Telemedicine Improves Health Of Diabetics, Research Says
Nonprofit group eHealth Initiative says clinics in poor neighborhoods can improve patients' health and cut hospitalizations by using mobile devices, patient Web portals, and social networks to monitor and inform.
An Issue Brief on eHealth Tools and Diabetes Care for Socially Disadvantaged Populations says "e-health" tools can assist clinics that have limited resources and personnel, are often the only center of care within a large geographic area, and are not connected to a large health system.
The new research shows that e-health technologies can reduce healthcare costs, said Jennifer Covich Bordenick, chief executive officer of eHI, an independent group that seeks to improve the quality, safety, and efficiency of healthcare through technology. Bordenick noted that, for instance, as more affordable smartphones get into the hands of consumers, they will increasingly use them to access apps to count calories and obtain nutrition information; log fitness workouts; monitor vital signs; calculate disease risks; and monitor adherence to medications. These tasks can have a significant impact on diabetic care.
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"Diabetes costs the nation almost $100 billion per year," Bordenick said in an interview with InformationWeek Healthcare. "The research shows that using e-health technologies to help patients prevent a deterioration of their health condition, as well as reduce costly emergency room visits, validates the pursuit of using these tools, especially among economically disadvantaged patients."
The report cites several examples in which technology has improved the health of diabetic patients. Take the Veterans Administration (VA) Care Coordination Home Telemedicine (CCHT) program, for example. Under this initiative, a group of over 400 veterans with Type II diabetes used a device to answer questions about their symptoms and health status every day for 24 months. The group was at high risk for multiple inpatient and outpatient visits, including those to an emergency department. After 24 months, the results showed significant decreases in diabetes-related hospitalizations as well as emergency room and outpatient visits.
Similarly, the Informatics for Diabetes Education and Telemedicine Study (IDEATel) used a randomized trial designed to compare telemedicine-based case management with usual care in older, ethnically diverse, Medicare beneficiaries with Type II diabetes residing in medically underserved areas of New York state. After five years, the researchers saw sustained reductions in glycohemoglobin (HgbA1C)--a measure of long-term blood glucose control--LDL cholesterol, and blood pressure for patients using telemedicine when compared to those receiving usual care.
DiaBetNet, developed by the MIT Media Lab, uses a wireless personal digital assistant with diabetes management software and an integrated motivational game to help youths between the ages of 8 and 18 manage their Type II diabetes. Patients enter their vital signs for transmission to a physician, and are encouraged to play the interactive game to educate themselves about blood glucose levels, blood pressure, diet, and exercise. Using this tool, over 70 patients improved their overall knowledge of diabetes and maintenance of HgbA1C levels, and lowered their overall carbohydrate intake.
Patient Web portals also play an important role in improving health, according to the eHI report. It cited Kaiser Permanente HealthConnect, MyGroupHealth, and Patient Gateway as three portals that show technology helps patients access and manage their health data, communicate with their providers, and improve their medical condition.
On the social media front, the report cited TuDiabetes.com as an example of an effective online community. Its 15,000-plus members share their experiences with diabetes through blogs, forums, events and news. Another example is dLife, a social networking site that offers more than 25,000 members information on Type II diabetes symptoms; healthy diet tips and exercise suggestions; medications for diabetes control; and an online forum for sharing personal experiences.
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