Virtual Visits

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Technology — in the form of electronic patient records, diagnostic imaging devices, or more accessible forms of medical education — is often touted as way to improve health outcomes and reduce health-care costs. One popular idea for diabetes care, as well as for other chronic conditions, is telemedicine: providing a virtual connection between patients and medical professionals to enable more frequent contact. For people with diabetes, this is likely to include using a computer program to record blood glucose readings, which a doctor or nurse can then review and discuss with the patient between regular office visits.

A study published in the July 2009 edition of the journal Diabetes Care found, however, that the benefits of a telemedicine program for Type 2 diabetes were greatly outweighed by its costs. According to a Reuters Health article, the study — commissioned by Medicare and carried out in areas of New York State with limited access to medical care — found that telemedicine “improve[d] self-care behaviors,” in the words of the lead researcher. But the program also cost 71% to 116% more than traditional care, making it an extremely expensive way to only slightly improve outcomes. The program provided participants with computers that allowed them to have video conferences with their health-care team, follow a Web-based diabetes education program, and use software to organize and share their blood glucose and blood pressure readings.

The authors of the study pointed out that other telemedicine programs have been far less expensive. And if telemedicine were to become more common — part of normal care rather than investigative trials — it’s possible that many people could use their own computers, making its cost extremely low. While most trials have looked at telemedicine as a supplement to regular visits, not as a replacement for them, seeing a doctor or nurse virtually could be far more convenient than an office visit for many people.

What do you think of telemedicine? Would you be interested in “virtual visits” between regular office visits? As a replacement for some of them? What would you want, or expect, to gain from more contact with doctors and nurses? Would you — or should insurance — pay for a 15-minute videoconference? For an e-mail exchange? Do you think it’s practical for large numbers of people to use computers for diabetes education, blood glucose records, and communication with their health-care team? Leave a comment below!

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