Eighty-five Percent of Type 2 Diabetes Management Could Be Remote

You Shouldn't Need to Go To the Office Nearly as Often

Think about it. You can order groceries and restaurant food over the phone or computer. The doorbell rings and the food is there. You can buy any kind of clothing, shoes, pet supplies, or entertainment over the phone or computer. You can buy fertilizer, plants, and equipment. You can file you taxes. Talk with your accountant. Manage your bank account. Pay your bills. Get your prescriptions. Only medicine is stuck in a model that dates to the days of the rotary telephone.

Changing the model for managing chronic diseases is especially important. The main need for a person struggling with diabetes is coaching to understand the disease and why changes in diet, exercise, and medication are worth the time. Equally important is testing the sugar and blood pressure at home. Blue tooth devices can report the results automatically. Computerized systems can notify your nurse if the result is out of bounds. She can arrange to change your treatment quickly. If your results are very abnormal, frequent phone or computer contact can walk you back into the normal range. Your other labs can be ordered over the phone and you can get them at your convenience. You would not need to find a babysitter, transportation, or leave work. Much more could be handled by your primary care office. It makes as much sense to manage chronic diseases like diabetes, high blood pressure, and related vascular diseases remotely as an other remote transaction.

There is only one reason you must drop everything a go in person to a doctor’s office. That is how doctors get paid. They are paid to see you in person and to write a note that describes why you came and what happened in the visit. Most of you get health insurance through your employer or the government. They can easily change the way they pay for your healthcare.

There are a few examples of where this is being done already. The best of these is in Alaska. You have seen television programs about the challenges in Alaska. It is a huge state with few roads and railroads. Most transportation is by air and water. Eighty-five percent of all healthcare from the Southcentral foundation is remote—over the phone or computer. Their quality scores are in the 75th to 90th percentile and they have receiveed two Malcolm Baldridge awards. They have adapted what they do to what their patients need. We should see more of that! Check out this podcast for a more complete description. The first minute or two of the podcast is in Swedish. Just hang in there for a couple of minutes and it switches to English. By the way, this system provides care for half the cost compared to other systems serving patients in Alaska.