ABSTRACT
A team quality improvement drive in 2018 to enable families to upload blood glucose data from home, encouraging self-review, independent management, and frequent proactive insulin adjustment, led to provision of a new nurse and dietitian led email clinic. The popularity and demand increased by 2019, and the service expanded in response to patient voice. Only a handful of families were able to review their data remotely, but within a few months of the initiative, an estimated 98% had this facility either at home, or via extended family, school or college. A remote email clinic was provided to review uploaded data. This proved so popular that the provision increased from 2 hrs a week for 4 days, to a 6 day a week service. It was well evaluated by families, and almost every review led to an insulin adjustment. The PDSA cycles for this work diminished the level of risk with each cycle by producing and adapting robust proformas to record baseline information and adjustments in a consistent format, and to encourage independent decision making from the outset. This wealth of experience was subsequently drawn upon by the medical team during Covid lockdown and the abrupt halt of face to face consultations. A rapid transition to telephone appointments could easily be made. Uploading and remote data review was already well practiced, and families felt this to be a normal way of support and reassurance. A diabetes team mobile app was provided free of charge to families at the start of lockdown to provide an immediately accessible means to share public health alerts regarding shielding, school closures, emergency advice, information about changes to hospital services, and support for well being. Communication between the multidisciplinary team for peer review and support and vulnerable patient handover was maintained by moving to Microsoft Teams and WhatsApp. Youth team support was delivered by Zoom. Families have been grateful for continuity of care in the face of other uncertainty.
ABSTRACT
The non-pharmaceutical intervention to reduce the impact and spread of COVID-19 requires the development of policies and guidance through a collaborative effort among government, academia, medicine, and citizens. To operationalize this effort, we have developed an all-encompassing situational awareness platform that can process multi-modal and multi-source data allowing informed decision making. Besides, showing the current spread of infection, the platform also captures the impact of human dynamics on the infection spread, location, and availability of critical infrastructure, prediction, and high-performance computing driven simulation. The platform is extensible, allowing third-party integration and services to consume the curated data and analytics in near real-time. We believe the platform will augment critical decision making for reducing the impact and spread of the pandemic. © 2020 ACM.