The future is now: technologies are changing the face of diabetes

Highlights from ADS/ADEA: Technology symposium. 

by Dr Elizabeth Holmes-Truscott

The rapidly growing landscape of widely accessible communication technologies is changing the way diabetes health services are provided and supporting self-management for people with diabetes. A highlight of the ADS/ADEA 2017 Annual Scientific Meeting was the Joint Technology Symposium entitled: ‘The future is now – technologies changing diabetes care’. In this symposium, three diverse presentations were delivered on the topic of digital health.

Professor Brian Oldenburg (University of Melbourne) presented on the evidence for digital health programs improving diabetes outcomes in general populations, and challenged anyone developing digital health interventions to plan for wide reach and sustainability. Oldenburg highlighted that while huge numbers of health ‘apps’ are available to people with diabetes, few have been adequately evaluated. Oldenburg provided an overview of the NHMRC-funded “My Diabetes Coach”, an m-Health app designed to support people with newly diagnosed type 2 diabetes in their self-management. He highlighted how My Diabetes Coach had evolved, through rigorous research and stakeholder engagement, from an automated telephone-based coaching intervention (Telephone Linked Care), into a technologically advanced 21st century ‘app’ suitable for engaging large numbers of people in their diabetes self-management. He concluded that further app development needs to be evidence-based, drawing on theories of behavior change, consistent with medical guidelines, provided in combination with traditional healthcare services, and tailored to the needs of multiple stakeholders.

CEO of Telethon Type 1 Diabetes Family Centre, Rebecca Johnson, presented on the use of technologies to build a better diabetes service. Johnson presented passionately about the role of technology in her personal journey with diabetes and how clinical services can use technology to deliver education with greater reach, conduct person-centered care, and build diabetes peer support. When it comes to digital health care, Johnson encouraged health service providers to “aspire to be sardines, not a whale” (i.e. to use technology to deliver dynamic, organised, responsive support services) and encourage a highly connected local diabetes community.

In a deliberate change of pace and context, Associate Professor John Furler (University of Melbourne) took the audience on a journey of the evolution of record keeping and technology in primary care over the past ~30 years. Furler presented common challenges for digital health use within primary care and suggested that technology intervention should be designed for, and integrated within, existing models of care to ensure uptake. For example, Furler presented on the development and evaluation of digital clinical tools embedded in primary care electronic medical records.

The technology toolbox from which service providers and people with diabetes can draw from is enormous: including telehealth and e-health coaching, apps, online peer support, real-time video consulting and digital clinical decision making tools, to name a few. The widespread use of smartphones and devices is changing the face of diabetes care, but the success of these interventions will be determined by their responsiveness, integration, and foundation in evidence.