The Impact of Interactive Home Telehealth on Outpatient Diabetes Management

AADE Program Session
Friday, August 13, 2004
2:00 - 3:00 PM

Reviewed by Joelle Escoffery, PhD

Interactive home telehealth involves the use of 2-way audio/visual technology to provide remote health care. Telehealth can be used to conduct patient assessment, education, and data collection. Through telehealth devices, blood pressure, pulse, auscultation of lung heart, and bowel sounds, pulse oximetry, blood glucose measures, weights, and wound management can be done. Specific diabetes care tasks that can be conducted via telehealth include downloading of blood pressure and blood glucose readings, validation of insulin administration skills, assisting patients with pattern management and medication adjustments, and helping them with nutrition modifications. Telehealth devices work through normal phone lines and are an ideal way to provide access to medical care to patients who may otherwise not receive it.

In one study conducted in a rural setting, use of telehealth was associated with a 76% decrease in hospital admissions, a 39% decrease in length of hospital stay, and a 12 % decrease in emergency room visits. Patients also achieved a 20% reduction in blood pressure and a 2.5% reduction in A1C (from 9.7% to 7.4%). Although this was a small pilot study that included only 18 patients with diabetes, a number of important lessons were learned. First, telehealth worked best among patients who required more real-time reinforcement between office visits, who had physicians that were invested in their care, who were not suffering from dementia, who were able to identify needs and respond to simple directions, and who had caregivers to assist with their home care. Telehealth resulted in enhanced patient self-management and increased staff productivity. It decreased the amount of time spent conducting home visits by 50%. Although this approach is promising, this study was not randomized, was conducted on only a small sample size, and used equipment that was very costly.