Using virtual appointments to achieve more interaction between doctors and patients — with the goal of following a more personal “mentoring” model when it comes to diabetes-related guidance — is linked to fewer hospital admissions and lower overall health care spending among people with diabetes, according to a new study published in the journal Medical Care.
A number of studies in recent years have found benefits from telemedicine, or telehealth — using virtual appointments, usually when a face-to-face appointment isn’t feasible or convenient. Telemedicine can mean connecting over the phone, video chatting, or even communicating by text within an app. It can be especially beneficial to people with diabetes who live in rural areas, since these areas often lack diabetes specialists or even primary-care doctors. Telemedicine was also linked in one study to more doctor “visits” (in-person or virtual) among children with type 1 diabetes during the COVID-19 pandemic. Not surprisingly, telemedicine has environmental benefits, since it reduces travel to and from a doctor’s office. Many people, of course, still aren’t totally comfortable with using new or unfamiliar technology to see their doctor, or may wonder how a virtual visit really works — but there are tips you can follow to help ensure a successful telehealth visit.
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For the latest study, researchers compared outcomes in two different groups of people with diabetes who were enrolled in Medicaid health insurance. One group, with 318 members, participated in a program called Project ECHO, in which doctors and other health care providers took a “telementoring” approach toward patients — connecting with them more often through virtual platforms to assess their diabetes management and address any concerns. Another group, with 1,454 participants, saw health care providers that didn’t participate in this program.
Telehealth participation linked to fewer hospital admissions
The researchers found that over the study period, participation in Project ECHO was linked to 44.3% fewer inpatient hospital admissions — due in part to fewer cases of severe hypoglycemia (low blood glucose) or diabetic ketoacidosis (DKA), which can occur with very high blood glucose levels. Largely because of this lower use of hospital resources, participants in Project ECHO accounted for 61.9% less health care spending per person. The researchers also looked at several other measures — such as use of A1C tests (a measure of long-term blood glucose control), eye exams, and diabetes-related prescription drugs — but found no significant differences in these areas between participants in Project ECHO and other study participants with diabetes.
“We find evidence that Project ECHO participation was associated with large and statistically significant reductions of inpatient hospitalization and spending,” the researchers concluded, adding that this outcome “demonstrates the feasibility and potential value” of evaluating programs like Project ECHO using data from Medicaid and possibly other insurance claims.
Want to learn more about telehealth? read “Diabetes and Telehealth: Tips for a Successful Virtual Visit.”