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While “telemedicine” certainly existed prior to the COVID-19 pandemic, it was simply an option for patients who preferred it or needed it due to travel and schedule restraints. Today, meeting with your healthcare team virtually has become the routine standard.
But is this modern method of healthcare providing people with type 1 diabetes the care they truly need?
“During COVID-19, we know that the use of telemedicine has dramatically increased across the country but we don’t know yet how well it works in terms of patients being able to access that care and how effective it is,” said Stephanie Crossen, M.D., M.P.H., a pediatric endocrinologist at the UC Davis Children’s Hospital in Sacramento, California.
Dr. Crossen reached out to T1D Exchange after years of admiring its efforts to improve the care of people with type 1 diabetes.
“I have been looking for opportunities to partner with the T1D Exchange ever since they started!”
Her first project with T1D Exchange involved surveying patients via email — from both the T1D Exchange Registry and from members of their online community — to better grasp where telemedicine is effective and where it’s falling short in serving this patient population.
Hoping for at least 500 participants, Dr. Crossen was thrilled with both the engagement and the ease of surveying people with type 1 diabetes across the entire country.
“We had over 2,000 participants!” Crossed shared. “I was hoping for at least 500, with a bigger goal of 1,000. I could have never surveyed 2,000 people with type 1 diabetes without a partnership with the T1D Exchange. It was essential and such an easy process.”
For Crossen, patient-focused research is a critical part of her overall mission since her early training in pediatric medicine.
“I just fell in love with endocrinology,” said Crossen, “because I love that you have these really strong, long-term relationships with patients and their families. You get to know them so well because you see them so often.”
With a master’s in public health, Dr. Crossen added that while she cares deeply about the health of each individual patient, she’s also very motivated to improve the general health and quality of life for the larger population of people with type 1 diabetes.
“My clinical work motivates my goal to improve the overall way we deliver healthcare,” explained Crossen, “and there is so much potential to improve the quality of life and health outcomes for people living with type 1.”
While Dr. Crossen has just begun reviewing the results of her survey, she has a few thoughts from her perspective as a provider on the benefits and flaws of telemedicine.
“I was doing home-video visits pre-COVID with patients who were struggling but had trouble coming into the office for more frequent visits,” said Crossen.
“Some obvious benefits of telemedicine include more frequent contact because there are fewer barriers around work, school, and transportation. But I also get a window into their home routines and I get to meet more of the family members who are part of their diabetes management team.”
On the other hand, Crossen noted that not all of her patients have access to high-speed internet, computers, and an overall technology education. While she can send patients to local blood labs for data like HbA1c levels, other technology is making this less of a necessity.
“Thanks to CGM technology, we don’t need A1c results the way we used to.”
Crossen said, however, that it can be hard to make a personal connection with new patients, it works best with those she already has established relationships with.
“But I can’t speak for my patients!” emphasized Crossen and the need for her patient-focused survey. “I think we’re still at the earliest stages of figuring out what type 1 diabetes care and the telemedicine landscape will look like in a post-COVID era.”
The patient-voice is a critical part of improving patient care.
“When people with type 1 diabetes participate in research,” said Dr. Crossen, “they’re ensuring that the next innovation in care is going to be important to them and make the biggest difference in living with diabetes.”
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