Telemedicine experience for diabetes care in a Brazilian referral center during COVID19 pandemic

ABSTRACT

Introduction: The COVID-19 pandemic has imposed crucial changes to healthcare systems, which had to adapt to the new reality of social distancing with maintenance of care, especially for patients with chronic medical conditions such as diabetes. In that way, telemedicine has become a new standard of care. Objectives: To compare the number and rate of scheduled, completed and no-show medical visits prior to the COVID19 outbreak in Brazil, when visits were exclusively in person, and during the pandemic, when both in person and telehealth visits were conducted. Methods: From January 2019 to June 2021, statistical analysis of electronic health record data for all patients from an outpatient clinic of a Brazilian diabetes referral center were collected. Results: Before the COVID19 outbreak, there was an average of 100 scheduled visits, 82 completed appointments and 18 no-show visits per month. In the months following the outbreak there was a 50% reduction in the outpatient clinic's capacity, due to health restrictions imposed by local authorities. Therefore, in these months (in which the outpatient clinic used telehealth via mobile app), there was an average of 51 scheduled visits, 40 completed appointments and 11 no-show visits per month. Telehealth consultations replaced 12.5% of the in-person appointments, with a 350% increase in the number of online consultations between the first and the last month analyzed by the study. Moreover, regarding the communication between patients and health center, there was a 65% reduction in the number of emails exchanged and a 64% increase in the number of messages exchanged through mobile telehealth app. Conclusions: Despite the poor infrastructure and technology access in a low-income country like Brazil, our service was able to replace 12.5% of in-person care with telemedicine, which allowed the patients safety during medical care in the context of the pandemic.