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Digital services for people with diabetes Aleksandr Pkhakadze, MD, PhD [email protected] Maryna Neborachko, MD, MBA [email protected]
DigitalMed Ukraine 2017, Kyiv, 4, October
Digital Med 2016
Digital Vortex 2015 vs 2017
Digital Agenda of Ukraine
According to the European Union's "European Health Strategy 2020" program in Ukraine, it is necessary to develop and ensure the implementation of the National Program "Health 2020: Ukrainian Dimension", which will improve the approaches to the methods of solving current health problems . "Digital" medicine should provide interactions between patients, healthcare providers and institutions through "digital" technologies. The transition of the medical document circulation of Ukraine to digital format is the key goal of "digital" medicine. A prerequisite for achieving this goal is the creation of the National Electronic Health Record System (EHR). EHR is a dynamic collection of systematic electronic data on the health of the individual patient, providing an information exchange between the participants in the process of production and consumption of medical services.
Digital Agenda of Ukraine
Key steps to create an EHR 1. Establishment and approval of national standards for "digital" medicine.
2. Introduction of Computerized Medical Record: systematic work on the digitization of patients medical records, the introduction of archival-backup functions. 3. Implementation of Electronic Medical Record: Patient medical records are kept by the physician in electronic form, which include digitalized archival patient medical records. Duplicates on paper are not required. 4. Introduction of Electronic Patient Record: Patient data from various medical institutions are stored unified in a single database, that is, Electronic Medical Record from different medical institutions is combined in one database, thus each physician from his terminal can access and enter data. This also applies to the data that the patient enters into the program on their own. 5. Introduction of Electronic Identifiers: identification of eHealth users.
Digital Agenda of Ukraine
Additional functions of the national Electronic Health Record system • epSOS (smart open service for European patients) - a minimum dataset (extract) from the EHR required for the medical care of an EU citizen. • CDSS (clinical decision support system) - a decision support system for clinicians. • Implementation of ePrescription (electronic recipe) is based on 3 procedures: - eCapture - the formation of an electronic recipe by a doctor of a medical institution. - eTransfer - confidential transmission of an electronic recipe to a pharmacy. - eDispensation - transfer of data from the pharmacy back to the health facility, confirmation. • The patient ID and ID of the employee (doctor, etc.). For a patient ID, a social insurance card, a citizen's card may be used. • Introduction of TeleHealth: "digital" technologies for providing remote medical services and support of doctors' work. • Introduction of eMedical Claim Forms: A package of electronic documents provided to social insurance bodies or health facilities for compensation.
Цифрові сервіси, представлені під час щорічного конгресу Європейської Асоціації по Вивченню Діабету (Лісабон, 11-15.09.2017)
Glooko
Glooko.
A universal cloud-based diabetes data management system. More than 140 compatible devices: one report for all diabetes devices. Data management for: • Glucometers •Insulin Pumps, CGMs, Mobile apps •See if and when patients are testing (f.e., did the patient test after a hypo to ensure BR levels are corrected) •4 meters + pump combined in one report • Easily identify patterns – for better control •Historical data readily available – no more scrolling through meters EMR integration.
Glooko. Diasend.com
PATIENT CLINIC
• Free for patients – register at www.diasend.com
• Patients can upload at home prior to visit or
at the clinic
•Bring together critical information from
diabetes devices and activity trackers
• Uploading devices is made easy with
diasend by simple plug and play
• Patients can share data with Health care
team
•EMR integration available
•No SW installation – view data on any
computer with internet access
•One report for all devices irrespective
device brand
•Customizable and printable reports with pdf
Wizard
Dexcom
All data online available remotely for patients and doctors
Standartized report = “ECG” for diabetics
Free monitor of BG profile on Android and/or iOS devices
Keeping track of child’s glucose has never been easier
Dexcom
Contour. Next ONE
Google Play:10 000 – 50 000 downloads
V.1.3.11 from 19.09.2017
Virtual reality mobile app
Connected glucometer
Light depends on the BG level
AccuCheck Network
The Eversense® Continuous Glucose Monitoring System by Senseonics, Inc.
Finally, the first and only CGM with an implantable sensor that lasts up to 90 days
DANA Smart Insulin Pump
Download all data to PC
DANA Diabecare R includes DANA Manager software for PC. All history can be downloaded from the insulin pump and displayed in colorful graphs and charts which are easy to interpret.
Access pump from internet
SOOIL Development Co is developing the DANA Manager as a secure server based software platform. It is designed to enable Healthcare Professionals to securely access pump history and adjust basal or bolus settings from their clinic computer.
Cellnovo pump: a connected diabetes management solution
YPSOMED: mylife Software Therapy management made easy
Accessible via the mylife Cloud or locally on your personal computer, it is now easier than ever to keep track of diabetes therapy data.
With the aim of optimised communication between people with diabetes and healthcare professionals, mylife Software is an easy-to-use, easy-to-share diabetes therapy management solution that focuses on the value of meaningful data output.
mylife Software accommodates the requirements of various diabetes therapy plans; from type 1 users on pump therapy to type 2 users who simply want to keep track of their blood glucose values.
Intuitive, user-friendly design for ease of use
Meaningful statistics and trend analyses for better treatment insights
Compatible with a range of diabetes devices to streamline therapy management
Identical interface for patient and healthcare professional to simplify communications
FOR A 6: multiparameter meter
MEDTRUM: S6 EasySense Disposable CGM System
2in1 solutions
500-1000 downloads at Google Play
Kaleido insulin pump from Netherlands
mySugr shows Significant Improvement of Blood Glucose Control in a High Risk Population
Google Play: 500 000 – 1 000 000 downloads
(1 year ago – 10 000 – 50 000) / last version 3.39 from 15.09.2017
☆ APP FEATURES - Easy and personalized logging screen (diet, meds, carb intake, meals, blood glucose levels and more) with clear blood sugar level graphs; - Estimated HbA1c at a glance, no more surprises; - Motivating challenges and feedback to help cope with Type 1 and Type 2 diabetes; - Daily, weekly and monthly medical analysis; - Detailed reports to bring (or send) to your doctor; - Secure data backup and registered medical device (built with regulatory compliance, quality and safety). ☆ INTEGRATIONS - Steps, activity, blood pressure, CGM data, weight, and more are available via Google Fit®; - Accu-Check® Aviva Connect, Accu-Check® Guide (get yours free from mySugr to automatically activate mySugr Pro for no charge! Please see our FAQ on the website for the latest information); ☆ PRO FEATURES Take your diabetes therapy to the next level! mySugr Pro can be activated at no charge with some Accu-Check® devices when ordered (for free) through mySugr or with a monthly ($2.99) or yearly ($27.99) subscription. - Smart search: find places, meals, activities..; - Insulin Calculator (EU only): calculate your insulin dose, corrections and meal shots. Faster, easier and smarter; - PDF & Excel reports: save or print all your data for you or your doctor; - Blood glucose reminders, you won’t forget to check and log; - Meal photos: snap your meals to improve your carb counting. - Basal rates for pump users
Diabetic retinopathy. Improved Automated Detection of Diabetic Retinopathy
Diabetic retinopathy. Improved Automated Detection of Diabetic Retinopathy by IDx
Within one minute, the IDx-DR user will know if: 1) Exam quality was sufficient Low quality images can be retaken immediately, while the patient is still at the camera 2) The patient is Negative for referable DR The patient can be re-screened at the normal interval 3) The patient has signs of referable DR Outputs of Moderate DR detected or Vision-threatening DR detected indicate further action: a. Over-read by a human grader b. Tele-consultation c. Referal to an ophthalmologist
Some of the tasks of diabetes management which can be solved with digital solutions
1. Therapeutic education.
2. Compliance with dietary and physical activity recommendations.
3. Control and self-control.
4. Support for motivation.
5. Observation of the profile of glycemia in children.
6. Screening of complications of the disease, etc.
Відкриті питання
Open questions
1. Medical certification
2. Saving personal and medical data
3. Compatibility of the programs
4. Standards
5. Payment systems and the grounds for getting money
6. Unification of individual electronic documentation
7. Inclusion of sections dedicated to affordable mHealth solutions in education programs
8. Full analysis of BigData
9. Clinical studies of mHealth solutions
10. The inclusion of usage of mHealth solutions in current guidelines
Thank you for your attention!
Aleksandr Pkhakadze, MD, PhD [email protected] Maryna Neborachko, MD, MBA [email protected]
