Continuing the quality improvement of an electronic personal health record and interactive website for people with diabetes in Scotland (My Diabetes My Way)

AIMS

eHealth applications have the potential to enable patients to take more control over managing their own health, helping to delay and prevent complications. My Diabetes My Way (MDMW) is an electronic personal health record/educational platform available to people with diabetes in Scotland. This study aims to assess user experience with respect to demographic subgroups, examine effectiveness of previous improvements made to the platform and inform its ongoing development.

METHODS

All active MDMW users (22,665) were invited to take part in a questionnaire combining Likert scale and free-response items relating to system utility. Likert responses were used to generate a 'utility score'. This was used in regression analyses to determine predictors of system utility scoring. Free-response answers were analysed thematically and themes were generated.

RESULTS

A total of 4713 (21%) MDMW users responded to the questionnaire. Most agreed that MDMW helps them to track changes over time, prepare for face-to-face consultations, remember information discussed in consultations and reduced the need to contact their general practitioner. Free-response answers showed that users valued earlier enhancements made to the site (e.g. linking Fitbit data), and highlighted areas needing further improvement. Evidence of the 'digital divide' was seen in respondent demographics, and some users mentioned 'lack of digital skills' as a barrier to engaging with the platform.

CONCLUSIONS

User experience of MDMW was positive. Users agreed with statements that MDMW facilitates diabetes self management. Several areas of potential improvement were identified, including linking more wearable device data, and assisting/directing users to gain the digital skills required to engage fully with MDMW.

User Experiences of an Electronic Personal Health Record for Diabetes

BACKGROUND

My Diabetes My Way (MDMW) is an electronic personal health record (ePHR) that provides access to educational resources and clinical data to people with diabetes in Scotland. This questionnaire study aims to assess user experience, barriers to access, and inform future development.

METHODS

All active MDMW users (n = 3797) were invited to complete an online questionnaire in May 2015, surveying usage patterns and system utility. A "utility score" was calculated, based on responses to Likert-scale questions and used as the dependent variable within regression analysis, with demographic features as independent predictors. Free-text responses were analyzed thematically and presented using descriptive statistics.

RESULTS

A total of 1095/3797 (27.5%) active users completed the survey. Of them, 690/1095 (63%) were male. There was representation of all age and socioeconomic groups. Respondents were positive regarding the system utility, which met expectations. The majority of respondents believed that online access to diabetes information has the potential to improve diabetes self-care within the population. The most valued features were personal clinical data associated visualizations. Th main problems cited were data accuracy and system access (ie, log-in procedure). Perceived usefulness of the system was inversely associated with duration of diabetes, which was the only significant predictor of utility score.

CONCLUSIONS

This study has demonstrated that MDMW users find the system useful in supporting diabetes self-management. The system was found to have greatest utility among those most recently diagnosed with diabetes. This study has informed further development of the service, including enhancing data visualization and the need to improve access to the system.

My Diabetes My Way: supporting online diabetes self-management: progress and analysis from 2016

Background

My Diabetes My Way (MDMW) is the National Health Service (NHS) Scotland website for people with diabetes and their carers. It consists of an interactive information website and an electronic personal health record (ePHR) available to the 291,981 people with diabetes in Scotland. We aimed to analyse the demographic characteristics of current registrants and system usage and activity during 2016.

Methods

We analysed system audit trails to monitor user activity and page accesses on the information website, and logins and activity within the ePHR. The ePHR contains data from SCI-Diabetes, NHS Scotland’s flagship diabetes record, sourcing data from primary and secondary care, specialist screening services and laboratory systems. We reviewed patient registration characteristics to collate demographic data for the MWDH cohort, then compared this to aggregate data published in the 2016 Scottish Diabetes Survey. The Scottish Diabetes Survey is an annual population-based report detailing diabetes statistics for the whole diabetes population in NHS Scotland.

Results

The MDMW information website received an average of 101,382 page accesses per month during 2016 (56.9% increase from 2015; n = 64,607). ePHR registrants were more likely to be younger (p < 0.001) and have an ethnicity of “white” (p < 0.001) than the background diabetes population. At the end of 2016, 11,840 people with diabetes had accessed their personal clinical information (58.6% increase since end 2015; n = 7464). During 2016, an average of 1907 people accessed their records each month (48.3% increase from 2015; n = 1286).

Conclusion

My Diabetes My Way is a useful tool aid to diabetes self-management. The service is unique in offering records access to a national population, providing information from all relevant diabetes-related sources, rather than a single silo. MDMW supports the diabetes improvement, self-management, healthcare quality and eHealth strategies of the Scottish Government. The service also has potential to be adapted to work with other clinical systems and conditions.