PAH team REMODeLs approach to diabetes management

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A group of healthcare professionals stands together in front of a sign that reads Diabetes in a medical facility.

Five years dedicated to advancing care for patients with Type 2 Diabetes (T2DM) has led PA Hospital Endocrinologist, Dr Anish Menon and a team of dedicated clinicians at the PAH Burke Street Centre to reimagine the approach to diabetes management.

Employing advances in diabetes technology and eHealth, the Rethinking Model of Outpatient Diabetes Care Using eHealth (REMODeL) service connects complex T2DM patients and their clinicians with virtual tools that help them monitor, review and manage symptoms in real time.

Using a Bluetooth glucose meter and a clinician dashboard app, REMODeL enables patients to efficiently record and upload their blood glucose readings to the app, where clinicians can review results in real time via a ‘smart alerts’ triaging feature that helps identify patients who may require enhanced support.

Launched in 2016 as a series of pilot projects, what started as a PhD study soon evolved into a fully-fledged service, demonstrably improving care delivery for both patients and clinicians.

“All three of our initial studies gained positive feedback from the patients, because they could self-manage and track their health stats from home. At the same time, the project reduced the time nurses had to spend because they could get this data electronically instead of having to call the patient to get their blood glucose readings,” said Dr Menon.

With a majority complex cohort on the clinic’s caseload, Dr Menon says time is of the essence when it comes to managing T2DM.

“We see complex patients who have to check their blood sugars three or four times a day. Factors like stress levels, exercise and diet can change from day to day, and that has a direct impact on blood sugar levels, so it’s important that patients can get advice and support from the nurse in real time.”

With an integrated team of nurses, doctors, researchers, and administrators behind the service, REMODeL is not only making T2DM care more efficient, but more accessible to patients who are now able to confidently self-manage their condition and avoid unnecessary appointments at the clinic.

“Self-management is key for any chronic disease. By changing our model of care, we are improving health outcomes for our patients, and that’s always the number one priority,” said Dr Menon.

Inspired by promising technological advancements, Dr Menon and his team are already looking at new ways to enhance the service for patients over time.

“We have apps on our smartphones that count everything from your steps to your heart rate. If we can harness the good side of AI to develop personalised suggestions for blood glucose management, we can improve self-management for people with complex T2DM.

“For example, if a patient plays tennis every Tuesday, the AI will pick up on that as it monitors the changes in their glucose levels. The AI can analyse that information and send a prompt to the patient to consider reducing their insulin on those days or eat more before exercising to prevent a low blood glucose reading,” he explained.

Celebrated for their progressive and highly efficient approach to T2DM management, Dr Menon and the REMODeL team claimed the 2023 Metro South Health Staff Ambitious Innovation Award.

Congratulations to the whole team and to Dr Menon for your ongoing dedication to developing and leading the service. Special mention also goes to Dr Anthony Russell and Director Endocrinology, Dr Lisa Hayes who have played an integral role in supporting, launching and sustaining the REMODeL project over the years.