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Guest blog: Smartphone self care for people with diabetes

Written by: Katherine Ward - 17th November 2020

For Self Care Week 2020 we’re highlighting some of the innovations and partners we work with who are empowering patients to take a more active role in managing their own health. Katherine Ward, Chief Commercial Officer and UK/Europe Managing Director for health-tech innovators Healthy.io, tells us more about the award-winning work they’re doing to help people with diabetes monitor their kidney health in Yorkshire and the Humber.

Self Care Week is about embedding support for self-care and, as the COVID pandemic is driving a rise in healthcare providers using tech innovation to achieve this, we’re also seeing encouraging signs of these new approaches prevailing in the long term.

In this region, we’re 3 years into our work with the AHSN to enable self-care through smartphone technology – and the evidence is now shining through, showing better health outcomes for patients whilst relieving cost and resource pressures on the healthcare system.

At our recent patient forum, people with diabetes explained what they really want from self-care technology. “What we’re going to talk about today is trying to make us feel a bit more normal” said Lee Phelps from Morley in Leeds, who’s lived with diabetes since his early 20s. “You don’t have to be at the doctors every five minutes. You can manage things a lot more easily” he suggested, pointing to the fact that more patients are able to monitor and manage their long-term health conditions themselves, from home. “It’s just so inconvenient having all these appointments,” added another panellist, “the idea of doing everything myself is an absolute dream.”

To ensure they stay healthy and their condition is well managed, people living with diabetes should complete eight “care processes” each year as part of the annual diabetes review. Diabetes as a condition makes them vulnerable to complications, like deteriorating kidney health, yet the annual diabetes audit still shows that traditional healthcare models fail to engage up to 60% of at-risk people.

The care process with the lowest uptake is the urinary albumin test, which measures albumin to creatinine ratios (ACR) to monitor kidney health. This low uptake means chronic kidney disease can be missed until it becomes symptomatic and much more serious for people’s health. But we’re turning that around in Yorkshire and Humber by giving people with diabetes the opportunity to complete the urine test themselves at home, without the need for an appointment at the GP surgery.

We pioneered this in 2018 in Hull, Airedale and Wharfedale – enabling 500 patients with diabetes, across ten Modality Partnership GP practices, to test their own kidney health from home using our ACR test kit and smartphone app. Urinary albumin testing compliance leapt up to 72% amongst consented patients with 96% saying they’d prefer to continue home testing in the future. GPs said they were able to identify more cases of early stage CKD which may have otherwise gone undetected. In fact, 11% of patients tested had new albuminuria indicating deteriorating kidney health, earning the programme team the title of “Diagnostic Team of the Year” at the BMJ Awards 2020.

An independent evaluation of this work commissioned by the AHSN showed the NHS could save £209m in care costs over 5 years by adopting the model nationally for people living with diabetes. Furthermore, testing other at-risk groups, like people with hypertension, could save £660m in total.

In September 2020, funded by NHSx and in partnership with Yorkshire and Humber Academic Health Science Network and NHS Leeds CCG, we began rolling out the programme in Leeds. Around 11,000 patients are being given the opportunity to self-test in the first cohort. Within the first six weeks, nearly 800 patients were contacted by our patient support team and 72% agreed to take part. Already 93% participants report the test “very easy” or “easy” to use and patients up to the age of 90 have used the app to complete the test.

The funding from NHSx will enable further roll-out to cohorts in the West Yorkshire and Harrogate ICS area, in the near future.

So far, 19% of tests completed in Leeds showed abnormal albumin content and will be followed-up by the patients’ GP. This huge potential for early intervention and prevention is attracting significant national interest. In September 2020, the Health Secretary, Matt Hancock, and NHS Chief Executive Officer, Sir Simon Stevens, announced that the NHS Accelerated Access Collaborative will support rolling-out our home kidney heath testing to over 600,000 more people with funding from the Artificial Intelligence in Health and Care Award.

Empowering people with diabetes is not the only way Healthy.io is improving self-care. For example, women with suspected urinary tract infections (UTIs) are being empowered to take control of their own testing and treatment using our Dip.UTI kits which are available in the women’s health section at Boots stores throughout Yorkshire and Humber (or go online to Velieve.io). But I’m particularly proud of how we have worked with the AHSN to spread innovation around kidney health self-care for at risk people in this region, because CKD is a silent killer and if our tests can help avoid unnecessary deaths, transplants or dialysis then, quite aside from the NHS savings that will be generated, we will be achieving significantly better outcomes for many people.

Find out more about Healthy.io