Diabetes patients at Children's Mercy Hospital in Kansas City have access to technology that healthcare leaders around the world dream about: an online tracking system that allows clinicians to monitor a patient's health status remotely and, when necessary, contact the patient electronically to make treatment changes.
The diabetes management software is designed to help pediatric patients improve their glycemic control, often attributable to poor self-care. Children's Mercy is one of more than 50 pediatric hospitals that make the software available to their patients at no charge, courtesy of a 10-year program funded by a healthcare IT vendor.
The system allows patients and their family members to upload data from their glucometers on a weekly basis. A longitudinal record of glucose values, carbohydrates, and insulin use is created, so clinicians can track their patients on an ongoing basis. Patients can securely contact their healthcare team through the online system if a question or concern arises between appointments.
A review of the program by the Agency for Healthcare Research and Quality found that parents of young patients who use the system were enthusiastic about their ability to collaborate more closely with their child's medical team.
Angela Turpin MD, associate medical director of diabetes program at Children's, is excited about the system's potential-although it is far from being realized.
"This has a lot of positives," she says. "But it requires a lot of change and that takes time."
For one thing, most patients and their families have been slow to embrace the technology. About 300 of Children's 1,600 eligible patients use it on a regular basis. Turpin has found that about 20 percent of patient families use the system easily, some patients reject it completely, and the vast majority are not willing to take the time to learn and use it.
For another, the system may increase communication but it does not necessarily speed it up. While some questions can be answered via a simple email exchange, more typically nurses need to call the patients' parents to address a question, leading to time-consuming phone tag.
Children's is conducting a study to evaluate whether use of the system by high-risk children with diabetes improves patients' health status or decreases emergency department visits and diabetes-related health expenditures. Turpin is optimistic that, as use of the technology increases, both outcomes are feasible.
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