Virtual Care in the COVID-19 Era: Assessing Telemedicine Experiences among Diabetes Care and Education Specialists

ABSTRACT

Objective: The rapid rise of telemedicine, necessitated by the COVID-19 pandemic, has changed how care is administered and created additional burdens for healthcare professionals. This study investigated how Diabetes Care and Education Specialists (DCES) have implemented telemedicine in their practices to identify possible areas for improvement. Method: 350 DCES from an opted-in US research panel were surveyed. Respondents were asked about their expected and present use of telemedicine, satisfaction with telemedicine versus in-person appointments, and perceived changes in the frequency of treatment decisions made over telemedicine compared to in-person. Result: On average, respondents reported that 57% of appointments were conducted using telemedicine this year and estimated a decrease in telemedicine use during 2021 (41%). While 67% of respondents were satisfied with in-person visits (selecting a 9 or 10 on a 10-point scale), just 25% were satisfied with telemedicine visits. Analysis of verbatim comments revealed dissatisfaction with telemedicine stems from difficulty with teaching patients virtually (20%), technology use (18%), establishing personal connections with patients (16%), and obtaining patient device data (11%). DCES indicated that larger treatment decisions like starting new therapies/devices occur less often over telemedicine whereas adjusting patient's settings occurs more often. For example, relative to in-person visits, 64% report starting patients on new insulin pumps less often while 62% report adjusting pump settings just as often. Conclusion: Telemedicine has become a regular part of DCES's practices despite notable gaps in satisfaction and ability to make certain treatment decisions when compared with in-person visits. Although telemedicine may be a useful tool for adjusting doses and device settings, these findings emphasize the need for improvements surrounding virtual diabetes care to alleviate the challenges experienced by providers.