Overview
Initiative type
Model of Care
Status
Close
Published
January 2026
Summary
The Wide Bay Gestational Diabetes Service at Bundaberg Hospital utilises a digital platform with in-app messaging to manage diabetes in pregnancy across a geographically dispersed region. The service integrates remote monitoring via an app (CHO Connect) with traditional antenatal care, aiming to reduce travel burden, improve patient engagement, and maintain safe maternal and foetal outcomes.
Dates: July 2021 ongoing
Implementation sites: Bundaberg Base Hospital
Partnerships: No Queensland Health partners
Aim
To provide efficient, patient-centred care for women with gestational diabetes by combining remote monitoring, and in-person visits. The goal is to optimise blood glucose control, reduce complications, and minimise disruption to patients’ lives while ensuring continuity of care.
Outcomes
- Maintained maternal and foetal outcomes comparable to traditional care
- Reduced clinic visits and resource use (average 0.5 fewer appointments per patient)
- Increased occasions of service revenue, offsetting app costs
- High patient satisfaction (average rating: 4.3/5)
- Improved compliance and accuracy of blood glucose reporting
- Enhanced convenience for rural patients and reduced travel-related stress
Background
Gestational diabetes affects 13–17% of pregnancies in Bundaberg, increasing the risks of complications such as preeclampsia, caesarean delivery, and neonatal issues, such as hypoglycaemia and jaundice. Wide Bay HHS covers a large area, with some patients living 2–3 hours from Bundaberg, making frequent clinic visits challenging. Prior to 2021, management relied on face-to-face visits and paper diaries, which often led to missed data and increased patient burden.
Methods
- Diagnosis & Initial Care
- Glucose tolerance test confirms diagnosis
- Patients receive a GDM pack (glucometer, strips, education materials, QR code for app)
- Education:
- Initial group videocall session with dietitian and diabetes educator to provide education on all aspects of GDM management, including use of the app
- Remote Monitoring:
- CHO Connect app (via Net Health Data) syncs with Accu-Chek glucometers via Bluetooth
- Patients log blood glucose readings, food diaries, and notes; clinicians access data via a secure web portal
- Messaging system enables real-time communication for medication adjustments and troubleshooting
- Follow-up:
- Combination of remote reviews and in-person visits for maternal and foetal monitoring
- Dietetic follow-up often conducted remotely via app review
- Governance:
- Daily review of app data by obstetric consultants; dietitian monitors dietary compliance
- Cost Model:
- App costs approx. $75 per patient annually; offset by increased occasions of service billing
Discussion
The service demonstrates that digital monitoring and video calls can deliver care equivalent to traditional models while reducing resource use and improving patient convenience.
- Benefits include:
- Reduced travel and time away from work/school
- Better engagement and compliance due to real-time feedback
- Centralised data collection and integration with clinical workflows
- Evidence from local audits and external studies (e.g., Sunshine Coast) supports cost savings and efficiency gains without compromising outcomes
- Challenges include:
- Technology barriers (device compatibility, connectivity issues in rural areas)
- Privacy concerns among some patients
- Limited utility for pre-existing diabetes patients using different devices
- Need for clinician oversight and clear governance for data review
Future improvements include compatibility with continuous glucose monitoring and streamlined onboarding processes.
References
- Queensland Clinical Guidelines. Gestational diabetes mellitus (GDM). Guideline No. MN21.33-V6-R26. Queensland Health. 2022. Available from: http://health.qld.gov.au/qcg
- Poulter, S., Meloncelli, N., & Mack, M. (2022). Use of a Smartphone-Based, Interactive Blood Glucose Management System in Women with Gestational Diabetes Mellitus: A pilot study. Diabetes research and clinical practice, 109224. https://doi.org/10.1016/j.diabres.2022.109224.
- Yue, S., Zhou, J., Li, L., Guo, J., Xu, J., Qiao, J., Redding, S., & Ouyang, Y. (2023). Effectiveness of remote monitoring for glycemic control on maternal-fetal outcomes in women with gestational diabetes mellitus: A meta-analysis. Birth. https://doi.org/10.1111/birt.12769.
Key contact
Dr Kylie Edwards
Director; Obstetrics and Gynaecology
Bundaberg Hospital