Telemedicine Consultation for Insulin Pump Therapy is Launched at Diabetes and Obesity Outpatient Services by Utilizing the "Blood Sugar Level Cloud Management System"

Keio University Hospital (Hospital Director General: Morio Matsumoto), Chubu Electric Power Co., Inc. (President & Director: Kingo Hayashi; "Chubu Electric Power") and Medical Data Card, Inc. (President & CEO: Yasuyuki Suzuki; "Medical Data Card") expanded the telemedicine consultation system used in diabetes and obesity outpatient services at Keio University Hospital to link with the CareLink system of Medtronic Japan Co., Ltd. (President: Rob Sandfelder; “Medtronic Japan”). The new system started providing online medical care for patients using insulin pump therapy with continuous glucose monitoring ("SAP Therapy" (Note 1)) for the treatment of type 1 diabetes and other conditions on January 27, 2022.

1. Overview of the telemedicine consultation system

Keio University Hospital, Chubu Electric Power and Medical Data Card have established a telemedicine consultation system at Keio University Hospital and started online medical care for outpatient obstetrics in June 2020 and for outpatient diabetes and obesity in November 2020（announced on July 15, 2020.December 22, 2020）。

Meanwhile, Medtronic Japan operates the CareLink System that accumulates 24-hour blood glucose and insulin dose data in the cloud.

This telemedicine consultation system links the "CareLink System" with Chubu Electric Power's data platform and Medical Data Card's "MeDaCa" (Note 2), and allows the patients to enter blood pressure, weight, blood glucose levels, 24-hour sustained glucose levels and insulin doses obtained from SAP, and other data. The system aggregates data and enables online medical care via videophone while viewing accurate data.

2. Challenges in SAP therapy

SAP therapy is an advanced medical treatment that enables meticulous blood glucose control and is expected to spread to patients with type 1 diabetes and other conditions. However, this treatment requires the burden on patients in terms of distance and frequency of visits to the hospital as well as the difficulty of receiving consultations in areas where there are no specialist doctors. For this reason, there had been also a demand for the introduction of telemedicine consultations for SAP therapy.

The CareLink system enables remote monitoring of information which is necessary for insulin dosage instructions and realizes online medical care, but in order to view the data on the CareLink system, physicians must log into the system each time to search for the corresponding person and the appropriate data. This requires physicians to distinguish the system from other diabetes-related data systems and to manage IDs that differ from patients' medical records, making confirmation and management of data intensive during short consultation times.

Furthermore, the sharing of measurement data such as blood pressure and weight measured by the patient at home and the videophone consultation had to be done separately via each different system, which was difficult to accommodate in short consultation times.

3. New initiatives

For this time, under the leadership of Keio University Hospital, Chubu Electric Power and Medtronic Japan have established a system to display reports centrally on the screen via the Medical Data Card’s MeDaCa system linked by Chubu Electric Power Cloud through use of RPA technology (Note 3). In addition to conventional self-measured data such as blood pressure, weight, and blood glucose levels, the new system enables viewing of 24-hour continuous glucose data and insulin doses obtained from SAP, and while viewing this accurate data, patients living in remote areas or underpopulated areas can receive the same quality of medical care as face-to-face patients via videophone function. This centralization of data is expected to improve doctors' work efficiency and reduce their stress, thereby enabling them to utilize the limited medical resources such as doctors who have mastered advanced medical techniques, and to provide higher quality medical care than face-to-face consultations by providing detailed care from specialized nurses on days beyond the consultation days. In addition, many type 1 diabetics, who are the main users of SAP therapy, are young people who play an active role in society, so reducing the frequency of hospital visits is expected to reduce the negative impacts on their work and daily lives, which is expected to bring a socioeconomic effect.

4. Future outlook

Keio University Hospital, Chubu Electric Power, and Medical Data Card aim to create a system in which all patients requiring advanced medical care can receive medical care and to utilize medical resources by reducing the workload of physicians. The goal is to create a seamless "data-linked telemedicine system" by further centralizing information across barriers and developing analytical techniques. Keio University Hospital and Chubu Electric Power will continue to be at the core of these efforts in propelling development for implementation of Society 5.0 as envisioned by the Cabinet Office.

5. Notes

The Cabinet Office commissioned Keio University Hospital to participate in a research and development project entitled the Cross-Ministerial Strategic Innovation Promotion Program: Advanced Diagnosis and Treatment System by AI (Artificial Intelligence) Hospitals. As part of this project, Keio University Hospital has been conducting research jointly with Chubu Electric Power on monitoring patients at home, remote medical consultations, and community health care support. This initiative is one of the achievements on this program.

【Glossary】

(Note 1) SAP (Sensor Augmented Pump) therapy is a diabetes treatment method in which insulin is injected continuously under the skin with a function that can estimate blood glucose from subcutaneous glucose levels and monitor blood glucose fluctuations in real time for 24 hours. It is also equipped with a function that alerts a user when blood glucose exceeds a certain range and automatically stops insulin infusion if hypoglycemia is predicted, thus preventing hypoglycemia.

(Note 2) This is a system for patients to self-manage their own medical information. It allows patients to store and view medical information held by hospitals, such as blood test data, test images, and prescriptions, as well as self-measured data such as blood pressure and weight on a smartphone or PC. Video call is also available for online communication.

(Note 3) RPA (Robotic Process Automation) technology is a function that uses AI and machine learning to replace human input work.