Glycemic management support for healthcare professionals
Interviewees with limited or no prior experience of HCL use expressed a need, initially at least, for support to review and interpret women's HCL data, especially during the initial period after a woman had transitioned onto the system “to help people get the best out of it [HCL]” (HP-008). Specifically, interviewees noted that:
“there was a requirement to have … support around trying to interpret patterns, thinking about carb counting, thinking about where hypos come in… as the system begins to change its algorithm and zero in on particular insulin doses. And that, probably for all of these women, was a bit more intensive for the first two or three weeks” (HP-012).As some interviewees observed, it took time and practice to develop skills to interpret data and determine which system settings to adjust: “you really only get the sense of the data … once you do it lots” (HP-013). Hence, some interviewees described benefiting from consulting and learning from experienced colleagues during the trial (Interviewees suggested potential ways to provide these kinds of support in routine clinical care. Reflecting on their use of the HCL's data sharing/remote access capabilities to obtain support from central trial staff, several, for instance, suggested that this functionality could enable inexperienced colleagues to seek mentorship/peer support from experienced staff at their own site or a regional expert:
“I think just having a mentor until you've got going… someone to ring up… who you share downloads with and say: this is what I did. What do you think? You know, I think that would be valuable.” (HP-015)Some also suggested that this kind of support could be provided using an online portal where “you could drop the image of what you're unsure about, and then somebody who has expertise could perhaps either call you, if that's necessary, or could give feedback based on what they can see.” (HP-006). Several also described benefiting from intersite case-based meetings arranged to share learning and discuss challenging cases during the trial: “to hear about other people's experiences of what had gone wrong and what had gone well” (HP-002). To facilitate wider rollout, they suggested establishing closed-loop pregnancy “masterclass” (HP-013) meetings or workshops to help develop competence and confidence reviewing and interpreting data (