Using Telemedicine for Diabetes Care

By Tolu Ajiboye  |  July 9, 2019

Diabetes is a condition that affects more than 30 million people in the U.S., nearly 10 percent of the entire population. It is also the 7th leading cause of death and shows no signs of slowing down. Treatment for diabetes has come a long way from the days when doctors would prescribe severe calorie-restricted diets. Now significant strides have been made in its treatment, and most people diagnosed with diabetes can lead normal lives.

A large part of successfully treating diabetes is through management and continuous monitoring. Offering services through telemedicine gives medical practices the ability to provide their diabetic patients with quality care on-demand. A study published by the Journal of Diabetes Science and Technology states that “diabetes is well suited for being treated with TM (telemedicine).” Moreover, the disease has better outcomes when monitoring occurs. This is primarily because diabetes is a chronic condition and patients need to be in regular contact with their healthcare providers.

Real-Time Diabetes Care

Practices are taking advantage of telemedicine to improve the treatment of diabetes in different ways. One is to deliver real-time care. Many issues that arise with diabetes require consultation with a physician. But not all  diabetes patients require in-person visits. Telemedicine allows you to quickly connect with your patient face-to-face and observe his/her symptoms. Real-time care can be provided to the patient in the form of prescribing medication or giving instructions to be followed.

“With telemedicine, it’s like a normal doctor’s appointment but using technology to connect with the patient. You need to think of telemedicine as an extension of the brick and mortar facility and the normal exam room,” explains Sean Brindley, product development manager for Kareo Telemedicine.  Brindley advises you to follow the same practices that you would if the patient was in front of you. "You are still providing high-quality medical care," he says, "just not necessarily in the office."

Better Outcomes With Telemedicine

Telemedicine can also benefit diabetes patients by helping them lower their blood glucose levels. Studies have shown that in cases where care was provided through a telemedicine visit,  there was  improved glycemic control (as evidenced by lower A1C results) in people with type 2 and gestational diabetes.

“After a diabetic patient has undergone an A1C test, either for diagnosis or as part of management, the physician can consult with the patient over a video visit,” Brindley says. “They can review the lab results together and discuss changes in glucose levels, and if any alterations are needed to the patient's treatment plan or lifestyle.” This process reinforces the concept of shared decision making. Studies and experts  increasingly agree that an ideal model of care is one where both parties, the patient and physician, take part in reaching a consensus on the best treatment option.

A large study, reported in the Journal of American Medical Informatics Association, analyzed the outcomes of two groups of 1665 Medicare diabetic patients. One group used telemedicine to deliver care and the other group treated patients through in-office visits. At the one year follow-up mark, the study found that the patients who were managed with telemedicine showed improved glycemic control, blood pressure levels, and total and LDL cholesterol levels compared to patients who received care the traditional way. 

Best Practices When Using Telemedicine for Diabetes

Deciding to incorporate telemedicine into your practice can be a significantly positive step in the right direction. However, there are some considerations and best practices for choosing the right telemedicine platform and continuing to use it effectively and safely for the benefit of your patients.

  1. Set Parameters. As a physician, you must set limits on the extent to which telemedicine will be used in the delivery of care. Diabetic emergencies like severe hypoglycemia and diabetic ketoacidosis should be excluded from treatment/management with telemedicine. “Telemedicine appointments should not be used for cases that are critical or require immediate attention. Telemedicine is not ideal for anything that you would need to lay hands on a patient,” says Lauren Cranford, Kareo Telemedicine Marketing Manager. “However, the final determination on the need for an in-office visit is reliant on the physician’s discretion.”
     
  2. Make a Patient Education Plan. After committing to a telemedicine software and strategy, it’s important to figure out how you’ll get your patients familiar with the concept. The success of using telemedicine to manage diabetic patients largely depends on how comfortable and well versed the patients are with using it. 

    “Patients need to know what they can and can’t do via telemedicine, and how," says Cranford. "For example, every Kareo telemedicine practice has a dedicated web page that can be tied to the practice's website, which provides more information to patients interested in scheduling a telemedicine visit. The page informs patients about the ideal use cases for telemedicine and tips and tricks to make the visit successful. We also send our practices email content with specific information around video visits that can be used as patient education pieces.”
     
  3. Invest in Staff Training. It is very likely (and even advisable) that the telemedicine platform will not be operated solely by you, the physician. As such, medical practice staff such as nurses should be extensively trained to use it too. Nurses can be responsible for monitoring diabetes patients virtually, including making sure patients take their blood glucose and perform their blood pressure readings. Nurses can also adjust patients’ medication dosages when necessary.

Join us for our upcoming telemedicine webinar, 5 Reasons Why You Should Start Telemedicine in 2019 on July 17. Visit our website here to sign up for the webinar. 

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For additional information about Kareo’s approach to providing telemedicine services, sign up for an informative demo below. Or, if you're ready to get started with telemedicine at your practice, give Kareo a call at (888) 775-2736 and we'll get you set up!

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