We share remarkable success stories from our valued customers who have achieved outstanding results using our eGlycemic Management System (eGMS). Prepare to be inspired by their dedication, innovation, and unwavering commitment to excellence.
Robby Booth: Hello and welcome. My name is Robby Booth. I'm the founder and chief strategy officer here at Glytec. I'm so glad to be welcoming you to our second day of Time to Target 2023. The theme of this year's conference is the glycemic management journey. And while yesterday we focused on ‘the why’. Today, day two, is going to be all about ‘the how’, and while we're fortunate to have an incredible and expert team at Glytec who are very experienced in the how, we thought today who better to explain the ins and outs of how to make a difference on the front line than some of our customers.
Here to share with you their stories are five Glucommander champions who have been actively walking this journey. First up, we have Marie Osborne. Marie is not a clinician, which may strike you as odd, she's an IT project manager at SUNY Upstate. And we thought it was important to highlight this story in particular because as most of you know, it's the collaboration between clinical and technical that makes healthcare technology projects like Glucommander really come to life.
It just can't be done without these cross team efforts. And in Marie, we're very fortunate to have an incredible IT advocate and collaborator. We were honored to recognize this yesterday with a Glytec Partner Award and honored even further to welcome her to our stage this morning.
Marie Osborne: My name is Marie Osborne.
I'm a Program Manager in SUNY's Program Management Office. And that office was created about four years ago to help with large enterprise wide projects that really take a lot of integrated teams, a lot of diverse teams, to have someone to lead the charge of those teams and make sure the communication is really excellent on those projects.
This was probably the biggest one in terms of the number of end users and the hospital units that were going to be affected. I've implemented third party software many times, but often they were niche programs that were for small populations or small segments of nursing or providers, certain specialties.
So this one was unique in that it really was going to help and affect and be used by nurses hospital wide. And we have two hospitals. The scope of this one was bigger. I knew that I didn't know anything about glucose management or diabetes or any of that. So I started off feeling, wow, I want to be able to speak the right language.
I have a big team. I don't want to be stumbling over words. Having those videos and e-learning from Glytec, they were so straightforward and easy to understand that I felt like right after watching them, I could start speaking and saying the right things so that we can bridge that gap between the clinical, what was necessary clinically and technically.
And once I did that, and I felt really good about it, I thought, well, I can understand this. Anybody can. So I begged all my IT counterparts to watch them, and most of them did watch them. And we were really able to hit the ground running because we all had a baseline of what we were talking about when we started.
And then on the clinical side, right off the bat, I was assigned basically a clinical project manager who I called right off the bat and said, we can do this so many different ways. I've done Agile, I've done Waterfall, I know different project methodologies. What do you want to do? And so between her clinical expertise and what I know of managing IT projects, we came up with a method that was going to work for us.
She did the same kind of analysis I did on the tech side from a nursing side and said, Oh, we really need a nurse from psych. And we need a nurse from some procedural areas because things are different there. And she'd explain that to me clinically. Having that two pronged project manager, clinical and technical, we were able to fill in all the blanks and we ended up with a large team, which sometimes is hard because it's too many cooks in the kitchen, but it did not turn out that way with this.
We had a large team and everybody we had was needed and played a role. I'm pretty proud of how that came together. On IT, we get a lot of requests and we just like to knock them out and sometimes we don't even hear how it's going to be beneficial.
So, from my team, I know they love it when they can point to a benefit and say, I was able to affect patient care with this order set that I made or these interfaces that we set up. So, treat everything as important that we're being asked to do, but when we really could see that it was making an impact after we went live, I know everybody really felt proud about it.
Robby Booth: All right, Marie, thank you so much for sharing your story. And I love how she mentioned the sheer scope of the project and the number of patients that it can reach, which is really our goal as an enterprise-wide glycemic management platform. I also think it's fantastic how much she committed herself to the project, rounding on units and watching educational videos, and so much more because that's what a true IT champion really looks like.
So what does the implementation of Glucommander look like from the clinical perspective? Once it's built, how does it roll out to the providers and the nurses? We're going to use it day in and day out to care for patients. Here to share that story is Geni Thompson. She's a nurse and a diabetes care and education specialist at Sentara.
Genevieve Thompson: My name is Geni Thompson. I am a nurse and certified diabetes care and education specialist. I've been with Sentara for about 10 years now and I work supporting the inpatient initiatives as well as outpatient resources for our program. This project was the first big project that I've been able to take part in and have such a significant role.
We did a great job throughout the Sentara system collaborating with our leadership team, IT, education, support. We had lots of support across the entire system in order to get this initiative going. This is not a project to do on your own. It is definitely something that you need wide support throughout the system from every single department.
Again, it has to be a collaborative team, ongoing, open communication, and willingness to take a look and see how you can best Worked together to make sure that it's the easiest process for the providers, for the nurses, for food team, for care partners, this project really did encompass our entire healthcare system, every single employee needed to be aware of the project and the implementation and how their role was affected.
And I think that from management and leadership and education, we had the support to be brought into updates for meetings and tip sheets and resources. We were creative with where we kept our resources, both on our intranet page, on our education page, newsletters, QR codes. We got all the information out in so many different ways just to make sure that everybody had the opportunity to be aware of what was coming and how it might impact their role.
On our Go-Live day, we had all the resources available electronically where we told everyone where they were. But on that go-live day, we had folders, we had all the tip sheets available. We had the contact information, the websites, the meeting links, because we touched base throughout the day. We had all the Glytec support had a way to communicate with staff and these folders were posted on each unit in the physician lounges, just so that everybody, it was.
All the information was right in front of them, and so there were no, as soon as there was a question, they were able to connect with somebody to be able to get that real shoulder to shoulder answer and education, real-time answer as they were facing something new. Excited with the implementation that we were able to work together as a team, that we really did have engagement from physicians and nursing, knowing how to get their questions answered.
They still know where to go to get their questions answered. It's exciting to see, uh, the patients really doing well in the hospital as far as getting to target a little bit faster. And additionally, the patients are learning what they need to do as far as insulin at home and around their food and how to take it.
So there have been, there, it's educational both for medical staff as well as the patients learning the insulin best practice
Robby Booth: Okay. Thank you, Geni. You know, Geni's story is a great example of how the small details can add up to make a big difference. And I think how one person can really leave their mark on a program, whether they're a pharmacist, a diabetes educator, or a nurse like Geni.
Another person here to tell a similar story, but from their provider's perspective, is Dr. Lohano from Baptist Health Floyd.
Vasdev Lohano: My name is Vasdev Lohano. I'm a board certified adult endocrinologist. I've been practicing here at Baptist Health Floyd since 2008. I'm currently the medical director for the Joslin Affiliate that we have here at Baptist Health Floyd.
And we provide both inpatient and outpatient services, endocrine services to this community. And we obviously provide inpatient services at the Baptist Health Floyd. Glucose management in hospitals sucks. I apologize for that. It's just not good, you know. It's put on the back burner. It's the least important thing.
And of course, you know, the data that we see is different than what we see in the practice.
And it's not because clinicians don't want to care. It's not like that. It's complicated. You know, a patient coming in with sepsis or some big things, you know, glucose is the last problem that anybody will pay attention to, generally speaking, and in the training programs, you know, generally in the family medicine or internal medicine residency training programs also, it's the focus has not been on the glucose management, just put them on sliding a scale and we'll worry about it later.
And then, you know, we'll just do the ID and we do the protocol. We do the protocol. We do the antibody protocol, but the glucose, I mean, we'll just do it whenever we get to it. Okay. And I've been practicing for 20 plus years. I've seen that. And when I saw this program, I said, okay, if nothing else, we'll have a conversation about it.
We'll have, you know, at least something to talk about that this is important. And I think the timing is right as well because I think there is a larger conversation that's happening. The CMS is paying attention and quality metrics are paying attention. So I think the timing was right. I've met with my hospitalist colleagues, my intensivist colleagues, my primary care colleagues, you know, and nobody is resistant.
That's never the problem. Resistance is not the problem. I think, you know, there are more. I mean, I understand because I have worked as a hospitalist as well, so I know what goes on in the mind, because the priorities change. Okay. When somebody's coming with a, you know, septic shock or pneumonia, or you're being pulled into 15 different directions, you know, I understand that, you know, so you just have to...
You just have to have a conversation and make sure they understand that you understand them, you know, it's a relationship issue. If they understand that you understand them, you know, where they're coming from, and then you bring in, you know, needs or whatever you call them, you know, I think then you get it.
As I said, the key is a buy-in. If I don't have buy-in from the other clinicians, bye, forget it, this program is going to be just sitting on the desktop, you know, so buy-in is very, very critical. And I think we are doing that. Luckily, we had a good team and we plan to continue to have this conversation going.
And, you know, we hope that we'll at least keep it up, if not improve, but at least keep it up and moving forward.
Robby Booth: As Dr. Lahano so eloquently mentioned, glycemic management is a journey. He knows it. I know you know it. And it's the whole theme of our conference. And one important step in that journey is ongoing optimization.
Here to help us tell that story is Darcy Allen from Chesapeake Regional Healthcare. Chesapeake has been using Glucommander for many years. And I think has really nailed the use of IV, SubQ, and most importantly, the transition in between. So let's hear more.
Darcy Allen: My name is Darcy Allen. I work at Chesapeake Regional Healthcare.
I have been there for 35 years. I am a registered nurse and a diabetes educator. I moved into the field of diabetes in 2005 and worked outpatient for a while and then moved to the inpatient setting. where we needed a lot of help because we did not have any endocrinology assistance or medicine happening at the hospital.
I was there for the birth of Glucommander and I've been raising it ever since with the help of the nurses in the hospital. Yeah, transition of course has a lot of moving parts. Walking into IV is fairly easy to do and follow the instructions and starting someone on IV insulin is fairly easy. But transition requires a right order at the right time with right decisions being made.
And we were messing that up. We were keeping patients in ICU or in step down unit too long. We couldn't quite get transition completed sometimes, whether it was an order that wasn't. It wasn't placed by the physician or if it was walking away from it saying we gave the Lantus, but we really didn't when we were busy.
So, we had to come up with something that would help us get through that process and do it the right way and safely for the patient and efficiently. So, we came up with the idea of doing laminated, like a half sheet of paper, two sides, of the transition process. Everything on there from how I would think about it if I was at the bedside myself doing it in that moment, is what do I need to do first?
What is the first step? So we made up the laminated cards, put them in little bins, and we placed our bins at all of our GlucoView meters, monitors, so that everybody would know where they were. And that has helped because it is laid out in each step of what they need to do. And also on the back of it, we put using the meal bolus.
Because just today at work, we had an issue with the patient eating down in the emergency room. The doctor said, yes, go ahead and eat to improve customer service. However, she stayed on the drip much longer than need be. Try to pack a lot of information in there, but make it very simple, very easy to use. I see a lot more confidence there in the nurses doing it when they've got a guide to follow that's right in front of them.
That has been hand delivered, and my office is, I'm very close, I go to every, everybody that calls me, I go to the, right at their hips, and our, yeah, that process is much improved now. We're not missing steps. We're getting it done in a timely fashion. I see that the SubQ insulin dosing is much more close to what it needs to be because the drips are done correctly.
Diabetes is scary. It's a big thing. It has a lot of parts to it, and you have to be a little brave and maybe a little crazy, but you need that help, that Glytec help is, as I can't say enough about it.
Robby Booth: Well, trust me, I love technology, and I believe it plays an integral role in our lives, but there's no denying the benefit of an old school approach in some scenarios.
And I think Darcy's printouts are a great example of how sometimes simple solutions can solve challenging problems. On the other hand, sometimes big challenges really do call for fully leveraging all of the technology resources at your disposal, which is what I love about this final story Emma's going to share with you.
Emma comes to us from Kaweah Health, a hospital serving one of the poorest regions in California, and their inpatient glycemic management program has a shoestring budget. But, they have phenomenal results, and I'm going to turn it over to Emma to tell you how.
Emma Camarena: My name is Emma Camarena, and I'm the Director of Nursing Practice.
I've been at Kaweah for about 32 years. Yeah, my role is multi-talented. I've been described as a jack of all trades. I currently oversee the Advanced Practice team, the PIC and RUNE teams. And my nursing background has been in critical care, so I worked in ICU for about 10 years, and then I was a clinical nurse specialist or advanced practice nurse for the ICU for about 10 years, and then most recently I became the director of nursing practice, so like I said, I'm in charge of almost everything that has to do with nursing practice, including diabetes.
I've been on the Diabetes Management Committee for many years, almost from the implementation of the committee. And then in about 2019, I became the chair of the committee. So our county, we have a very high patient population with diabetes. About 40 percent of our patients have diabetes. In our county, in our state, there's 58 counties, and we rank about 39th with deaths related to diabetes.
So we have a robust outpatient diabetes program, but we wanted to bring that and expand that into our inpatient population. Over the years, we've had many discussions about implementing a diabetes inpatient management team. So last, in February 2022, we were finally able to implement a part-time diabetes inpatient diabetes team, which consisted of a nurse practitioner and an endocrinologist.
Our endocrinologist works with us via telemedicine, so when we have a more difficult patient, we usually will call him and talk to him about the situation. So as a short time endeavor to see if we could improve the return on investment for our team, our nurse practitioner sees about two to three patients per day.
He would consult with our endocrinologist for those, like I said, for those more difficult patients with renal disease or insulin resistance. So from February 2022 to February of this year, he saw, he reviewed about 1,369 patients. Because of his limited time, he chose to look at only the patients who were in danger of becoming hypoglycemic.
So those patients had blood glucoses between 70 and 90, which actually was about 437 or 32 percent of the total patients. So, of those patients, we were able to, the patients who had hypoglycemic events, of those patients with interventions performed, 420 or 96 percent of those patients had no hypoglycemic events.
17 of those patients, or 4%, did have a hypoglycemic event. Both with interventions, none of those patients had a recurrent hypoglycemic event.
And he would then take those patients and review their charts, talk to the nurses, and if he was able to make adjustments on his own or make those recommendations to the nurses to talk to the hospitalist, he would do that. And if not, then he would talk to the hospitalist himself and then make those recommendations.
So, the number we chose to calculate, so the hypoglycemic events less than 70, if we were to, we had 420 patients, so if we were to avoid, have that cost avoidance, we had 420 and we used that middle number about 4,800 and when we did the calculation, we had a savings of over 2 million. So that was a cost avoidance there.
So I don't know. I just have never been able to be like, we just do the work that we can to improve patient outcomes. We're not looking for praises or anything else. What we're really looking for is the opportunity to improve that patient care and providing that patient with everything they need to have better outcomes.
That's just what inspires us to keep moving forward. You know, because if we don't do that, then who will? And that's the way we look at things and that with whatever help we can get, that's what we're going to use to move forward.
Robby Booth: All right. It's amazing what can be done when you empower passionate people with the right mix of supportive partners, useful technology, and proper process.
The work they're doing out at Kaweah and Chesapeake, Baptist Floyd, Sentara, SUNY, and all the rest of our 300 plus hospital partners It's really nothing short of remarkable. In the last year, they've treated hundreds of thousands of patients and drastically reduced their rates of severe hypoglycemia. I know I don't have to tell you, excelling in this space takes focused effort.
It takes continued commitment to a belief that all patients deserve the best possible care and that change is possible. At Glytec, we're here to help. Your success is our success. And your passion fuels our passion. So I hope you'll join me not only in thanking our phenomenal customers who have so generously shared their stories with all of us today, but also to our presenters, scheduled over the course of the rest of the day, who have just as generously agreed to share their wisdom, expertise, and know how.
We've got a really great day lined up and it all starts in just a few minutes. So thanks again and enjoy the conference.