According to the CDC, 37.3 million Americans have diabetes (11% of the U.S. population). Americans with pre-diabetes, a preventable diagnosis, amount to 96 million people aged 18+ (38% of the adult U.S. population).1 Care for people with diabetes accounts for 1 in 4 healthcare dollars and costs employers $90 billion in indirect costs (such as absenteeism and lost productivity) and $327 billion in direct costs.2,3
Virtual primary care offers an opportunity for employers to deliver evidence-based diabetes care. Research from the University of Minnesota Medical School found that 3 systems of care led to superior diabetes management which virtual primary care can support.4
According to research from the Mayo Clinic, “Shared decision making is a collaborative process by which patients and clinicians work together in a deliberative dialogue. The purpose of this dialogue is to identify reasonable management options that best fit and address the unique situation of the patient.”5
Virtual primary care gives patients and doctors the opportunity to collaborate and have a dialogue whenever and wherever is most convenient for the patient. Phone and video conversations in virtual primary care facilitate shared decision making by reducing the time and space barriers to patient communication. Plus, patients have more time to discuss behavior changes with their doctor that can manage diabetes compared to in-person visits — like losing weight, exercising or changing their diet.
As famous doctor Atul Gawande found in his research, checklists in healthcare save lives. There are many tasks that a doctor needs to accomplish for proper diabetes care. For example, a doctor must check a patient’s Hemoglobin A1c every 3 months, refer them to an ophthalmologist for a retina exam yearly, check their kidney function with urine and blood tests regularly.
A checklist is a vital tool to ensure those tasks are performed. Virtual primary care enabled by checklists built into the electronic medical record and workflow of the doctor allow them and the diabetic patient to accomplish these care tasks.
Guideline-based, age-appropriate screening is vital to keeping people with diabetes healthy. Patients must be screened for hypertension, high cholesterol, depression, smoking, substance use and many other health concerns. Diabetes affects the entire body and keeping all aspects of a patient healthy is key to preventing the progression of diabetes. Checklist tools for the large number of screenings are necessary for their completion.
Virtual primary care is an effective tool for coordinating these screening activities. Patients can check their blood pressure at home and many labs perform blood pressure checks as well. Blood tests must be performed in-person, but virtual primary care allows the doctor to order the tests at a lab location near the patient and eliminates the need for two in-person visits. Questionnaire-based screening for depression and healthy behaviors can also effectively be performed via virtual primary care.
Primary Care is a powerful way to put these evidence-based approaches into practice. Phone and video conversations in Primary Care facilitate shared decision making between doctor and patient by reducing the time and space barriers to patient communication. Patients have more frequent, longer visits (35 minutes on average), keeping them engaged in their healthcare journey to ensure they are in control of their diabetes. The convenience of virtual visits also keeps patients on track with routine visits also allow for regular testing to manage and monitor a diabetes checklist (includes hemoglobin A1c screenings every 3 months, annual eye checks, urine and blood testing, etc.)