Southampton's youngest patients supported by life changing technology in virtual clinics

There's no doubt about it; technology has been a huge help during this pandemic.

Teams across all NHS hospitals are benefitting from different ways of working and have embraced new platforms to make sure their patients are prioritised, while getting the same high-quality care they received prior to the COVID-19 outbreak.

VirtualClinic-TomWilson+Kian+FamilyThe diabetes team at Southampton Children's Hospital have completely revolutionised the way they work and how they run appointments since lockdown began. They've adopted platforms such as Attend Anywhere which has allowed the team to run virtual clinics that would usually be held in person. They've now hosted over 150 virtual appointments in the past three months and have received positive feedback from both patients and their families. It also allows staff to share their screens to discuss the data which patients have remotely uploaded from their devices such as insulin pumps, continuous glucose monitoring systems and their blood glucose meters.

Attend Anywhere has also been successfully used to deliver newly diagnosed, structured education pathways to families who have been discharged from hospital, to school personnel and to children and young people who would ordinarily receive home visits for support in between clinic visits. This is something the team will definitely continue with in the future.

Most importantly, virtual platforms have changed the way the team deliver educational clinics to teach families how to use insulin pumps and continuous glucose monitoring systems (CGMS) so that children can start using these technologies. This has probably been the most valuable and beneficial change as previously these educational clinics would be held at the hospital which meant that the team had to find a suitable room, the representative from the company supplying the device had to travel to the hospital, and the family had to take time out of their school and work day, travel to the hospital, find child care for siblings and find somewhere to park. Running the clinics virtually has saved time, space and money for everyone involved. The team are now able to run clinics more effectively and ultimately enable children to have access to the technology sooner.

Insulin pumps continuously deliver tiny doses of insulin to the body therefore replacing the need to give routine insulin injections with insulin pens. A CGMS is a small device that children and young people with diabetes wear just under their skin. It measures glucose (sugar) levels every 5 minutes throughout the day and night allowing them see trends in their levels and alerting them to high and low blood glucose levels. Some CGM devices are also able to talk to the patients’ insulin pump to suspend insulin delivery when it recognises that the blood glucose levels are running too low, therefore preventing hypoglycaemic episodes.

For a parent of a child or young person with Type 1 diabetes these devices are life changing. Parents are often up for hours over night, monitoring their child’s blood glucose levels to prevent episodes of hypoglycaemia (low blood glucose levels) or worrying that their child does not recognise the signs and symptoms of their hypos and that as a result they are going to become very unwell. Having an alarm on their smart phones which goes off when the child is too low (or too high) gives them more peace of mind.

Over the past three months the team have been able to start 20 children on CGMS and have been able to upgrade the insulin pumps of 18 children. Virtual platforms such as Zoom, Google and Webex have facilitated this. The equipment is sent to the patient’s home, the relevant paperwork to support the sessions is emailed out to the families. The virtual platforms enable YouTube clips and guidelines to be shared on screen with the families during the group discussion.

If any further support is needed, an on-call paediatric diabetes nurse specialist (PDNS) can be available to speak to the family after the session. Nurse specialist Jo Summerton said: "Virtual platforms have revolutionised the way that we can deliver these technologies and educate our patients and their families.

"It is hard to find the available required space in the hospital to educate groups of children and their parents on how to use these devices, so doing it virtually has meant that more children have access to the life changing equipment earlier than they would have done otherwise. This is definitely something we will be keeping once the COVID pandemic is over, the process is much more seamless".

Patients and their families have also responded positively to the change. Carolyn, a parent of a Lily, a 9 year old patient, said: "The online sessions have saved time and money. Less school time has been missed due to travelling and making sure you can get parked and obviously there are no parking fees or eating out costs due to sessions usually falling over meal times etc.

"I would definitely recommend this new way of training. It would be good if we could also be given the option to attend clinic sessions if required but we haven’t had any issues that could not be solved over the phone so far".

Posted on Wednesday 15 July 2020