Telemedicine to Help Manage Diabetes

Telemedicine is obtaining a chance to prove itself in the state of Mississippi. With the second highest rate of diabetes diagnosis behind West Virginia, Mississippi has developed a plan for delivering top of the line diabetes management to some of its neediest residents.

This plan is implementing steps to cut the devastating effects on the state economy - $2.7 billion annual cost and improve the overall health of Mississippians. In January, the University of Mississippi Medical Center and three private technology partners developed a plan to help low-income residents manage their diabetes via telemedicine. This will be accomplished by helping these residents keep the diabetes in management and avoid unnecessary hospitalizations while remaining active and productive.

The Mississippi legislature passed and Governor Phil Bryant signed the bill which was enacted in March. This requires private insurers, Medicaid and state employee health plans to reimburse medical providers for services dispensed via computer screens and telecommunications at the same rate they would pay for in-person medical care. This means those with insurance or Medicaid will have their providers reimbursed. The telemedicine project will be free to the poor uninsured participants.

Mississippi's telemedicine law goes further than any other state to remove what the telehealth industry considers its biggest impediment, lack of insurance reimbursement.  Twenty states, plus the District of Columbia, have requirements that private insurers must pay for some telemedicine services. Most states pay for certain services through Medicaid, but the Mississippi law requires parity from all insurers for all types of telemedicine services. In April, Tennessee joined Mississippi with a similar law.

Beginning in June, about 200 people with diabetes in one of the state's poorest regions, the Mississippi Delta, will be given internet-capable computer tablets load with the necessary software. Then medical professionals at the University of Mississippi and North Sunflower Medical Center, will be able to monitor patients' test results and symptoms. The third technology partner will provide technical support for the wireless telecommunications services required to transmit the medical data.

Local clinicians in Sunflower County are choosing diabetes patients who are the sickest in the community. The idea is to show that even patients with the least-managed diseases can see improved health outcomes with careful monitoring. Each patient will have a baseline exam and a treatment program. This will require each patient to check blood glucose levels two to four times daily using a home testing kit. These results will be transmitted to medical teams at both hospitals. Patients will also check their weight and blood pressure daily and transmit the information.

The medical team at the University of Mississippi will include a dietitian, a pharmacist, an ophthalmologist, an endocrinologist, a diabetes education expert, and a nurse practitioner. They will work with the medical providers at Sunflower Medical Center to assist and provide a full range of specialty care for the patients. A member of the team will consult with patients daily using video teleconferencing to make sure they are making the lifestyle changes needed to improve their conditions.

This proactive patient monitoring should improve patient care and patient health outcome. It will be interesting to see the interim progress if we are informed and I will be watching for these reports. The diabetes project will run 18 months and interim results will be released during this time. Hopefully the progress will be significant in 18 months that other states will feel encouraged to do longer studies and the results will stem the diabetes epidemic.