Collaboration within PIHC should further improve diabetes care

That question led to DIABASE: a database containing data from about 700 people with type 1 diabetes. In 2020, the project received a voucher from the Pioneers in Health Care Innovation Fund. This voucher enabled the temporary appointment of a second technical physician who helped set up the project. "We're currently conducting research with two additional centers," says Laverman enthusiastically. "And thanks to the voucher, we were able to continuously include students: so far, we've completed about ten master's theses in technical medicine."

One student at the University of Twente, for example, investigated how long measurements with such a sensor are required to assess a person's glucose regulation reliably. International experts recommend two weeks. "The student investigated this in detail," says Laverman. "Two weeks appear to be a very good starting point, but if you want the highest level of certainty, you need to measure for about thirty days."

Another UT student researched how to optimise insulin pump therapy. The student earned a perfect score on his master's thesis and has now been nominated for a national award from the Dutch Society of Technical Medicine. The project is creating a ripple effect, says Laverman. The first two scientific articles have already been published.

DIABASE stores not only summaries and averages but also all the raw data, minute by minute, day after day. "Other research groups often have aggregated data, so summarised figures," explains Laverman. "We have all the individual data points. This enables the identification of patterns that would otherwise remain hidden."

Another special aspect of the project is that it helps to highlight the role of technical physicians - relatively unknown professionals in healthcare. "They are trained to work with patients, but also have a very strong analytical side," Laverman explains. This combination makes them ideal for working with patient populations that generate large volumes of data. "They speak the language of the physician, but also that of the technician. That's a valuable combination."

At ZGT, two technical physicians work in the diabetes outpatient clinic, dividing their time between patient care and scientific research. That concept is spreading. "At Deventer Hospital and MST, they now also have a technical physician at the diabetes clinic. Other hospitals in the Netherlands are beginning to adopt this concept as well. Twente is truly a pioneer in this area."

Laverman emphasises that this is about more than just scientific research. DIABASE also lays the foundation for a fundamentally different approach to care. "People currently come to the hospital a few times a year," he explains. "In a normal consultation setting, both doctor and patient primarily look back: how have things been going over the past few months? But it's more useful to look ahead. It allows you to intervene when things threaten to go wrong, instead of concluding afterwards that things have gone wrong." With a program that receives data daily, healthcare providers can monitor patients much more directly, even remotely. For patients, this means less travel time, fewer away from work, and less time spent waiting in the hospital. For the hospital, this means working more efficiently. And for both parties: faster intervention if issues threaten to escalate.

The work is far from finished. The team hopes to implement a new monitoring program early next year. Follow-up applications are pending, and new collaborations are being initiated. For example, a third technical physician within ZGT has received a grant to study physical activity and its effects on glucose regulation - another spin-off of this voucher. "This is solid scientific work," says Laverman about the research. "But it's more than that. It's also a way to restructure healthcare fundamentally. To get the most out of all the technology that already exists. And to offer a platform for a new generation of healthcare professionals."

What does Laverman personally appreciate most? "The contribution of those young researchers who are generating excellent results." This gives his work enormous depth. His wish: "That within five years, every diabetes outpatient clinic in every hospital in the Netherlands will have at least one technical physician on the team."

The Pioneers in Health Care (PIHC) Innovation Fund is a collaboration between the University of Twente (TechMed Centre), Saxion University of Applied Sciences, and the hospitals MST, ZGT, and Deventer Hospital. Each year, the Fund provides €600,000 for 10 innovative projects that make smart use of technology for the healthcare of tomorrow. PIHC brings doctors and researchers together to develop new technology for better patient care or to use existing technology for new medical applications.