20 m-Health clinic partnership project between HHU düsseldorf and bosnia-herzegovina: creation of a digital network of diabetes type 1 children and adolescents in rural and remote areas in Bosnia and Herzegovina

BackgroundType 1 Diabetes Mellitus (T1DM) is a chronic disease requiring lifelong insulin therapy. Poor management can lead to severe acute and chronic complications. Children from rural and remote areas in Middle-Bosnia Canton have limited access to diabetes pediatric care.ObjectivesTo improve the care of pediatric and adolescent patients with T1DM in rural and remote areas of Bosnia-Herzegovina by creating a digital diabetes network using modern mobile health technologies. With this, the digital diabetes competencies of healthcare professionals in Bosnia should be expanded and patients should be trained and connected with the mHealth diabetes app to the main pediatric diabetology clinic.MethodsPatients and doctors from rural and remote areas were provided with smartphones and a digital diabetes app, Diabetes M and received training in diabetes management. Diabetologists from the main pediatric clinic in Bosnia were digitally connected to patients and could monitor their everyday diabetes management and provide competent advice digitally. The main indicators and measure instruments of the network were the total number of healthcare professionals trained as well as the number of patients and their satisfaction and diabetes mHealth App usability.ResultsA network between diabetologists from the main pediatric clinic in Bosnia, 50 patients (with parents), and 10 healthcare professionals from rural and remote areas was created. Thirteen doctors across Bosnia-Herzegovina received training in digital diabetes care. Fifty T1DM patients from rural and remote areas, usually deprived of regular diabetes care, were connected with the main pediatric diabetologist and the team in Sarajevo by utilizing a diabetes app to improve diabetes management and to receive access to diabetes care.ConclusionmHealth is a powerful tool that can offer seamless communication between patients and their healthcare professionals. For the first time, 50 young patients were able to receive qualified diabetes care remotely, regardless of their location in Bosnia.Financially supported by Gesellschaft für Internationale Zusammenarbeit (GIZ No 81277521).