NetHealth and remote monitoring of GDM care: Ethnographic analysis and perspectives on rollout and implementation — ASN Events
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  3. NetHealth and remote monitoring of GDM care: Ethnographic analysis and perspectives on rollout and implementation

NetHealth and remote monitoring of GDM care: Ethnographic analysis and perspectives on rollout and implementation (#111)

Rachel R Hicks 1 , Michael Do 2 , Alia Tun Ismail 2 , Elizabeth Fletcher 2 , Namu Hangsarumba 2 , Nima Mathew 2 , Darcey Swadling 2 , Robyn Barnes 3 , David Simmons 1 2 4
  1. Western Sydney University, Campbelltown, NEW SOUTH WALES, Australia
  2. Diabetes and Endocrinology, Campbelltown and Camden Hospitals, Campbelltown, NSW, Australia
  3. Clinical Stream Office, South Western Sydney Local Health District, Campbelltown, NSW, Australia
  4. Diabetes Australia, Sydney, NSW, Australia

Background: Gestational Diabetes Mellitus (GDM) management involves close observation and timely intervention to reduce adverse pregnancy outcomes. However, such close observation is onerous for both the mother, healthcare professionals (HCP) and the service. The aim of this study is to assess the feasibility, acceptability and workload perception of a model of care change involving remote monitoring via a GDM-specific app in a hospital serving a multiethnic community.

Methods: Macarthur Diabetes Service piloted a new model of care utilising remote monitoring via BlueTooth linkage of self-monitoring of blood glucose (SMBG) data with a patient app (“NetHealth”), linked to a remote dashboard accessible to the healthcare team. All women with GDM at a tertiary hospital clinic were invited to have their SMBG data reviewed using this platform. GDM clinic team received portal accounts to triage and manage women remotely. A working group was established, with monthly meetings once the platform was operational. Ethnographic analysis of working group meetings and preliminary feedback from women with GDM and HCPs was conducted.

Results: Of 310 women registered in GDM education sessions, 294 converted to active users (95%). Common themes from women, HCPs and our working group included: liking real-time integration and uploads, ease of use and more effective communication between diabetes and midwifery/obstetric teams. Women with GDM reported feeling more confident, having increased autonomy and reduced burden in managing GDM, and liking the reduction of face-to-face appointments. GDM clinical teams have reported half the number of CDE/Endocrinologist patient visits, easier and quicker review of glucose monitoring and a clinic workload reduction by 2 appointments/day.

Conclusions: The new model of care utilising remote monitoring for triage and management has improved clinical experiences for women with GDM, and achieved a reduction in appointments and time/resources for HCPs. Onboarding was easy with near universal use. Further data analysis is needed to determine longer-term acceptability and satisfactio, including a broader rollout across the local health district, as well as impact on glycaemic and birth outcomes.