when telemedicine does deliver!: telemedicine and diabetes management
DESCRIPTION
When Telemedicine Does Deliver!: Telemedicine and diabetes management. Schwarz P. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)TRANSCRIPT
Prof. Dr. med. habil. Peter Schwarz
Department for Prevention and Care
University Hospital „Carl Gustav Carus“ Dresden
Chairmen „Diabetes Prevention“ German Diabetes Association
Telemedicine and diabetes
management
1. Type 2 diabetes and its cardiovascular complications are becoming
more prevalent throughout the world.
2. The conditions and risk factors that precede type 2 diabetes have also
increased substantially. These risk factors are well-known: obesity,
central adiposity, physical inactivity and unhealthy diet.
3. At the time of diagnosis and the longer that diabetes exists, disease
complications are more likely – mostly CVD.
4. Prevention is the key: modifiable risk factors need to be addressed
through effective interventions
5. Prevention of type 2 diabetes is effective and needs management
TIME to ACT - alarming facts
16.03.2010
It includes 4 regional districts and 1 district capital – the city of Dresden.
Carus Consilium Sachsen (CCS) - geographic area
Aged population 2006
with prospective development 2020
- 7.0
35.9
47.3
- 10,0
-
10,0
20,0
30,0
40,0
50,0
60,0
Ratio of the elderly
Population 65+ years
of age compared to
18 to <65 years of age
jeweilige Bevölkerungsveränderung in %
Altenquotient
Altenquotient 2020
Quelle: Statistisches Landesamt Sachsen
Overall population
Aged population
Aged population 2020
Challenge The patient with diabetes
• Chronic disease with stigmatization
• Patients in all age groups with the nadir in middle age
• Quality of treatment depends on physician - patient interaction
• 45% of the patient have depressive symptoms
• Self Monitoring of blood glucose is the main step of diabetes treatment
• Documentation is integral part of self-management
• Compliance for documentation is the key in diabetes treatment
• Extremely costly diseases due to treatment and complications
Overview of the current way of Diabetes Management
Diabetes Management - GlucoTel one possible Answer
• Current system involves patient manually recording results in a log book or via manual down- and uploading procedures
• Reviews of this data with a caregiver is only done periodically (generally every 3 months)
• Patients are routinely poorly or non-compliant and results are not recorded accurately resulting in poor monitoring of disease and potential mis-diagnosis
• Any deficiencies in a patient’s treatment can only be spotted by the caregiver at long intervals
The Problems The Solution
GlucoTel has the potential to significantly reduceoverall healthcare costs for diabetes treatment
• Removes requirement for patient to manually record and transfer measured values
• Caregivers, granted access by the patient, can monitor values anytime online and deficiencies in treatment can be spotted in ‘real-time’
• Closes the gap between the patient and the caregiver offering better disease management for the patient and better quality of care for the caregiver
• Payers will have the option to monitor non-compliant patients and might consider potential solutions to this costly problem
Blood Glucose Meter
GlucoTel | Blood Glucose Monitoring and Diabetes Management System
• Real-time transmissions
• Bluetooth enabled meter
• Wireless transmission to
mobile phone
• Mobile phone automatically
transfers test result to
patient online log book
Diabetes Telemonitoring & Management System
Online Disease Management - www.bodytel.com
Internet platform that is accessible via normal internet browser and contains:
• Secure Patient Data CenterReal-time, CE Approved and FDA conform, HIPAA compliant, hosted by third-party with double redundancy
•Alert ManagerEnables caregivers to set up thresholds and alerts Web 2.0 Module (Instant Messaging, Email), Legacy Module (Text Message, Fax, etc.)
•Access Managerfor administrating access rights to caregivers
•Web ShopSubscription manager (automatic. supply with goods [e.g. test strips]) for all BT products and special 3rd party products
•OEM Interfacefor third party sensors
•eHealth InterfaceHL7 electronic, patient record e.g. into the Google healthcare record
• In the medium term, the BodyTel Center will seek to become a ‘one stop shop’ for patients with diabetes with numerous add-on options including:
– Ability to order diabetes focused books on cooking, disease management, lifestyle, etc.– Access to information on diabetes for newly diagnosed patients including online blogs, etc.– Ability to attract third-party diabetes relevant
advertising
Care Study to test the effect of Telemedicine
16.03.2010 11Prof. P. Schwarz,
1. Critical analysis of the telemedicine need
and the compliance situation of the patient
in real health care
2. Baseline analysis of the treatment status
and possible telemedicine adherence
3. Every 6 month standardized survey with
up to 4000 patients about the added
value of diabetes telemedicine (GlucoTel)
application and treatment effect
4. Identification of barrier to telemedicine in
real clinical care of diabetes patient
5. Development of an telemedicine medical
management for diabetes patients in real
health care
893 patients included
Advantage for patients and disease management
• GlucoTel changes and eases the live of diabetics
no written diary anymore; Glucose values immediately available to caretakers, etc.)
• Telemedicine can offer more convenient services to the patient
Patients receives service than stigmatization
• The patients do what they do and receive more quality service
• Telemedicine changes behavior do to perceived supervision
my doctors know my glucose value in the same moment
• Telemedicine helps reducing costs to the Social Security System
Pay per test and quality management
• Telemedicine (GlucoTel) is able as a tool to build customer satisfaction
• Telemedicine (GlucoTel) provides the missing link
National Health
insurance
(reimbursement)
National
Diabetes Plan
City planning
(reimbursement)
Tax incentive in
private sector
for screening
Community
based primary
prevention
programs
Environmental
programs for
exercise
Physician
education
Work side risk
reduction small
and big
business
Secondary
prevention
programs
Community
screening
programs
Intervention
manager
education
Targeted
intervention in
high risk groups
Quality
management
intervention
Guidelines for
diabetes
prevention EB
and practice
Health lifestyle
education at
school
Management
structures for
intervention
programs
Easy healthy
food choices in
daily life
Perrsonal
feedback about
progress
Easy to understand
intervention material
(minorities, social
groups)
State
Community
Intervention
structures
Personal
Necessary strategies for intervention for a new public-
health approach to diabetes prevention
MY benefit
from prevention
National Health
insurance
(reimbursement)
National
Diabetes Plan
City planning
(reimbursement)
Tax incentive in
private sector
for screening
Community
based primary
prevention
programs
Environmental
programs for
exercise
Physician
education
Work side risk
reduction small
and big
business
Secondary
prevention
programs
Community
screening
programs
Intervention
manager
education
Targeted
intervention in
high risk groups
Quality
management
intervention
Guidelines for
diabetes
prevention EB
and practice
Health lifestyle
education at
school
Management
structures for
intervention
programs
Easy healthy
food choices in
daily life
Perrsonal
feedback about
progress
Easy to understand
interventionmaterial
(minorities, social
groups)
State
Community
Intervention
structures
PersonalMY benefit
from prevention
Necessary strategies for intervention for a new public-
health approach to diabetes prevention
Development and Implementation of a European Guideline
and Training Standards for Diabetes Prevention
www.activeindiabetesprevention.com
Network
who are active in
diabetes prevention
Thank you for
your attention