Dataset Information

In-Person and Telehealth Provider Access and Glycemic Control for People With Diabetes During the COVID-19 Pandemic.

ABSTRACT:

Background

Ambulatory care underwent rapid changes at the onset of the COVID-19 pandemic. Care for people with diabetes shifted from an almost exclusively in-person model to a hybrid model consisting of in-person visits, telehealth visits, phone calls, and asynchronous messaging.

Methods

We analyzed data for all patients with diabetes and established with a provider at a large academic medical center to identify in-person and telehealth ambulatory provider visits over two periods of time (a "pre-COVID" and "COVID" period).

Results

While the number of people with diabetes and any ambulatory provider visit decreased during the COVID period, telehealth saw massive growth. Per Hemoglobin A1c, glycemic control remained stable from the pre-COVID to COVID time periods.

Conclusions

Findings support continued use of telehealth, and we anticipate hybrid models of care will be utilized for people with diabetes beyond the pandemic.

SUBMITTER: Eiland L

PROVIDER: S-EPMC10067707 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

In-Person and Telehealth Provider Access and Glycemic Control for People With Diabetes During the COVID-19 Pandemic.

Eiland Leslie L Datta Proleta P Samson Kaeli K Anzalone Jerrod J Donovan Anthony A McAdam-Marx Carrie C

Journal of diabetes science and technology 20230330 4

<h4>Background</h4>Ambulatory care underwent rapid changes at the onset of the COVID-19 pandemic. Care for people with diabetes shifted from an almost exclusively in-person model to a hybrid model consisting of in-person visits, telehealth visits, phone calls, and asynchronous messaging.<h4>Methods</h4>We analyzed data for all patients with diabetes and established with a provider at a large academic medical center to identify in-person and telehealth ambulatory provider visits over two periods ...[more]

PMID: 36999204

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Project description:BackgroundUnderstanding perceptions of telehealth implementation from patients and providers can improve the utility and sustainability of these programs, particularly in under-resourced rural settings. The purpose of this study was to evaluate both patient and provider perceptions of telehealth visits in a large rural healthcare system during the COVID-19 pandemic. To promote sustainability of telehealth approaches, we also assessed whether the percentage of missed appointments differed between in-person and telehealth visits.MethodsUsing anonymous surveys, we evaluated patient preferences and satisfaction with telehealth visits from November 2020 -March 2021 and assessed perceptions of telehealth efficiency and value among rural providers from September-October 2020. We examined whether telehealth perceptions differed according to patients' age, educational attainment, insurance status, and distance to clinical site and providers' age and length of time practicing medicine using ANOVA test. We also examined whether the percentage of missed appointments differed between in-person and telehealth visits at a family practice clinic within the rural healthcare system from April to September 2020 using a Chi-square test.ResultsOver 73% of rural patients had favorable perceptions of telehealth visits, and satisfaction was generally higher among younger patients. Patients reported difficulty with scheduling follow-up appointments, lack of personal contact and technology challenges as common barriers. Over 80% of the 219 providers responding to the survey reported that telehealth added value to their practice, while 36.6% agreed that telehealth visits are more efficient than in-person visits. Perception of telehealth value and efficiency did not differ by provider age (p = 0.67 and p = 0.67, respectively) or time in practice (p = 0.53 and p = 0.44, respectively). Technology challenges for the patient (91.3%) and provider (45.1%) were commonly reported. The percentage of missed appointments was slightly higher for telehealth visits compared to in-person visits, but the difference was not statistically significant (8.7% vs. 8.0%; p = 0.39).ConclusionsTelehealth perceptions were generally favorable among rural patients and providers, although satisfaction was lower among older patients and providers. Our findings suggest that telehealth approaches may add value and efficiency to rural clinical practice. However, technology issues for both patients and providers and gaps in care coordination need to be addressed to promote sustainability of telehealth approaches in rural practice.

Project description:ObjectiveTo explore the perspectives of lactation support providers delivering breastfeeding education via in-person and telehealth consultations and assess the impact of COVID-19 on the provision of breastfeeding education.DesignQualitative descriptive study using purposive sampling.SettingMassachusetts-based lactation support providers who provided in-person and/or telehealth consultations in various practice settings (e.g., inpatient; outpatient; private practice; and the Special Supplemental Nutrition Program for Women, Infants, and Children).ParticipantsFourteen Massachusetts-based lactation support providers, ages 36 to 68 years.MeasurementsParticipants completed an online demographic and employment characteristics survey and virtual key informant interviews, from which six main themes were defined.ResultsThe six main themes included Common Questions Asked by Clients, Prenatal and Postpartum Consultation Topics, Facilitators for Telehealth Versus In-Person Consultations, Barriers for Telehealth Versus In-Person Consultations, Best Practices, and COVID-19 Adaptations. From participant interviews, common subthemes emerged. The primary adaptation due to COVID-19 was shifting to telehealth. Content in lactation consultations was similar via in-person and telehealth sessions. Typical content areas included breast pumping and mother's milk supply. A notable difference was the lack of physical examinations for women and newborns in telehealth sessions. Scheduling flexibility was a key facilitator of telehealth consultations, whereas the inability to provide hands-on assistance and chaotic home environments were common barriers. In-person facilitators included weighing newborns to assess feeding success and insurance billing coverage, whereas unsupportive family members were noted as a barrier. Diversity, equity, and inclusion-related barriers (e.g., language barriers, lack of reflective diversity, lack of stable Internet access) were observed in both settings. Best practices for in-person and telehealth consultations included meeting mothers where they are and focusing on mothers' goals.ConclusionPractice adaptations adopted during the pandemic and best practice recommendations may be useful for lactation support providers and other health care professionals caring for breastfeeding dyads.

Dataset Information

In-Person and Telehealth Provider Access and Glycemic Control for People With Diabetes During the COVID-19 Pandemic.

Background

Methods

Results

Conclusions

Publications

In-Person and Telehealth Provider Access and Glycemic Control for People With Diabetes During the COVID-19 Pandemic.

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