Featured project: More efficient diabetes care thanks to MiGuide

Name: MiGuide
Goal: To have diabetes patients carry out standard measurements themselves
Intended result: A healthier lifestyle, more autonomy for the patient and independence from the care provider and therefore less pressure on healthcare
Partners: MiGuide, ‘Het Huisartsenteam’ and Medical Delta Living Lab NeLL
Status: Upscaling with the support of a ZorgTech voucher

Diabetes patients go to the doctor about four times a year, but the standard measurements during such a check-up can also be easily carried out at home. With the MiGuide app, a diabetes patient can keep track of measurement data and receive personal lifestyle advice based on this.

In order to successfully integrate the app in GP practices and to conduct more research into the effects on both the practice and the patient, MiGuide successfully applied for a ZorgTech voucher together with ‘Het Huisartsenteam’ (organization of general practitioners) and Medical Delta Living Lab NeLL. ZorgTech is a joint program of Metropolitan Region Rotterdam The Hague (MRDH), Medical Delta, TNO, the province of South Holland and InnovationQuarter to promote innovation in healthcare. ZorgTech focuses, among other things, on support in the upscaling and implementation of technological care solutions.
"Thanks to MiGuide, patients can better prepare the check-ups and get more control over their own treatment. This stimulates a healthy lifestyle and reduces the pressure on healthcare," says Jasper Schellingerhout of the care group ‘Het Huisartsenteam’, which is already using the app.

More than a million diabetes patients in the Netherlands

Diabetes is a big and growing problem. There are currently about 1.1 million Dutch people with this chronic disease and 70,000 patients are added every year. As a result, the pressure on healthcare is increasing. A healthier lifestyle, greater patient autonomy and caregiver independence can significantly reduce this pressure. "Our aim is that patients will have 25% less use of the GP in the long term," says Arjen Huizinga, managing director of MiGuide. "In doing so we can reduce healthcare costs by at least €500,- per patient per year."

Care based on data

To achieve this, MiGuide wants to offer lifestyle coaching from the general practice. Huizinga: "It is not always easy for GPs to convince someone of a certain advice, to check whether the patient follows the advice and to actually initiate behavioral change. While it is precisely this lifestyle that is essential to reduce complications, medication use in the long term and hospital admissions."
The app uses data from the GP computer system, wearables (such as watches, pedometers and glucose meters) and data entered by the patient (such as weight and a food diary). On this basis, MiGuide, under the direction of the general practitioner, provides personal lifestyle advice in the field of nutrition and exercise.

Continuum between home and practice

One of the focus areas of GPs is the care of people with a chronic illness, such as diabetes. Care group ‘Het Huisartsenteam’ from West Brabant consists of 21 GP practices and has recently started working with MiGuide. The organization has been using a digital patient portal with an app for several years now. This gives patients the opportunity to make an appointment, view their file, order repeat prescriptions and ask questions via an e-Consult.

As frontrunners in digitization, the organization has succeeded in getting a large proportion of patients to use this. In Schellingerhout's practice, ‘Het Huisartsenteam De Keen’, this concerns more than half of the 12,500 patients. "In recent years we have been expanding the functionalities further and further. Health insurer CZ is helping us, for example by proposing many new digital tools, including MiGuide. In our opinion, MiGuide has the potential to create a continuum between the checks in the GP practice and the patient's daily life. Normally, patients come for a check-up four times a year. Now they keep track of the measurement data themselves, such as weight and blood pressure, which makes the consultations more customized. For the practice, this means fewer checks. so that the time that GPs now spend on the standard treatments can be spent more effectively.”

There is clearly enthusiasm for the app, Schellingerhout notes. "Already in the first week that we used MiGuide, we received many registrations and positive response from patients. It helps that most of them are already familiar with the digital possibilities of the patient portal. We also see that people appreciate it more to have an overview of and control over their treatment process. That creates trust and promotes the goal we strive for: more person-oriented care.”

Integration and upscaling thanks to ZorgTech

Schellingerhout emphasizes that, for a successful integration, healthcare administrators and healthcare insurers must first be convinced of the importance of the app. "For each type of consultation, the general practitioner enters a code with which the health insurer arranges the payment. There is no such code for e-health, and a long process is needed to change this. The lack of this is a possible threat to technological healthcare innovations such as MiGuide.”
That is precisely why Huizinga and his colleagues came into contact with ZorgTech at exactly the right time. In addition to a company and a healthcare institution, ZorgTech projects also involve a field lab, in this case Medical Delta Living Lab NeLL. Huizinga: "With the cases in the NeLL we can demonstrate the effects of the app and thus show other practices how much value MiGuide adds to their care provision."
This substantive and research-oriented support is what makes ZorgTech so special, says Huizinga. "It is one of the few projects in the Netherlands that helps with the implementation and upscaling of innovations in the field of healthcare digitization." Schellingerhout adds: "ZorgTech not only provides project support during the set-up and integration, in this case the integration of MiGuide with our app and the patient portal, but also remains involved afterwards for advice on upscaling. So that the technology is not only accelerated and successfully integrated. , but also gets a permanent place in healthcare. Which is certainly valuable for MiGuide, because we believe that the app contributes to more targeted consultations, more patient-oriented care and time savings for the practice, lower costs and a better life for diabetes patients."