‍Empowering Patients: A Hybrid Approach to Diabetes Management‍

What is the project? 

Our innovation team at i-mens, a healthcare organisation, conducted a clinical study to enhance support for diabetic patients through the integration of various technologies into home care to monitor and respond to patient needs more efficiently and effectively. Specifically, our project focused on diabetic patients with smartphone access, as there is a digital requirement.

The project introduced a remote monitoring centre, Z-plus, into a hybrid care pathway for the intervention group. Z-plus is staffed 24/7 by nurses who continuously review patient data and provide necessary triage based on a medical protocol. When an irregular reading is detected, a nurse contacts the patient by phone and offers personalised advice or, in more serious cases, coordinates with a doctor or hospital. Calls last approximately four minutes. After each intervention, Z-plus documents the advice given, sends it to the patient’s doctor or another healthcare professional and thus facilitates a better understanding of individual cases and enables appropriate adjustments.

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The link between our project and the 8 CTPs 

Our mission was to explore new, sustainable ways to provide homecare. While it's uncommon for a homecare organisation to conduct clinical studies, we launched ours in 2023 to determine whether we could provide better healthcare for diabetic patients by adding self-management and remote monitoring by Z-plus to the regular care pathway.

In the regular care pathway, diabetic patients (type 2) receive uniform care with five annual nurse visits of 30 minutes each. In the hybrid care pathway patients get more insights into their values and direct feedback when their parameters cross a threshold. Caregivers then use this extra data to improve their consultations (e.g. adapt medication). This approach benefits patients as well as families, who can step back from constant ‘controlling’ and focus on support. Patients feel more in control, viewing their condition as manageable rather than burdensome, and are reassured by real-time monitoring (CTP 4).

The reminder feature in the app reduces missed measurements and increases awareness for regular measuring of glycemia levels (CTP 4, CTP 8). Around 5% of all measurements resulted in an intervention. The high number of interventions at the beginning of the project highlighted the need for personalised thresholds to avoid unnecessary “red flag” alerts (CTP 1).

Our approach prioritised functional, impactful technology over trend-driven choices (CTP 1). Devices were selected based on rigorous testing and user feedback to ensure reliability (CTP 2, CTP 6). To maintain cost-effectiveness, patients used their own smartphones, though this limited participation to those with digital skills. Ensuring data safety was critical, with all devices meeting medical standards and GDPR compliance (CTP 7, CTP 4).

The eight guiding principles we followed offer a framework for healthcare professionals, policymakers, and developers, promoting thoughtful technology integration. These principles guided project planning and solution evaluation, helping avoid unnecessary disruptions.

Looking ahead, we believe these principles should be embedded in healthcare education to instil a patient-first, technology-second mindset. Practical training will prepare caregivers for a technology-integrated landscape, leading to improved patient outcomes and system efficiency.

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Challenges:

We experienced a few technical issues, but they were minimal and mainly occurred at the start due to app-related challenges, which we quickly resolved. We anticipate fewer issues in future iterations, thanks to improvements in the app's reminder feature that helps patients remember their measurements. We are currently analysing the results of our first study and beginning a new phase set to conclude in December 2025. We build each project step-by-step to avoid overwhelming complexity and to better understand the impact of each component.