1030-P: Large-Scale Implementation of a Digital Solution to Support Management of Gestational Diabetes

Abstract

Introduction: Gestational Diabetes Mellitus (GDM) is one of the most common medical conditions of pregnancy and its incidence is rising. The MoTHer system, an App and web-based portal, was developed to support GDM management. It enables multidisciplinary care co-ordination by providing shared access to healthcare professionals involved in GDM care. Methods: MoTHer was developed through co-design with users at an urban Australian hospital and tested in a feasibility study (n=40) in 2017-18. An implementation trial commenced in June 2020 and is currently underway in 5 Australian hospitals of varying sizes. Results: More than 5000 women have utilised the MoTHer app. Care models differ at participating hospitals, some offering MoTHer as business as usual to all women with GDM, others providing MoTHer as an alternative to the traditional paper-based blood glucose diary, and one hospital only offering MoTHer to GDM patients on insulin. Each site has different implementation requirements and experiences, yet feedback from surveys administered (>300 responders) is positive, suggesting long-term adoption. Initial economic evaluation indicates a modest saving to health services. However, cost savings for the woman are estimated to be considerable (≈US$400 per patient) after accounting for lost wages, childcare, and travel expenses avoided. Comparing pre- and post-implementation groups, maternal (onset, mode of birth) and neonatal (birthweight, nursery admission) outcomes suggest MoTHer is clinically equivalent to traditional care. Discussion: The MoTHer system has been created to see greater efficiencies for both healthcare providers and for expectant mothers. This multi-site study highlights the adaptability of a digital solution to different GDM health services. Moreover, re-imagining GDM patient care by introducing a digital based model of care is promising substantial positive cost implications for patients without compromising their clinical outcomes. Disclosure M.Varnfield: None. K.Butten: None.