June 21, 2012

Telemedicine Aids Diabetes Management

The American Association of Clinical Endocrinologists 21st Annual Meeting and Clinical Congress in Philadelphia, PA has had some interesting topics coming out of its sessions. While they are not of an official nature until something shows acceptance or is passed through peer review, some topics are interesting just the same. Telemedicine is an acceptable way to deliver care to endocrinology patients in rural areas, according to a study given at the meeting.

Even with many states passing laws requiring patients to be seen by doctors before being issued prescriptions, this still should not stop this proposal from gaining traction. In a conversation with a friend from a northwestern state, he mentioned that a few doctors were considering and doing this, but another group of doctors is opposing them. He commented that this is very amusing for several reasons. Doctors bickering with doctors, but he found that it was the better doctors that were wanting to do this and the doctors losing patients that were in opposition.

I asked if these were endocrinologists and he said they were from a variety of specialties and primary care. He said that a few were already doing this with success and others were hoping this could be a big help for patients that needed to travel long distances in cutting down their travel. He also stated that another doctor had several patients that needed to travel over long distances and did not have computers, so he was consulting with them on the telephone.

I agree that it is time for doctors to take the initiative and this statement is true. "There is an increased 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 University of Tennessee Health Science Center in Memphis.

The study took place in Tennessee and the telemedicine unit of the University of Tennessee. There were 66 patients from five rural areas that were referred by their primary care providers. The study lasted two and one-half years.

Patients were interviewed and examined using the video conferencing in the telemedicine studio. A nurse was used at the patient site and assisted the physician in assessing the general condition of the patient. The nurse looked for swelling in the legs and did a thyroid exam. Laboratory tests and management strategies were sent to the patients' primary care physicians for follow-up.

The study author stated that, "We think 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 for the 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 multiple morbidities and complications that result from uncontrolled diabetes."

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