3 Takeaways from the Virtual Front Lines of Telehealth

By Dr. Arnold Saperstein

3 Takeaways from the Virtual Front Lines of Telehealth

In my last post, I shared Cecelia Health’s key learnings from our ongoing partnerships with specialty diabetes clinics around the United States. Our clinical team has been doing a tremendous job in assisting many of our nation’s leading diabetes outpatient clinics and their patients that have been adversely impacted by the COVID-19 pandemic. Our programs have increased the clinical care capacity of our partners by providing virtual access to our team of over 200 Certified Diabetes Care and Education specialists (CDCES) resulting in a more efficient care delivery process for providers and their patients.

Since launching these programs in April, we’ve prioritized listening to our patients, clinical partners, and our customers across our other segments (health plans, pharmaceutical manufacturers, and device manufacturers) to better understand the true impact of COVID-19 on healthcare operations and delivery in the United States. Our partners have shared that these have been difficult times for both patients and front-line healthcare workers- we’ve been doing our best to mobilize and provide support. Thankfully, our team is built to assist a diverse set of patients and industry participants. Our experiences thus far “on the virtual front lines” have provided us with some important insights regarding the future of telehealth and the impact of COVID-19 on the ability of people with diabetes to be able to receive care.

1. Telehealth Provides Safe Access to Care

As the threat of COVID-19 remains prevalent in the United States, people with chronic conditions will continue to avoid in-person appointments. And, many will be unable to seek treatment given that some clinics are not allowing for high risk patients to seek in-person treatment. We’ve heard from our partners that they fear that risk of exposure to the virus from crowded, indoor groups of individuals would be simply too high. Thus, across our programs we’ve seen a significant drop in the rates that patients have been able to connect with their care team in-person. If their providers are not set up to conduct telehealth visits, our Cecelia Health coaches have often been their only source of medical support.

Our clinical partners have recognized the potential long-term nature of this obstacle and most are preparing to extend their telehealth offering for the foreseeable future. Dr. Ruth Weinstock, Founder and Medical Director of the Joslin Diabetes Center at SUNY Upstate Medical University, Syracuse noted: “Even as we re-open, telemedicine will have to continue if we are to be safe. We anticipate needing to see almost all our diabetes patients remotely until there is a vaccination.”

Additionally, health plans will need to carefully consider how to enable and support their members with chronic conditions to receive care in a safe, efficient manner. Plans should expect telehealth demand to remain high for the foreseeable future, laying the groundwork for a new normal in care delivery. They should act quickly to ensure that the financial incentives and support are aligned to meet the demand for telehealth services.

2. Telehealth Contributes to Streamlined Care Delivery and Improved Efficacy

Many of our partners have shared the operational challenges they’ve face in delivering in-person care at specialty clinics even prior to COVID-19. Like many provider organizations across the United States, diabetes specialty clinics are frequently resource constrained. To put it simply, there are simply not enough endocrinologists to meet the rapidly growing population of individuals with diabetes in the United States.

The result of this shortage is often tenuous wait times for both existing patients and those newly diagnosed with diabetes, with wait times for an appointment regularly in excess of 6 months. This contributes not only frustrated patients but also to poor or even dangerous health outcomes. For example, when it comes to Continuous Glucose Monitoring (CGM), we’ve learned that many of the patients served by our clinics initiate on their device independently, often leading to frustration and drop-off. In 2020, there should be no reason why an individual with diabetes is unable to get the support they need to fully adopt their care plan. Cecelia Health understands the challenges associated with CGM adoption, and engages with patients immediately after receiving their prescription for a CGM device to ensure that they are empowered not only to initiate on the device but also to adhere and persist over time.

It’s clear that telehealth via expert clinician coaching provides a critical channel for additional touchpoints necessary to reinforce care plans and improve outcomes for people with diabetes given the intensive management required by the disease. Importantly, this approach frees up endocrinologist to focus on advancing care plans by while increasing their efficiency and impact of in-person visits.

3. Telehealth Eliminates Operational Bottlenecks - Continuous Blood Glucose Data

Cecelia Health has a long history of supporting medical device initiation and adherence programs, but our recent clinical partnerships have provided us an opportunity to collaborate directly with providers to augment and reinforce their care plans. We’ve scaled up our partnership efforts to target a major operational bottleneck for our clinical partners: patients’ ability to interpret their data and seamlessly upload it from their CGM device prior to an in-person visit with a specialty provider. Our team proactively addresses these issues by connecting with patients prior to their visit and empowering them to utilize their devices capabilities to share data with their providers significantly reducing the amount of time spent on non-disease state related education during in-person visits. Telehealth can have a dramatic impact on the high cost of care of the healthcare system in the United States and should be leveraged to optimize care in-person where appropriate.

In conclusion, it’s important for all healthcare stakeholders to consider the numerous benefits that telehealth can provide to improve access, reduce costs, improve patient outcomes, and allow specialty care providers to focus on their area of expertise. As COVID-19 continues to threaten the health of our most vulnerable populations, I expect that telehealth will continue to play an important role in providing care to people with diabetes.

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Orignially published on June 24, 2020, updated on June 24, 2020

Topic: Industry Innovation

Dr. Arnold Saperstein

About Dr. Arnold Saperstein

Arnold Saperstein MD, FACP, began his career in managed care in 1992 and joined MetroPlus Health Plan in 1995 initially as Chief Medical Officer and then as President and CEO from 2006 until 2019. MetroPlus Health Plan, a wholly-owned subsidiary of the New York City Health + Hospitals is a managed care organization that, under Saperstein’s leadership grew from 40,000 members to over 500,000 members with an estimated 32,000 participating providers. Dr. Saperstein has spent the majority of his career developing programs that ensure the highest quality of care. During his tenure at MetroPlus, it ranked as one of the highest scoring plans for quality of care as measured by the New York State Department of Health Medicaid Incentive Program and by the Medicaid Consumer Guide for New York City. Under his leadership, MetroPlus rose to the forefront of Value Based Purchasing. Programs he developed included groundbreaking quality incentive pay for performance programs across the entire MetroPlus network.