Introduction

Data collected between 2019-2020 showed a 17% increased prevalence of women diagnosed with gestational diabetes (GDM) at Christchurch women’s hospital (CWH). With no increase in resources, physician burnout, overloaded clinics and covid 19 hitting New Zealand, a new dietitian-led telehealth model of care was initiated for diet-controlled GDM women. With the current model of care, diet-controlled women were seen by an obstetrician one to two times and a physician three to four times throughout their pregnancy. 

Aim

To evaluate the reduced physician and obstetric work load and financial cost savings of the service delivery with the move to a dietitian-led telehealth model of care initiated at 0.6 FTE for diet-controlled women with GDM.

Method

To review and develop a dietitian-led telehealth model of care for our women with GDM and to secure funding for permanent resourcing for a diabetes dietitian. Obtain statistics on clinic appointment and cost avoidance after 12 months.

Results

Our telehealth model of care was rolled out successfully in June 2021. Across 12 months, we had 429 referrals for women with GDM. Each of these patients was initially part of our telehealth model and continued so if they remained diet controlled. Twenty eight percent of our cohort (n=119) remained diet controlled and under the care of a dietitian throughout pregnancy. We successfully reduced the workload and clinic space of 464-696 physician/obstetrician appointments with a cost avoidance of upward of $235,000 per annum. We also successfully introduced Diabetes Midwifery metformin prescribing which further reduced the workload and clinic space of physicians and secured permanent 0.6 FTE dietetic funding to continue our model of care.

Conclusion

We have successfully introduced a dietitian-led telehealth model of care for diet-controlled women with GDM at CWH, with large savings in terms of reduced physician and obstetric input and cost avoidance. It is hoped this model of care can be extended nationwide.