Leslie Eiland, MD, offers insights on whether use of certain technologies among patients with type 1 diabetes (T1D) will continue after the pandemic ends.
Overall, telehealth visits are not equitable for all patients with type 1 diabetes (T1D), said Leslie Eiland, MD, an endocrinologist at the University of Nebraska Medical Center in Omaha, Nebraska.
Do you think care technology use among patients with T1D will continue once the pandemic ends?
I hope home visits continue. I think for many people, they are a very efficient way of providing care. I think I have many patients that normally just don’t make it to their quarterly office visits, because they have a lot going on, they travel for work, they have to change or cancel their appointment at the last time. Rarely do I get 4 quarterly visits in during the year, even though they need it. Their control is not great, and they could use more regular visits. But over the last year, they’re logging in from hotel rooms or various places that they’re traveling to at work, and they’re actually making their quarterly visits, because this is so convenient for them, especially if they’re on a continuous glucose monitor. I can share data with my clinic in the cloud. It’s so convenient to have these visits.
But that’s not all of my patients. It’s a percentage of my patients. But overall, these visits are not equitable, right? Not everyone has access to a smartphone or lives in a place with stable internet or can afford stable internet or has the literacy needed to troubleshoot and initiate these videos. I think that the clinics that we do at these rural community hospitals do address these exact disparities and give people the stable internet connection they need to have a visit. There’s somebody available to help troubleshoot. If there any technical issues, they’re not responsible for that. So I think home visits are great for a lot of people, but I don’t think they should take the place of these more traditional telehealth sites at rural community hospitals. They still serve a big need for a lot of my patients who I’ve been doing phone call visits with over the last year. I think improving broadband access in these communities is also necessary. It’s not going to fix the problem completely. But it’s important both in urban and rural areas.