Background and Aims

During the COVID-19 pandemic, appointments for diabetes clinic visits rapidly switched to a telemedicine format, impacting all aspects of the routine clinical care, including: sharing data, clinic flow, technological readiness, and billing. To understand this shift, we surveyed member clinics of the T1D Exchange QI Collaborative.

Methods

A total of 21 clinics across the USA completed surveys. Telemedicine was defined as any video visit or telephone visit that took place in lieu of a face to face in response to social distancing measures during COVID-19 pandemic. Outcome metrics included survey responses and monthly metrics regarding telemedicine visits (January - August, 2020). The survey covered topics related to access to technology tools, the telehealth visit process, and insurance coverage.

Results

Of 21 clinics (16 pediatric and 5 adult), 62% used both video software and phone calls. Clinics reported that insurance covered 95% of telemedicine visits during the pandemic (see Table 1). All clinics had access to Carelink, T-Connect, Glooko, and Clarity platforms to support remote monitoring of patients.

Over half (62%) of clinics instituted workflows to obtain patient lab results, less (38%) had a system for conducting depression screening. Only 3 clinics had psychologists available to participate in telemedicine.

Clinics described similar rates of prescribing for CGM and pumps (62%). . Clinics continued to provide support for pumps (100%) and CGM (70%).

Conclusions

Physicians and insurers have adopted telemedicine with remarkable speed. Future studies will assess the effectiveness of telemedicine visits during this pandemic in different patient populations.