1136-P: Remote Patient Monitoring—The Road to Patient-Centered On-Demand Health Care

by sugaradmin



Introduction and Objective: People with diabetes and their clinicians spend valuable time on routine visits (RV). Increasing life expectancy among people with diabetes, and an increasing incidence represents a need to restructure outpatient clinics and let technology take care of the RV using remote patient monitoring (RPM). We aim to develop an effective RPM-algorithm to support our Patient Centered On-demand Healthcare.Methods: We combined glucose data upload (using our co-created software Stenopool, capturing both cloud-based continuous glucose monitoring (CGM) and point measures) with HbA1c, blood pressure (BP) values (homeBP, 24h-BP), measures of kidney function (urine-albumine creatine ratio, estimated glomerular filtration rate) and notifications of hospital admissions in an algorithm to detect and flag values out of predefined ranges as well as missing values to serve as safety net instead of RV. An overview of flagged values is presented in a dashboard.Results: We have included all patients at Steno Diabetes Center Copenhagen (N=10069, 5478 T1D, 3780 T2D, 811 children) in the RPM-algorithm. Thresholds for flagging are predefined on each variable to detect clinically relevant changes. Flagged patients are subsequently handled according to level of concern, with an interdisciplinary team of clinicians addressing the most concerning flags, while less concerning flags are handled by the primary physician.Conclusion: Combining available technologies, an RPM system can provide a real-time cloud-based interface to ensure timely reaction to clinical events (i.e. hypoglycemia, hypertension, changes in kidney function). Population based monitoring can facilitate individualized patient centered on-demand healthcare delivery instead of RV.

Disclosure

J.I. Bagger: Speaker’s Bureau; Novo Nordisk A/S. Research Support; Novo Nordisk A/S, Lexicon Pharmaceuticals, Inc, Bayer Pharmaceuticals, Inc. K. Ascanius Pilgaard: Other Relationship; Novo Nordisk A/S. T. Manders: None. M. Nalholm: None. K.B. Hansen: None. D.L. Hansen: None. H.U. Andersen: Stock/Shareholder; Novo Nordisk. F. Persson: Speaker’s Bureau; AstraZeneca. Advisory Panel; Novo Nordisk. Speaker’s Bureau; Boehringer-Ingelheim.

Funding

Steno Diabetes Center Copenhagen



Source link