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Dr. Crossen and her team surveyed 2,235 people with T1D and caregivers of children with T1D from both the T1D Exchange Registry and Online Community to better gauge where telehealth is effective and where there are gaps that need to be improved.
Although telehealth and virtual care existed long before the COVID-19 pandemic began, it became a standard routine over the past two years. In the spring of 2020, most diabetes clinics participating in the T1D Exchange Quality Improvement Collaborative (T1DX-QI) moved to entirely or mostly virtual care. Until this study, little data had been collected about the experiences of the people receiving virtual care, and how they felt about the quality of this care.
Use of Video Care for T1D
At the time of this study between August and October 2020, 65% of survey respondents had used telehealth. Within this group, 96% stated that their first video appointments took place during the COVID-19 pandemic. In addition to the 65% who had already used telehealth, 10% of respondents planned to use video for their next diabetes appointment.
The most common reason study participants began using virtual visits was that their providers were not offering in-person care. Other frequently reported reasons for seeing providers virtually were concerns about the health risks of visiting a clinic in person, providers offering a virtual option for the first time, insurance covering telehealth for the first time, and local or state orders to stay home.
For the 25% of survey respondents who had not used telehealth and had no plans to use video for their T1D health care, the most reported reason was that their health care providers did not offer virtual visits. Other reasons for not using video appointments included preferring face-to-face care, feeling that video, care would be of lower quality, and needing in-person labs or a physical exam.
Many respondents also reported that telehealth felt unnecessary due to low perceived risk from COVID-19, already being in contact with their providers by phone or electronic messaging, or preferring to manage their T1D independently during this time.
Opinions about Video Care for T1D
Of the 65% of respondents who used telehealth, 62% felt their video visits were either equally as effective or more effective than in-person visits, while 38% felt that their video visits were less effective than in-person visits.
Additionally, 85% of those who had used telehealth felt that it saved them time, 44% felt that it saved them stress, and 29% felt that it saved them money compared to in-person visits.
When asked if they would choose to continue using video appointments for T1D care in the future, 17% responded that they preferred video appointments, 17% responded that they preferred in-person, and 65% responded that they would choose to use video care in some circumstances.
These survey results highlight the role of telehealth in allowing people with T1D to still have access to care during a pandemic. The study suggests that this shift to virtual care was driven primarily by health insurance and health care providers changing the availability of virtual versus in-person appointments, and secondarily by concerns about the health risks posed by in-person visits.
These findings show that virtual visits work well for many people with T1D, but not for everyone, and a person’s individual needs and preferences should be taken into consideration as telehealth continues to evolve.
Moving forward, our healthcare system and the T1D care community should work to maintain and improve access to telehealth for all people with diabetes.