A scoping review of digital solutions in diabetes outpatient care: Functionalities and outcomes

Abstract

BACKGROUND: Digital interventions are increasingly used in outpatient diabetes care to address growing healthcare demands and workforce limitations. This study investigates the functionalities of digital solutions and their impact on Quadruple Aim outcomes: enhancing population health, improving patient experience, supporting clinician well-being, and reducing healthcare costs. METHODS: We followed Joanna Briggs Institute guidelines, searching PubMed, Embase, Cochrane, Scopus, and Web of Science (January 2019-February 2024). Included studies reported digital diabetes interventions with outcomes directly relevant to the Quadruple Aim. Each intervention was mapped to a digital solution horizon: Horizon 1 involves foundational digital workflows; Horizon 2 leverages real-time data to create analytics; Horizon 3 encompasses transformative uses, such as predictive analytics. RESULTS: We identified 4,397 articles with 56 meeting the inclusion criteria. Interventions included telehealth (n = 15), mobile health (mHealth) (n = 20), combined telehealth and mHealth (n = 14), robotics (n = 1), electronic medical records (n = 1), and artificial intelligence (n = 5). Most interventions (n = 51) were categorised as Horizon 1, with 10 adopting Horizon 2, 5 using Horizon 3, and 10 spanning multiple horizons. Regarding Quadruple Aim outcomes, 44 studies addressed population health (41 positive), 31 targeted patient experience (29 positive), 4 focused on clinician well-being (3 positive), and 6 on cost reduction (4 positive). CONCLUSION: Digital solutions have demonstrated measurable benefits, particularly in population health and patient experience. Most interventions remain at Horizon 1. Advancing these digital solutions to Horizon 2 and 3 is essential for system-wide transformation. Future research should include cost efficiency and clinician experience alongside evaluations of population health and patient experience.