Retrospective evaluation of triage data and diabetes educator and dietitian appointment utilisation following introduction of GDM remote monitoring  — ASN Events
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Retrospective evaluation of triage data and diabetes educator and dietitian appointment utilisation following introduction of GDM remote monitoring  (#108)

Michael Do 1 , Rachel Hicks 1 , Elizabeth Fletcher 2 , David Simmons 1 2
  1. Western Sydney University, Campbelltown
  2. Campbelltown Hospital, Campbelltown, NSW, Australia

Background:  

NetHealth is a digital platform for remote monitoring and triage of gestational diabetes mellitus (GDM) through patient-uploaded blood glucose levels (BGLs), red-amber-yellow-blue glycaemic target alerts, and clinician feedback. This evaluation aimed to assess engagement, alert management, and resource utilisation across three hospital sites following platform implementation. We present triage data from the lead site. 

Methods:

A retrospective audit was conducted between 3 June 2025 and 5 January 2026, utilising data from medical records, NetHealth database and appointment records. Women with type 2 diabetes and overt diabetes in pregnancy were excluded. Variables included BGL submissions, alert frequency, triage category, actions taken, and diabetes educator (DNE) and dietitian appointments. Descriptive statistics were used to summarise activity and efficiency outcomes. 

Results:  

Among 224 women, 1,248 triage episodes were performed, with 5,928 alerts reviewed (mean 4.8 alerts per triage). Alerts were predominantly related to fasting and postprandial hyperglycaemia. Hypoglycaemia events were rare (<1%). Most triage episodes resulted in continuation of current management (58.8%). Insulin adjustment was required in 25.6% and DNE referral in 15.3%, usually for insulin commencement or further evaluation. Once NetHealth use was “normalised” it was used by 94% of women. 

DNE and dietitian appointments in May compared to October 2025 dropped from 360 to 248, a 31% reduction. DNE phone consultations decreased by 36% (p<0.01), face-to-face reviews by 29% (p=0.03), and dietitian appointments by 23% (p=0.11), the latter more likely reflecting the change in diagnostic criteria. The 40-hour monthly reduction in clinician time equated to one full clinical day saved per week for a multidisciplinary diabetes care team, even when taking into account the estimated workload of the triaging clinician. 

Conclusions:  

The NetHealth rollout demonstrated high engagement, timely triage, and reduced clinical workload without compromising patient safety. Digital triage effectively managed most alerts remotely, highlighting the potential for scalable, resource-efficient GDM care. The high alert-to-triage ratio highlights the need for structured digital triage systems to manage the significant data burden from remote monitoring. Further research should compare appointment data in women who would not meet new diagnostic criteria and evaluate whether this translates to improved maternal and neonatal outcomes.