Digital diabetes: remote consultations
At the beginning of my fellowship...
My fellowship began with the ambition to introduce virtual consultation models, using digital photography into the diabetic foot clinic. This ambition was to support a patient population at significant risk of deterioration and for whom regular hospital follow up was both arduous and could be a risk to them.
I wanted to expand my understanding of how to effectively implement and evaluate the use of digital technologies in the NHS context and to do this in a multi-disciplinary environment that enabled me to broaden my network.
During my fellowship...
The Topol Fellowship has exceeded my expectations in almost every way. Working with a fantastic, dynamic multi-disciplinary group through the programme has been inspiring, stimulating and supportive.
I was able to successfully implement the digital diabetes foot app I proposed as my Topol project. However, the breadth of opportunity regarding digital health interventions was readily apparent. I was also able to work collaboratively to implement a digital solution for gestational diabetes, alongside two unique and innovative digital technology implementations to support with the COVID-19 pandemic. These interventions involved working with a broad multi-disciplinary team and external industrial partners. I have also been involved in a further range of digital projects both at my Trust and in collaboration with the University of Warwick. I have a clear pipeline of future digital innovations already under development.
During the period I was a Topol Fellow, I was able to complete my PhD with the Institute of Digital Health at The University of Warwick. Following the Topol programme I will start as an NIHR Clinical Lecturer with Warwick Medical School in February 2021 with a clear digital ambition within my proposed research work. Having identified the importance of leadership and management in achieving effective digital change, I have been fortunate to start an MBA with Coventry University to further develop my skills in these areas. The Topol programme has certainly been a career-defining opportunity and I hope utilise the experience and skills learned to benefit patients and the wider NHS in the years to come. Thank you!
Lessons learned:
- The COVID-19 pandemic has changed the digital healthcare landscape in a way that was utterly unpredictable at the start of this fellowship. Despite this, the key principles of effective implementation and evaluation remain as important as ever and will be essential if we are to sustainably integrate and capture the benefits of digital transformation beyond the pandemic period.
- The breadth of opportunity to implement digital change to support both patients and healthcare practitioners is enormous, but to achieve this we need clinicians passionate in digital health who are supported, as I have been honoured to be, by their healthcare employers, mentors and supervisors.
- The NHS lacks sufficient, integrated, training opportunities for digital health clinicians. Programmes such as the Topol Fellowship are vital in bringing together multidisciplinary teams to develop skills to benefit patients and their peers.
Links, writing and work that I completed while I was a Topol Fellow.
Published Papers
Varying degrees of ‘digital’ but an element in all, some funded through routes other than Topol but completed during the Topol Fellowship period. I’ve included academic references. If links are needed please let me know.
Robbins, T., Hudson, S., Ray, P., Sankar, S., Patel, K., Randeva, H. and Arvanitis, T.N., 2020. COVID-19: A new digital dawn?. (https://journals.sagepub.com/doi/full/10.1177/2055207620920083)
Robbins, T., Zucker, K., Abdulhussein, H., Chaplin, V., Maguire, J. and Arvanitis, T.N., 2020. Supporting early clinical careers in digital health: Nurturing the next generation.
Kyrou, I., Robbins, T. and Randeva, H.S., 2020. COVID-19 and diabetes: No time to drag our feet during an untimely pandemic. Journal of Diabetes and its Complications.
Davey, S.L., Lee, B.J., Robbins, T., Randeva, H. and Thake, C.D., 2020. Heat stress and PPE during COVID-19: impact on healthcare workers’ performance, safety and well-being in NHS settings. Journal of Hospital Infection, 108, pp.185-188.
Weickert, M.O., Robbins, T., Kyrou, I., Hopper, A., Pearson, E., Barber, T.M., Kaltsas, G. and Randeva, H.S., 2020. Impact of the COVID-19 pandemic on neuroendocrine tumour services in England. Endocrine, pp.1-6.
Robbins, T., Kyrou, I., Laird, S., Morgan, N., Anderson, N., Imray, C., Patel, K., Sankar, S., Randeva, H. and Jones, C., 2020. Healthcare Staff Perceptions & Misconceptions regarding Antibody Testing in the United Kingdom: Implications for the next steps for antibody screening. Journal of Hospital Infection.
Deogon, G.S., Robbins, T., Randeva, M.S., Kyrou, I., Sankar, S., Randeva, H.S. and Murthy, N., 2020. Managing high-acuity outpatient services during the COVID-19 pandemic: lessons from the acute diabetes foot service. Future healthcare journal, 7(3), p.e77.
Patel, J., Robbins, T., Randeva, H., de Boer, R., Sankar, S., Brake, S. and Patel, K., 2020. Rising to the challenge: Qualitative assessment of medical student perceptions responding to the COVID-19 pandemic. Clinical Medicine, 20(6), p.e244.
Harrison, G., Newport, D., Robbins, T., Arvanitis, T.N. and Stein, A., 2020. Mortality statistics in England and Wales: the SARS-CoV-2 paradox. Journal of International Medical Research, 48(6), p.0300060520931298.
Despotou, G., Evans, J., Nash, W., Eavis, A., Robbins, T. and Arvanitis, T.N., 2020. Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application: A cross sectional exploratory study. Digital Health, 6, p.2055207620924949.
Awards
COVID-19 Action Fund Award – https://www.wcmt.org.uk/covid-19-action-fund-winners/covid-19-action-fund-winners-health-and-social-care
HSJ Value Awards – Finalist – Digital Empowerment for Patients with Diabetic Foot Disease; A Topol Fellowship Project
QiC Diabetes Commended 2020: Diabetes Education Programmes – Healthcare Professionals Developing World-Class D&E Training: The Health Education West Midlands Model
Blog post
Reflections on my first month as a Topol Digital Fellow
Academic achievements during Topol period (alongside Topol Fellowship)
Completed my PhD in Engineering with the University of Warwick (Factors Associated with Poor Outcomes when Patients with Diabetes are discharged from Hospital: A Health Informatics Approach)
Started MBA with Coventry University
Will start as NIHR Clinical Lecturer in Feb 2021
Published Abstract (Conference cancelled due to COVID-19): Robbins, T.D., Hunt, L.J., Arvanitis, T.N., Rao, R., Deogon, G., Sankar, S., Murthy, N. and Randeva, H., 2020, September. Development and pilot implementation of a smartphone camera-based diabetic foot remote management tool. In DIABETIC MEDICINE (Vol. 37, pp. 120-120). 111 RIVER ST, HOBOKEN 07030-5774, NJ USA: WILEY.