Summary
Traditionally, communication has been limited between primary and specialist care when providing holistic, seamless diabetes care. As part of an overall package to support primary care delivering diabetes within the community, the team developed a communication portal: it delivers electronically a diabetes journal, Solent Diabetes Voice (SDV), to every practice manager, lead diabetes GP and lead diabetes nurse within the Portsmouth district. It provides a variety of information, including reviews of pathways, education course delivery modules and new drug developments. In a recent survey, all replies indicated SDV was educational, informative, kept them up to date with diabetes care and events locally and had a positive impact upon their clinical practice.
Results
SDV has contributed to enhancing diabetes care within the Portsmouth community by GPs and practice nurses. The specialist diabetes team visit all 83 practices twice a year, and without exception, the verbal feedback has been that the SDV has been very helpful and informative in assisting practices deliver diabetes care within the community. It has enabled them to update their knowledge of key areas at a time that is convenient to them and improve time utilisation for learning. In addition, in a recent survey of the readership, 100% of replies indicated that they ‘strongly agreed’ or ‘agreed’ that the SDV was educational and informative, 87.5% that the SDV had a positive impact upon their clinical practice and 81.25% that it kept them up to date with diabetes care and events locally.
Challenge
Prior to this IT initiative disseminating the SDV, there was limited capacity within Portsmouth for specialist diabetes care to communicate with primary care regards diabetes care delivery, education delivery, specialist diabetes care services and referral criteria, educational opportunities and new pharmacological developments. Attempts to run face-to-face meetings were limited by the availability of healthcare professionals with ever increasing clinical commitments. The specialist and primary care services were aware of significant educational gaps within the community governing delivery of effective diabetes care and appropriate utilisation of specialty diabetes clinics. Finally, low attendances at diabetes related meetings were in part due to limited dissemination of awareness of these events.
Objectives
To enhance diabetes care within Portsmouth through improving knowledge via an IT solution relevant to delivery of this care. The aim was to develop an IT portal for delivery of an electronic solution (the Solent Diabetes Voice) to every practice manager, lead diabetes GP and lead diabetes nurse (83 practices, 4 CCGs) within the Portsmouth district.
Solution
An IT link was established through local IT infrastructure - the Primary Care Information Portal, PIP - which enabled a direct IT communication to every practice manager, lead diabetes GP and lead diabetes nurse (83 practices, 4 CCGs) within the Portsmouth district. Local healthcare professionals were surveyed to determine the information that would help them deliver diabetes care more effectively. This led to the SDV including the following information: keeping all practices informed of up-to-date reviews on delivering aspects of diabetes care relevant to Portsmouth, reviews and information on pathways of diabetes service delivery, education course delivery modules, referral criteria and new drug developments. A steering group was set up to meet every 4 months to determine the content of the SDV. All articles are written by members of the Portsmouth Diabetes Specialist Care team, assimilated into the SDV and circulated electronically: 27 SDV journals have been issued since its inception.
Learnings
Through effective organisation of the partners listed below, it has been possible to produce a comprehensive up to date IT solution to deliver relevant diabetes education on care and service delivery. This has been a simple solution that has been achieved through prospective engagement and enthusiasm of the relevant individuals. Partners involved in developing the SDV are: the SDV Steering Group, local CCG IT leads, the Specialist Diabetes Service in Portsmouth and primary care Diabetes GP and nurse leads who have provided honest and constructive feedback. This approach, utilising IT infrastructure, contributes to enhancing local education which in turn contributes to improved diabetes care.
Evaluation
The effectiveness of the SDV was ascertained through direct conversation with readers at the time of GP practice visits and also through an online survey tool linked to the SDV that helped shape future editions. Other diabetes centres within the UK and internationally (e.g. India) have indicated that they aim to replicate this initiative given the simplicity of the IT approach. They have also asked if they could recirculate previous SDV editions. The team’s approach is simple to reproduce and is especially helpful for centres worldwide where face to face education is challenging geographically.
