Background - opportunities for improvement
Nottingham University Hospitals NHS Trust has a well-established, multidisciplinary diabetes foot team (MDFT) service, led by Dr Kamal Chokkalingam, Consultant Endocrinologist. The service was running well but there was recognition that a number of improvements could be made to develop a more optimised and sustainable model of care. The key areas to address were a high caseload (5500-6000 patient episodes/year) and information overload (mixed digital and paper records). There were potential risks to manage, such as discontinuity of care, clinical inertia, recall bias, lack of real-time monitoring, unclear wound care oversight and high administrative burden from complex workflows.
Solution - technology enabled digital ulcer assessment and patient management
A new model of patient management was conceived and executed to make improvements, deploying a digital wound assessment and data management solution (Silhouette, ARANZ Medical). The new approach uses a web-based application hosted on Trust servers, with point of care ulcer imaging devices. The solution enables automated, digital 2D/3D imaging, ulcer measurement, reporting and data sharing. Configured to create user-friendly workflows with visualised data on ulcer outcomes, the solution integrates with the hospital systems, is accessible from any Trust computer and complies with NHS data security standards.
Results - key impacts demonstrated with the new MDFT model
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- Seismic shift from data gathering to data interpretation
- Improved consultation experience for patients and health care professionals
- Digital and almost paperless clinic is now a key asset of the service
- Administrative cost savings
- Improved 12-week healing rates for multiple ulcers
EWMA 2024_NUHT_Technology Enabled Diabetes Foot Ulcer Multidisciplinary Clinic (2019-2024)
Dr Kamal Chokkalingham, May 2024
Download EWMA2024_NUHT_Technology Enabled Diabetes Foot Ulcer Multidisciplinary Clinic
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