Top 10 Tips for Successfully Implementing a Diabetes Telehealth Program

Crossen, Stephanie S.; Raymond, Jennifer; Neinstein, Aaron B.

doi:10.1089/dia.2020.0042

Cited by 45 publications

(45 citation statements)

References 31 publications

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“…Although telehealth can reduce inconvenience and anxiety about exposure to the virus caused by a trip to a healthcare facility, it can also introduce multiple challenges, including participants' lack of experience with the medium, technological difficulties, lack of access to glucose downloads and lab reports, and a wish for more of a “human touch”. 16 It will be important to document if this initial lack of satisfaction persists over time and the reasons for it; and to identify ways to improve telehealth encounters for this population.…”

Section: Discussionmentioning

confidence: 99%

The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study

Fisher

Polonsky

Asuni

et al. 2020

Journal of Diabetes and its Complications

106

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Aims To describe the effects of the COVID-19 pandemic on adults with T1D or T2D in the U.S. Methods Participants, recruited from the Taking Control of Your Diabetes Research Registry, were ≥19 years old and diagnosed with either T1D or T2D for ≥12 months. Participants completed an online survey on a HIPAA-protected platform. Results Completed surveys were received from 763 T1Ds and 619 T2Ds. Average T1D age was 53.3 (SD = 15.3); average T2D age was 64.9 (SD = 10.3). Both samples were predominantly female, non-Hispanic white and well-educated. Average self-reported HbA1c was 6.9 (SD = 1.0; 52 mmol/mol) for T1Ds and 7.1 (SD = 1.1; 54 mmol/mol) for T2Ds. About 40% of respondents reported that all of their diabetes healthcare appointments at the time were cancelled or postponed, 40% reported a switch to telehealth appointments and almost half reported lower overall satisfaction with these visits (compared to pre-pandemic). There were widespread increases in general and diabetes-related stress and social isolation, and negative effects on disease management. About 25% reported increases in highs, lows, and glucose variability in both groups. Conclusion There has been a substantive increase in level of diabetes-related and general life stress and social isolation due to the pandemic, with a significant impact on disease management.

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Section: Discussionmentioning

confidence: 99%

The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study

Fisher

Polonsky

Asuni

et al. 2020

Journal of Diabetes and its Complications

106

View full text Add to dashboard Cite

show abstract

“…The beliefs and attitudes of HCPs may be barriers to increasing the universal accessibility of advanced diabetes technologies [56,59,60]. New care models may initially result in feelings of uncertainty, and they might seem overwhelming to people who have usually delivered in-person care for the past few decades [61]. Organizational and structural changes can lead to frustration and negatively impact people's motivations for adopting new care pathways.…”

Section: Principal Resultsmentioning

confidence: 99%

Shaping Workflows in Digital and Remote Diabetes Care During the COVID-19 Pandemic via Service Design: Prospective, Longitudinal, Open-label Feasibility Trial

Braune¹,

Boß²,

Schmidt-Herzel³

et al. 2021

JMIR Mhealth Uhealth

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Background The COVID-19 pandemic poses new challenges to health care providers and the delivery of continuous care. Although many diabetes technologies, such as insulin pumps and continuous glucose monitors, have been established, the data from these devices are rarely assessed. Furthermore, telemedicine has not been sufficiently integrated into clinical workflows. Objective We sought to remotely support children with type 1 diabetes and their caregivers, enhance the clinical outcomes and quality of life of children with diabetes, increase multiple stakeholders’ engagement with digital care via a participatory approach, evaluate the feasibility of using an interoperable open-source platform in a university hospital setting, and analyze the success factors and barriers of transitioning from conventional care to digital care. Methods Service design methods were used to adapt clinical workflows. Remote consultations were performed on a monthly and on-demand basis. Diabetes device data were uploaded from patients’ homes to an open-source platform. Clinical and patient-reported outcomes were assessed before, during, and after the COVID-19 lockdown period in Germany. Results A total of 28 children with type 1 diabetes and their caregivers enrolled in this study and completed 6 months of remote visits. Of these 28 participants, 16 (57%) also opted to attend at least one of their regular visits remotely. After 3 months of remote visits, participants’ time in range (P=.001) and time in hyperglycemia (P=.004) significantly improved, and their time in hypoglycemia did not increase. These improvements were maintained during the COVID-19 lockdown period (ie, between months 3 and 6 of this study). Participants’ psychosocial health improved after 6 months. Conclusions Remote consultations and commonly shared data access can improve the clinical outcomes and quality of life of children with type 1 diabetes, even during challenging circumstances. A service design approach helped with the delivery of comprehensive and holistic solutions that accounted for the needs of multiple stakeholders. Our findings can inform the future integration of digital tools into clinical care during and beyond the pandemic. Trial Registration German Clinical Trials Register DRKS00016170; https://tinyurl.com/skz4wdk5

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“…Many facilities, including our own, rapidly expanded telemedicine services to facilitate patient care. 1 Though telemedicine has been utilized for both paediatric and adult diabetes care before, [2][3][4][5][6][7][8][9][10][11] current endeavours by many institutions are now on an unprecedented scale. In some cases, health systems may have limited existing infrastructure due to previous state law limiting telemedicine services, such as in Pennsylvania.…”

Section: E D I T O R Imentioning

confidence: 99%

Paediatric diabetes care during the COVID‐19 pandemic: Lessons learned in scaling up telemedicine services

March

Flint

DeArment

et al. 2020

Endocrino Diabet & Metabol

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Top 10 Tips for Successfully Implementing a Diabetes Telehealth Program

Cited by 45 publications

References 31 publications

The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study

The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study

Shaping Workflows in Digital and Remote Diabetes Care During the COVID-19 Pandemic via Service Design: Prospective, Longitudinal, Open-label Feasibility Trial

Paediatric diabetes care during the COVID‐19 pandemic: Lessons learned in scaling up telemedicine services

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