Diabetes telehealth initiative bridges care gaps in rural settings
NEW ORLEANS — A telehealth program developed at the University of Mississippi Medical Center is helping bridge gaps in care to meet the health needs of a high-risk population of patients with uncontrolled diabetes in the state's rural delta region.
“For you and I an hour may not be a big trip, but some of these patients never leave their communities, so if they need to see endocrine or ophthalmology because they are losing their eye sight, chances are they are just going to lose their eye sight,” Tearsanee Carlisle Davis, DNP, NP-C, of the Center for Telehealth at the university told The Clinical Advisor.
One of the most important facets of the program, called the Mississippi Diabetes Telehealth Network, has been allowing rural patients to continue to see the local providers that they know and trust. The only difference is that local providers are using technology to work in partnership with small community hospitals and an academic medical center to increase the quality of the care.
“The community hospital manages patient care. However, if a patient needs endocrine we set up the appointment. The patient simply shows up at the primary health clinic's office and has an endocrine visit via telehealth,” Davis explained. “The only time they actually have to drive in to the academic medical center, is if a procedure is taking place.”
Another facet of the program is that each patient who is enrolled undergoes an automatic diabetic retinopathy screening, because many locations are so remote patients do not have access to an ophthalmologist.
“We've trained a staff member to be in each clinic. They have a special camera that takes the images. They then forward the images to the ophthalmologist at UMC, who reviews, makes recommendations and transmits them back, the same way radiology tests are done,” Davis said.
Since the program was first implemented in Aug. 2014, outcomes have been excellent among the first 100 patients.
“The average HbA1c decrease has been 1.7% from an average start of 10. The first patient who was ever enrolled came in with an HbA1c that was 12.6, and now it's down to 6.8,” Davis said.
Overall medication compliance is at 96%. The program has saved patients approximately 9,451 miles driven, and nine new cases of diabetic retinopathy were identified.
“We're proving that having that constant communication — patients having an easy in to be able to ask a question and healthcare providers knowing what's going on with a patient — can improve diabetes outcomes,” Davis said.