Publication date: 9 September 2021
K’aute Pasifika and Pinnacle Ventures, both based in Hamilton, have teamed up to support people and their families to monitor, understand and manage their diabetes.
The initiative has received funding from the Ministry of Health’s Digital Enablement Programme, which provides support for innovation in digital health care. The programme has a particular focus on co-investing in projects that improve access or participation for people who do not access health services and need to. It’s all about improving equity.
The Ministry is working closely with project teams, sharing learning between participating organisations as a community of practice and looking for opportunities to help others learn from these initiatives as they adopt and promote these or similar services elsewhere. The projects are examples of the types of innovation that will be supported by the better access to information enabled by the Hira programme.
Hira will be an ‘ecosystem’ of data and digital services that will enable consumers to access and control their health information through their choice of website or application using a digital device such as a smartphone, tablet or computer. New Zealanders will be more empowered to manage their health, wellbeing and independence. Organisations can work together to share information so that people don’t have to repeat personal details multiple times. Clinicians can harness digital technologies to improve services. The sector and digital innovators can design and contribute innovative data and digital services, making Hira more powerful.
It is estimated that there are over 250,000 people with diabetes in New Zealand – mainly type 2 diabetes. The prevalence of diabetes in Māori and Pasifika populations is around three times higher than among other New Zealanders. Prevalence is also high among South Asian populations.
Pinnacle Ventures project lead, pharmacist Bianca Montgomery, says the overall aspiration is to reduce health complications associated with diabetes by empowering people to understand and proactively manage their blood glucose levels.
‘We do this by giving them and their clinical and support team access to their data. In particular, we want to improve self-management by Māori and Pasifika people, and those living in rural areas.’
The pilot, which began in July 2021, has already seen over half of an initial 20 patient cohort with type 1 or 2 diabetes fitted with a Dexcom continuous glucose monitoring unit. Fine sensors placed under the skin transmit their blood glucose levels to a mobile phone app via Bluetooth at five-minute intervals. The project’s support team looks for patterns and trends within the data, and works with patients to help interpret this information and provide lifestyle advice. A summary will also be sent to the person’s GP, who will continue to be responsible for making any changes to their treatment plan based on the additional clinical information available to them.
The project team also assists people to set app alerts that notify them when their glucose levels fall outside the desired range. Bianca says the app supports people to learn and understand the impact of diet and exercise on their glucose levels, and how to manage them more effectively.
‘By giving people the tools and real time information about their own health, we hope to empower them to make informed choices about their wellbeing. We work closely with people and their whānau to ensure they’re comfortable using the monitoring equipment and app and offer help if needed. People can also choose to share their data with whānau and friends, who can support them to make positive diet and lifestyle changes.’
Bianca says anticipated challenges include helping people understand how the monitoring could make a difference to their lives, so they can see the benefits of participation.
‘That is going to require thoughtful framing. We need to consider the pressures people are faced with day-to-day, including financial and housing, and the different levels of digital literacy people have.
‘K’aute Pasifika is keenly aware of the realities some people within their community are facing. For example, are they going to have power so they can charge their phone; will they have money to buy suitable food to support a healthy lifestyle?’
The patient-centric diabetes continuous glucose monitoring project team is made up of staff from both K’aute Pasifika and Pinnacle Ventures, with everyone having a specific role. Results will be evaluated using a variety of tools and methods.
Bianca says the pilot is an opportunity to assess how regular monitoring by the individual, clinical oversight, and lifestyle coaching – using digital tools – can help improve people’s health.
‘To me, success would be having a group of people who understand how their diet and lifestyle affects their blood glucose levels, and are motivated to make long-term changes to improve their health. We’re looking forward to seeing a fully automated, end-to-end system where the person’s data is able to be delivered directly to their GP’s PMS.
‘And of course the ultimate goal is for the initiative to be able to be scaled for use nationally. I believe there is the potential for this to impact positively not just on individuals but on many communities.’