Remote Patient Monitoring in Diabetes: How to Acquire, Manage, and Use All of The Data

2022 ◽  
Author(s):  
Eric L. Johnson ◽  
Eden Miller
Keyword(s):  
Health Care Providers ◽  
Glucose Monitoring ◽  
Successful Implementation ◽  
Care Providers ◽  
Remote Patient Monitoring ◽  
Digital Devices ◽  
Diabetes Technology ◽  
Acquisition Management ◽  
Remote Patient ◽  
Monitoring Devices

The ability of patients and health care providers to use various forms of technology for general health has significantly increased in the past several years with the expansion of telehealth, digital applications, personal digital devices, smartphones, and other Internet-connected platforms and devices. For individuals with diabetes, this also includes connected blood glucose meters, continuous glucose monitoring devices, and insulin delivery systems. In this article, the authors outline several steps to facilitate the acquisition, management, and meaningful use of digital diabetes data that can enable successful implementation of both diabetes technology and telehealth services in primary care clinics.

scholarly journals Exploring a New Security Framework for Remote Patient Monitoring Devices

Computers ◽  
2017 ◽  
Vol 6 (1) ◽  
pp. 11 ◽  
Author(s):  
Brian Ondiege ◽  
Malcolm Clarke ◽  
Glenford Mapp
Keyword(s):  
Patient Monitoring ◽  
Remote Patient Monitoring ◽  
Security Framework ◽  
Remote Patient ◽  
Monitoring Devices

Understanding the Effects of Participation in a Large-scale Remote Diabetes Monitoring Program: A Qualitative Survey and Retrospective Analysis Study (Preprint)

2021 ◽  
Author(s):  
Yee Chieh Chew ◽  
Michael Swiernik ◽  
Thomas McCormick ◽  
Angie Stevens
Keyword(s):  
Health Outcomes ◽  
Care Management ◽  
Patient Monitoring ◽  
Monitoring Program ◽  
Care Providers ◽  
Remote Patient Monitoring ◽  
Kaiser Permanente ◽  
Program Adherence ◽  
Remote Patient ◽  
Diabetic Care

BACKGROUND Remote patient monitoring has shown promise in helping management of population health by facilitating care management between providers and patients by providing real-time accurate data of relevant readings for chronic conditions from outside a medical facility. Kaiser Permanente offers remote patient monitoring as part of a holistic care management program for its members. OBJECTIVE The purpose of this study was to examine qualitative and quantitative measures of patient and provider feedback of Kaiser Permanente’s remote patient monitoring program for diabetes, patient perspectives on ability to manage diabetic care, patient health outcomes and program adherence, and utilization of Kaiser Permanente services under the program. METHODS In this study, patients who were enrolled in the RPM program in Southern California from 2017 onwards as well as care providers who had enrolled at least one patient in the program were studied. For qualitative data, online surveys were deployed. For quantitative analysis, clinical and demographic data drawn from existing data systems, which included Kaiser Permanente membership records, encounter records, electronic medical records, and administrative data repositories were used. RESULTS Providers (N=160) and patients (N=1,106) responded to the survey and reported many qualitative benefits from participating in the study, including improved coordination of clinical care and increased accountability. Patients who were enrolled in the program experienced a mean decrease of 1.25 in HbA1c results and an increase in encounters over 90 days which gradually come back to pre-enrollment encounter levels around 6 months. Those who actively upload glucose readings met the program upload goals within the first month a majority (92%) of the time. CONCLUSIONS There are many qualitative benefits for patients and providers incorporating Kaiser Permanente’s remote patient monitoring program as part of diabetic care. The quantitative descriptions of health outcomes, service utilization, and program adherence speak to the feasibility and value of deploying remote monitoring tools at scale within healthcare organizations.

scholarly journals Teleassistance for Patients With Type 1 Diabetes During the COVID-19 Pandemic: Results of a Pilot Study (Preprint)

2020 ◽  
Author(s):  
Martina Parise ◽  
Linda Tartaglione ◽  
Antonio Cutruzzolà ◽  
Maria Ida Maiorino ◽  
Katherine Esposito ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Disease Management ◽  
Health Care Providers ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Care Providers ◽  
Virtual Visits

BACKGROUND Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers. OBJECTIVE During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period. METHODS This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit. RESULTS Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; <i>P</i>&lt;.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (<i>P</i>=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; <i>P</i>=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; <i>P</i>&lt;.001) than in those with a GMI of &lt;7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; <i>P</i>=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (<i>P</i>=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters. CONCLUSIONS These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.

scholarly journals Stakeholders’ Intention to Adopt Gene Therapy in Malaysia: Effects of Age, Education, and Religion

SAGE Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 215824402097020
Author(s):  
Muhammad Adzran Che Mustapa ◽  
Latifah Amin ◽  
Ahmad Firdhaus Arham
Keyword(s):  
Gene Therapy ◽  
Health Care Providers ◽  
Behavioral Intention ◽  
Genetic Material ◽  
Successful Implementation ◽  
Medical Procedure ◽  
Care Providers ◽  
Intention To Adopt ◽  
Predicting Factors ◽  
Validated Questionnaire

Gene therapy is a medical procedure in which new genetic material (genes) are introduced into the human body to treat disorders or diseases. Although the technology holds huge promises for improving human health, it is also one of the most controversial topics in modern medicine. Therefore, research into stakeholders’ intention to adopt gene therapy and its predicting factors is important to influence the successful implementation of this new therapeutic tool. The objective of this article is to assess the effect of background variables such as age, gender, and religion on behavioral intention to adopt gene therapy and its predicting factors. A validated questionnaire was distributed to 421 adult respondents (aged 18 years and older) comprised of two groups: health care providers ( n = 221) and patients ( n = 200). The results of the study suggest that the Malaysian stakeholders involved in the study were cautious although they perceived gene therapy as having high benefits, and were highly accepting from a religious perspective. This was reflected in their high intention to adopt gene therapy. At the same time however, they acknowledged the existence of moderate risks. One-way MANOVA analysis detected significant differences in terms of perceived benefits across ages, and behavioral intention across educational level. However, no significant differences were detected in the comparison of all factors across religions. This study serves as a useful baseline for scientists, government regulators, policy makers, and political leaders for understanding Malaysian acceptance of gene therapy and should encourage more research in the future.

scholarly journals Identifying factors associated with successful implementation and uptake of an evidence-based voluntary medical male circumcision program in Zambia: the Spear and Shield 2 Program

2019 ◽  
Vol 10 (4) ◽  
pp. 970-977 ◽  
Author(s):  
Violeta J Rodriguez ◽  
Antonio Chahine ◽  
Aileen de la Rosa ◽  
Tae Kyoung Lee ◽  
Nicholas V Cristofari ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Male Circumcision ◽  
Qualitative Data ◽  
Sexual Practices ◽  
Successful Implementation ◽  
Evidence Based ◽  
Voluntary Medical Male Circumcision ◽  
Care Providers ◽  
Medical Male Circumcision ◽  
Implementation And Dissemination

Abstract Voluntary medical male circumcision has been shown to provide a 50%–70% reduction in the risk of HIV infection without contributing to behavioral disinhibition of safer sexual practices. This study examined the interim implementation and dissemination data of Spear and Shield 2, an HIV risk-reduction program in Zambia. The purpose of this interim review was to identify contextual challenges to implementation and implement midcourse corrections associated with sustainability of program delivery. Using a mixed-methods design, quantitative evaluations of organizational functioning, barriers to implementation, burnout, and organizational readiness, as well as qualitative data utilizing the Consolidated Framework for Implementation Research (CFIR), were examined to evaluate program implementation. Participants were 184 health care providers from 46 clinics in Zambia. Successful implementation was associated with better community and leader support, and employee readiness and motivation. Quantitative assessments were not related to implementation and provided a limited picture of implementation outcomes. Results suggest that the qualitative data underlying the CFIR constructs provided a nuanced, contextual assessment of implementation, and dissemination outcomes. The CFIR may be valuable in informing the implementation of evidence-based interventions in other parts of Zambia.

Chilean Health Care Providers’ Perceived Comfort in Performing Oral Rapid Testing for HIV: A Cross-Sectional Study

2020 ◽  
Vol 18 (4) ◽  
pp. 191-197
Author(s):  
Lisette P. Irarrázabal ◽  
Judith A. Levy ◽  
Rosina Cianelli ◽  
Kathleen F. Norr ◽  
L. Michele Issel ◽  
...  
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Successful Implementation ◽  
Test Results ◽  
Rapid Testing ◽  
Care Providers ◽  
Cross Sectional ◽  
Rapid Hiv Testing

Objectives: To understand key factors influencing Chilean health care providers’ perceived comfort performing oral rapid HIV testing. Design: One hundred and fifty health care providers completed a self-administered questionnaire that included a five-item scale measuring self-perceived comfort in conducting HIV pretest counseling, oral rapid testing, finger-prick testing, and delivering test results. Results: Most participants (60%) envisioned good overall comfort performing oral rapid HIV testing (mean score of 16.21; range 0-20), including doing at least four of the five steps. They perceived least comfort delivering HIV-positive test results during posttest counseling. HIV stigmatizing attitudes reduced self-perceived comfort. Conclusions: Providing training to counter HIV stigmatization while increasing comfort in performing oral rapid testing would help facilitate its successful implementation.

COPD360social Online Community: A Social Media Review

2018 ◽  
Vol 19 (4) ◽  
pp. 489-491 ◽  
Author(s):  
Michael Stellefson ◽  
Samantha R. Paige ◽  
Julia M. Alber ◽  
Margaret Stewart
Keyword(s):  
Health Care ◽  
Social Media ◽  
Chronic Disease ◽  
Health Care Providers ◽  
Online Community ◽  
Self Management ◽  
Successful Implementation ◽  
Evidence Based ◽  
Care Providers ◽  
Media Review

People living with chronic obstructive pulmonary disease (COPD) commonly report feelings of loneliness and social isolation due to lack of support from family, friends, and health care providers. COPD360social is an interactive and disease-specific online community and social network dedicated to connecting people living with COPD to evidence-based resources. Through free access to collaborative forums, members can explore, engage, and discuss an array of disease-related topics, such as symptom management. This social media review provides an overview of COPD360social, specifically its features that practitioners can leverage to facilitate patient–provider communication, knowledge translation, and community building. The potential of COPD360social for chronic disease self-management is maximized through community recognition programming and interactive friend-finding tools that encourage members to share their own stories through blogs and multimedia (e.g., images, videos). The platform also fosters collaborative knowledge dissemination and helping relationships among patients, family members, friends, and health care providers. Successful implementation of COPD360social has dramatically expanded patient education and self-management support resources for people affected by COPD. Practitioners should refer patients and their families to online social networks such as COPD360social to increase knowledge and awareness of evidence-based chronic disease management practices.

scholarly journals Implementation of Universal Health Coverage Program in Kisumu County, Kenya: Importance of Social Marketing Strategies

2020 ◽  
Vol 1 (2) ◽  
pp. p22
Author(s):  
P. Otambo ◽  
L. Nyandieka ◽  
J. Kariuki ◽  
R. Mutisya ◽  
E. Echoka ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Universal Health Coverage ◽  
Reproductive Age ◽  
Ethical Review ◽  
Successful Implementation ◽  
Elderly Persons ◽  
Health Coverage ◽  
Care Providers ◽  
Political Class ◽  
Universal Health

Universal Health Coverage is where communities have access to all needed health services without financial hardship. In Kenya, Universal Health Coverage (UHC) program was launched in December 2018, through a presidential decree. This study aimed to understand population needs, acceptability, and perceptions about UHC implementation. The study was undertaken in four pilot counties of Kisumu, Machakos, Nyeri and Isiolo between February and March 2019, using exploratory qualitative data collection techniques. However, this paper focuses on the County of Kisumu which was selected due to its high prevalence of infectious diseases. Respondents included women of reproductive age, men, youth, and elderly persons. In-depth interviews were conducted among health care providers and managers. Scientific and ethical approval was obtained from the Kenya Medical Research Institute’s Scientific and Ethical Review Unit (SERU). Consenting to participate was individualized. Analysis was done thematically. Findings suggest that UHC was understood variously by different groupings. Sensitization about the UHC programme was done through electronic media, by CHVs, education sessions, political class and outreaches. Planning for the programme was done by holding meetings, trainings for community registration and developing budgets. However there was a lot os misunderstanding, confussion and misconcepts about the UHC concept as it was seen as a means to seek for votes by politicians. Barriers for successful implementation included critically understaffed facilities. 

scholarly journals Diabetes Technology Experiences of Young People Living with Type 1 Diabetes Mellitus and their Parents: Hybrid Theoretical Foundation Guided Analysis

2021 ◽  
Author(s):  
Nicola Brew-Sam ◽  
Madhur Chhabra ◽  
Anne Parkinson ◽  
Adam Henschke ◽  
Ellen Brown ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Young People ◽  
Continuous Glucose Monitoring ◽  
Theoretical Foundation ◽  
Glucose Monitoring ◽  
Self Management ◽  
Diabetes Technology ◽  
Specific Device ◽  
Monitoring Devices

Background. An important strategy to understand young people's needs and preferences regarding technologies for Type 1 Diabetes Mellitus (T1DM) management is to examine their day-to-day experiences with these technologies. Objective. This study aimed to describe T1DM youth and their caregivers' experiences and preferences regarding insulin pumps, sensor technologies, and related communication technologies based on a hybrid theoretical foundation, as well as to describe derived ideal device characteristics. Materials and Methods. Sixteen face-to-face interviews were conducted with young people with T1DM and their parents about their diabetes technology use. A combination of data-driven thematic analysis in a first stage, and theory-driven analysis in a second stage was used to incorporate in-depth study analysis and existing theoretical literature. Relevant literature included technology adoption (Unified Theory of Acceptance and Use of Technology/UTAUT) and value sensitive design (VSD) models. Based on this approach ideal device characteristics for young people with T1DM were summarized. Results. Initial themes derived from the interviews included aspects of diabetes self-management, device use, and specific device-related technological characteristics and feelings associated with the specific device types (continuous glucose monitoring, insulin pump, flash glucose monitoring). The interview data delivered information congruent with all UTAUT and VSD factors except for one (privacy). Discussions around ideal diabetes devices focused on reliability, flexibility, and automated closed loop systems that enabled an independent and normal life for adolescents, and alleviated parental anxiety. However, in line with the previous systematic review, the interview analysis showed that reality deviated from these expectations, with inaccuracy problems reported for continuous glucose monitoring devices, and technical failures occurring in both continuous glucose monitoring devices and insulin pumps. Conclusions. UTAUT and VSD approaches were found useful as a combined foundation for structuring our study findings. Technologies for diabetes self-management require continual advancement to meet the needs and expectations of young people with T1DM and their caregivers. Understanding their experiences, as well as challenges with the devices, enabled us to identify theory-supported ideal device characteristics that can be useful in the designing and developing of improved technologies.

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