Telemedicine Aids Diabetes Management

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The American Association of ClinicalEndocrinologists 21st Annual Meeting and Clinical Congress inPhiladelphia, PA has had some interesting topics coming out of itssessions. While they are not of an official nature until somethingshows acceptance or is passed through peer review, some topics areinteresting just the same. Telemedicine is an acceptable way todeliver care to endocrinology patients in rural areas, according to astudy given at the meeting.
Even with many states passing lawsrequiring patients to be seen by doctors before being issuedprescriptions, this still should not stop this proposal from gainingtraction. In a conversation with a friend from a northwestern state,he mentioned that a few doctors were considering and doing this, butanother group of doctors is opposing them. He commented that this isvery amusing for several reasons. Doctors bickering with doctors,but he found that it was the better doctors that were wanting to dothis and the doctors losing patients that were in opposition.
I asked if these were endocrinologistsand he said they were from a variety of specialties and primary care. He said that a few were already doing this with success and otherswere hoping this could be a big help for patients that needed totravel long distances in cutting down their travel. He also statedthat another doctor had several patients that needed to travel overlong distances and did not have computers, so he was consulting withthem on the telephone.
I agree that it is time for doctors totake the initiative and this statement is true. "There is anincreased prevalence of diabetes in rural compared with urban areas,which is compounded by the problem of a lack of endocrinologists,"said Rabia A. Rehman, MD, an endocrinology fellow at the Universityof Tennessee Health Science Center in Memphis.
The study took place in Tennessee andthe telemedicine unit of the University of Tennessee. There were 66patients from five rural areas that were referred by their primarycare providers. The study lasted two and one-half years.
Patients were interviewed and examinedusing the video conferencing in the telemedicine studio. A nurse wasused at the patient site and assisted the physician in assessing thegeneral condition of the patient. The nurse looked for swelling inthe legs and did a thyroid exam. Laboratory tests and managementstrategies were sent to the patients' primary care physicians forfollow-up.
The study author stated that, "Wethink it may be a little costly to set up the equipment up front. However, in the long-run, this will be cost effective, not only forthe patients but for overall healthcare," She continued,"This will save patients from traveling long distances,resulting in timely consultation and leading to better control.Improvement of HbA1c will also result in prevention of the multiplemorbidities and complications that result from uncontrolleddiabetes."