CollaborationSCI Diabetes Collaboration

�� National diabetes information systemNational diabetes information system

�� Shared electronic record Shared electronic record –– data from:data from:

–– Primary CarePrimary Care

–– Secondary CareSecondary Care

–– LaboratoriesLaboratories

–– Specialist screening servicesSpecialist screening services

�� Covering all 14 health boards since 2006Covering all 14 health boards since 2006


Citizen AccountCitizen Account

�� Scottish Government National Infrastructure Scottish Government National Infrastructure subsub--programmeprogramme

�� Allows citizenAllows citizen’’ access to public servicesaccess to public services

�� Diabetes demonstrator first in NHSDiabetes demonstrator first in NHS

�� Authentication using Authentication using OneScotlandOneScotland portal portal


Enrolment ProcessEnrolment Process

�� Patient registers on the website and is sent Patient registers on the website and is sent

and enrolment packand enrolment pack

�� Patient completes an enrolment (consent) Patient completes an enrolment (consent)

form which is verified by a clinician to form which is verified by a clinician to

confirm the patientconfirm the patient’’s identitys identity


Enrolment ProcessEnrolment Process

�� Authentication details created and sent to Authentication details created and sent to

the patientthe patient

�� Data is transferred securely from SCIData is transferred securely from SCI--DC to DC to


�� Patient uses authentication details received Patient uses authentication details received

to access personal informationto access personal information


Patient AccessPatient Access

�� Limited to key diabetes data initiallyLimited to key diabetes data initially

�� Information to explain clinical Information to explain clinical

measurementsmeasurements

�� Feedback mechanism to report errorsFeedback mechanism to report errors

–– ClinicalClinical

–– Technical: Errors and password issuesTechnical: Errors and password issues

�� Full user audit trailFull user audit trail

�� Pilot available in all Health BoardsPilot available in all Health Boards


Patient Access Patient Access –– StatusStatus

�� Live: 15Live: 15thth December 2010December 2010

�� 262 registered users262 registered users

�� 174 completed the enrolment process174 completed the enrolment process

�� 120 active users120 active users

�� 13/14 health boards represented13/14 health boards represented

�� Aim to reach 5000 patients in Aim to reach 5000 patients in three yearsthree years


Patient Access Patient Access –– FeedbackFeedback

�� This is superb This is superb …… I'm so impressed by the I'm so impressed by the information and how it is presentedinformation and how it is presented

�� The knowledge provided helps me The knowledge provided helps me understand the normal parameters and understand the normal parameters and where I stand/can improvewhere I stand/can improve

�� I find that, especially with Diabetes, more I find that, especially with Diabetes, more information available to me means I can information available to me means I can play a more positive role in my treatment play a more positive role in my treatment ……I am extremely pleased with this initiative.I am extremely pleased with this initiative.

�� Just a quick note to say what a fantastic Just a quick note to say what a fantastic site this is!!site this is!!


Thank you!Thank you!

www.mydiabetesmyway.scot.nhs.ukwww.mydiabetesmyway.scot.nhs.uk

cunningham my diabetes - knowledge.scot.nhs.uk · my diabetes my way scott cunningham – technical...

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