Several years ago, the American Diabetes Association advanced three major strategies to successfully improve the quality of diabetes management. The first strategy focuses on changing the behavior of providers and care teams. The idea is that by implementing explicit goal setting with patients; identifying and addressing language, numeracy, or cultural barriers to care; and integrating evidence-based guidelines and clinical information tools into care processes, caregivers can play a more proactive role in improving the quality of diabetes care.
The second objective established by the ADA is to redesign the system of care. Specifically, the American Diabetes Association encouraged providers to adopt and use the chronic care model for treating patients with chronic diseases. This model includes six core elements and has been proven to be effective across all chronic disease types.
The third objective is to facilitate and support patient behavior changes that improve health outcomes. This includes:
- Helping patients make healthy lifestyle choices (physical activity, healthy eating, tobacco cessation, weight management, and effective coping);
- Teaching patients how to self-manage their condition (taking and managing medications and, when clinically appropriate, self-monitoring of glucose and blood pressure); and
- Monitoring patients to prevent diabetes complications (self-monitoring of foot health; active participation in screening for eye, foot, and renal complications; and immunizations).
Most providers agree that supporting patients’ own ability to manage their chronic illness makes a big difference in health outcomes. For instance, people with diabetes must make daily decisions about food intake, medications, and blood glucose measurements. The strength of their decisions can easily impact re-hospitalization rates.
Unfortunately, even though providers understand the efficacy of diabetes self-management, only about 7 percent of Americans with private insurance – and 4 percent of Medicare patients – receive diabetes self-management education and support within 12 months of diagnosis. Solving this problem has been a real problem.
The Impact of Telemonitoring on Diabetes Management
But there is a solution, and technology is the answer.
Telemonitoring, with all of its advances in recent years, can be the tool to manage diabetes through ongoing patient monitoring, patient education, and problem solving. A brief educational session in the physician’s office or just prior to a hospital discharge cannot teach a patient how to effectively self-manage their disease. Why? Approximately 150 different tasks must be mastered for the diabetic to reach a state of self-management. This takes time, ongoing counseling, and regular interventions. Only through telehealth can this be achieved.
A telehealth diabetes management program not only supports patients with home diagnostics for monitoring of their disease, but also provides lifestyle advice, prevention tools, and disease management tools from a team of medical professionals.
In a study conducted of patients in Advanced TeleHealth Solutions’ diabetes management program, a 44 percent improvement in health outcomes was documented. This level of improvement simply cannot be achieved with intermittent encounters with a primary care physician or care team.
The patient isn’t the only one who benefits. With a well-designed telemonitoring program, the healthcare provider’s role in patient management is simplified. Daily log books are eliminated, replaced by daily remote monitoring of blood glucose readings, which helps providers improve patients’ glycemic control, prevent or delay complications, and reduce potential health risks by addressing warning signs early.
Look for these elements in any diabetes telemonitoring program:
- An ehealth device in the home
- Daily monitoring of vital signs
- Medication compliance assistance
- Timely patient education
- Individualized coaching
- A specialized clinical team trained in chronic disease management
- A URAC-accredited health call center
Who Would Benefit from Diabetes Management?
Patients who would most benefit from a telehealth diabetes management program:
- Have diabetes,
- Have multiple risk factors and an elevated fasting blood glucose,
- Are 30 pounds or more overweight,
- Had gestational diabetes and are now experiencing unstable blood glucose levels,
- Have a known history of Type 1 or Type 2 diabetes that is uncontrolled, and
- Have a sedentary lifestyle.
In order to maximize the health outcomes of patients with diabetes, it is important that the healthcare system implements the American Diabetes Association’s three strategies. If you are looking for a place to start, we suggest telemonitoring, as patient self-management is the foundation for improvements in diabetes care.
About Karen Thomas
Karen Thomas is a certified management accountant and the president of Advanced TeleHealth Solutions, one of the leading telehealth monitoring companies in the U.S. Karen is a nationally renowned speaker, a lecturer for Missouri State University’s graduate-level Health Care Administration program, and a contributing author to, “Home Telehealth: Connecting Care Within the Community,” published by Royal Society of Medicine Press Ltd. Karen has appeared on numerous webinars and has spoken at dozens of conferences on the benefits of remote patient monitoring, generating enhanced clinical outcomes, patient engagement, and coordination of care. She is a member of the Missouri Governors Innovation Task Force, a past board member of the National Association for Home Care and Private Duty Home Care Association, a member of the American Telemedicine Association and the American Society on Aging, and a past ex-officio member of the advisory board of HealthCare Technology Association of America.