Health2Sync Pilot Program for Diabetes Management during Pregnancy

Abstract Description

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Authors (including presenting author) :

Mok MPH(1), Ng MMP(2), Chan SWM(2), Sin CWM(2), Tsang IW(2), Choi ACY(2), Kam GYW(2)

Affiliation :

(1)Department of Nursing Services Division, (2) Department of Medicine and Geriatrics, United Christian Hospital

Introduction :

To achieve optimal maternal and fetal outcomes, pregnant women with gestational or pre-existing diabetes should aim for near normoglycemia throughout pregnancy. They perform self-monitoring of blood glucose (SMBG) 4–7 times a day and phone report to DM nurses weekly for treatment titration. A new electronic platform Health2Sync Apps was introduced to streamline this monitoring and titration process. Patients uploaded SMBG results through Bluetooth for DM nurses to review.

Objectives :

1. To ensure accuracy of SMBG data upload and transferral 2. To enhance effectiveness of intensive diabetes management in pregnancy

Methodology :

DM nurses introduced and set up the Health2Sync Apps for patients after obtaining written consent. Patients uploaded SMBG data weekly, and DM nurses phone-contacted patients to explain treatment decisions. Finally, DM nurses documented the management plans on CMS. An evaluation survey was conducted.

Result & Outcome :

21 gestational and 9 pre-existing diabetic women participated in this pilot program during June - December 2018. Their mean age was 35.1±3.6 and mean gestational age was 20±8.4 weeks. 8 patients were on diet control and 22 were on insulin. On average, each patient was phone-contacted 9.3±1.4 times, including 6.6±4.0 times for insulin titration. 27 patients completed the survey. 100% of them agreed Health2Sync was effective in blood glucose management, user friendly and would recommend to others. The preferred communication method was by message (n=13), telephone (n=8) or both (n=6). Patients found communication by message convenient, while more detailed by phone. They appreciated the support from DM nurses at anytime and anywhere. Among the 4 DM nurses who completed the survey, 100% agreed this platform was accurate, user friendly and effective in communication. They preferred phone contact for more detailed information and 75% preferred adding message to double confirm the treatment decisions. To improve the system, patients suggested to enhance wifi synchronization and DM nurses suggested adding reminders to patients for uploading data and indicating SMBG before and after meals instead of only the date and time. Conclusion Health2Sync is a use-friendly, accurate, convenient and effective communication platform well-accepted by pregnant diabetic mothers and DM nurses.