The aim of this study was to describe rates of telemedicine use 18 months after the start of the coronavirus disease 2019 pandemic and to assess the institutional barriers to its implementation for type 1 diabetes care across centers of the T1D Exchange Quality Improvement Collaborative. Observational electronic health record data capturing telemedicine rates from 15 U.S. centers between September 2020 and September 2021 and a survey of 33 centers capturing telemedicine rates and key components of telemedicine were analyzed. A capacity score was developed and summed to a total capacity score and compared with overall telemedicine rates across centers. Telemedicine visits decreased by 17.4% from September 2020 to September 2021. Generally, it was observed that the lower the average telemedicine capacity score, the lower the rate of telemedicine visits. Despite a decline in the utilization of telemedicine 18 months after the start of the pandemic, visit rates were still 20% higher than in the pre-pandemic period. However, there is a need to improve structural components to ensure telemedicine capacity and robust telemedicine utilization.
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Feature Article|
September 07 2023
Institutional Barriers to the Successful Implementation of Telemedicine for Type 1 Diabetes Care
Joyce M. Lee;
Joyce M. Lee
1Susan B. Meister Child Health Evaluation and Research Center, C.S Mott Children’s Hospital Ann Arbor, MI
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Emma Ospelt
;
2T1D Exchange, Boston, MA
Corresponding author: Emma Ospelt, eospelt@t1dexchange.org
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Osagie Ebekozien;
Osagie Ebekozien
2T1D Exchange, Boston, MA
3University of Mississippi School of Population Health, Jackson, MS
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Meenal Gupta;
Meenal Gupta
4Seattle Children’s Hospital, University of Washington, Seattle, WA
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Faisal S. Malik;
Faisal S. Malik
4Seattle Children’s Hospital, University of Washington, Seattle, WA
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Naomi R. Fogel;
Naomi R. Fogel
5Ann & Robert Lurie Children’s Hospital, Chicago, IL
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Siham Accacha;
Siham Accacha
6School of Medicine NYU Long Island Mineola, NY
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Susan Hsieh;
Susan Hsieh
7Cook Children’s Hospital Fort Worth, TX
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Meredith Wilkes;
Meredith Wilkes
8Icahn School of Medicine at Mt. Sinai New York, NY
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Anna Neyman;
Anna Neyman
9Indiana University School of Medicine, Riley Children’s Hospital, Indianapolis, IN
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Francesco Vendrame;
Francesco Vendrame
10University of Miami Miller School of Medicine, Miami, FL
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T1D Exchange Quality Improvement Collaborative
T1D Exchange Quality Improvement Collaborative
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Corresponding author: Emma Ospelt, eospelt@t1dexchange.org
Clin Diabetes cd230056
Article history
Received:
June 29 2023
Accepted:
July 14 2023
Citation
Joyce M. Lee, Emma Ospelt, Nudrat Noor, Ann Mungmode, Osagie Ebekozien, Meenal Gupta, Faisal S. Malik, Naomi R. Fogel, Siham Accacha, Susan Hsieh, Meredith Wilkes, Anna Neyman, Francesco Vendrame, T1D Exchange Quality Improvement Collaborative; Institutional Barriers to the Successful Implementation of Telemedicine for Type 1 Diabetes Care. Clin Diabetes 2023; cd230056. https://doi.org/10.2337/cd23-0056
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