Finger Prick to Finger Tip: Use of Mobile Phone Technology to Send PKU Blood Results.

Anne Clark,Ahmad Monavari,Emma Corcoran,Ina Knerr,Nicola Newcombe,Ellen Crushell,Aoife Coughlan,Margaret Macauley,Aoibhin Moore Heslin,Peter Branagan,Eimear Daly,Joanne Hughes,Deirdre Deverell

doi:10.1155/2018/2178346

Abstract

The Metabolic Dietetic Team in the National Centre for Inherited Metabolic Disorders (NCIMD) in Ireland deals with approximately 120 weekly phenylalanine (Phe) levels for both adults and children. A review of 500 Phe levels highlighted that 52% of the results were within the target range. Collaboration between information and communication technologies (ICT) departments, metabolic laboratory, and metabolic dietitians enabled the development of the PKU texting system. Following a successful pilot study, the system was then offered to all PKU patients aged over 2 years. The Phe is analysed and authorised on the laboratory system. The demographics are matched with the patient mobile phone number. Text messages are then validated and sent by the dietitian via a web portal using the Defero SMS texting service. Approximately 290 patients/families currently use the texting system. In order to assess the effectiveness of this quality improvement initiative, a patient survey was carried out in 2017. This showed 87% rated the system as either very good or excellent. 94% agreed it was time saving. 84% felt there was no influence on dietary compliance. Analysis of financial implications on dietetic time over 21 months revealed savings of €3,275 and 580 hours of dietetic time. There is no evidence, two years after implementation, that the system has had an effect on either the Phe levels in terms of recommended range or frequency of sampling.

Highlights

Metabolic dietitians review approximately 120 phenylalanine (Phe) levels weekly and discuss these results with patients via telephone
A review carried out of 500 Phe levels in 2012 highlighted that 52% of the results were within the target range. is suggested that there were a large percentage of patients who did not require further follow-up by a dietitian on a regular basis
Following this successful pilot period, patients Journal of Nutrition and Metabolism with results within target range received a text with their/their child’s Phe level directing them to continue with current management. ose with levels outside of the target range received a text advising them to contact the National Centre for Inherited Metabolic Disorders (NCIMD) for further advice and support

Summary

Introduction

Metabolic dietitians review approximately 120 phenylalanine (Phe) levels weekly and discuss these results with patients via telephone. During this period, 28 parents received weekly text messages with the appropriate text messages for the Phe result via the Defero [1] texting service. Parents engaged with the dietitian as appropriate Journal of Nutrition and Metabolism with results within target range received a text with their/their child’s Phe level directing them to continue with current management. E objectives were to ensure that patients/parents received the correct advice via text in a timely matter without having a negative impact in terms of both metabolic control and the number of Phe samples posted for analysis Aims and Objectives e aim of this study was to examine the PKU results texting system in terms of patient acceptability, safety, and any financial implications. e objectives were to ensure that patients/parents received the correct advice via text in a timely matter without having a negative impact in terms of both metabolic control and the number of Phe samples posted for analysis

Patients and Methods

Financial Implications

Impact on Dietetic Time

Conclusion