A study has identified the main barriers in the application of telemedicine to diabetes, among them the lack of diabetes training for patients and professionals, the low level of digital literacy and the lack of availability of the necessary infrastructures.
In the preparation of the report ‘ Telemedicine and innovation in diabetes ‘, presented by IESE Business School and Abott, the president of the Spanish Society of Endocrinology and Nutrition (SEEN), Francisco Javier Escalada; the vice president of the Spanish Health Informatics Society (SEIS), Jesús Galván Romo; the president of the Spanish Diabetes Federation (FEDE), Juan Francisco Perán, the president of the Spanish Diabetes Society (SED), Antonio Pérez; the professor of the Andalusian School of Public Health, José Martinez Olmos and Francisco the head of the Area of Clinical Information Systems of the Ministry of Health, José Sánchez Laguna.
In this sense, another difficulty found in the study is the reluctance of health professionals themselves , who sometimes fear that telemedicine will replace in-person care.
Another barrier to the implementation of telemedicine in these patients is the cost of acquisition in the short term of interstitial fluid glucose monitoring devices by the Administration.
“Despite the abundant literature that demonstrates its efficiency, from the point of view of reducing costs derived from complications, or reducing absenteeism and improving quality of life, at present, the factor of greatest weight in the implementation of its financing for patients with type 2 diabetes is the cost of acquisition “, is collected in the study.
In this sense, according to the authors, the fact that the Administration has a siled vision makes it difficult to see the savings that it can entail in the medium term, giving prevalence to the perspective of the economic impact on the health budget in the short term.
Another reason for the lack of implementation of telemedicine in patients with diabetes is the delay in the adoption of the innovation by the Autonomous Communities. In fact, the regional access time for new products, from the approval of the financed price until they finally reach the patient, ranges between 3 and 7.8 months on average, with significant differences between the Autonomous Communities.
Thus, the authors of the report propose an investment in infrastructure. “It is not possible to provide solutions for the future with tools from the past, and quality telemedicine requires investment in technology by public health,” they claim.
In this sense, it is necessary to “make robust and easy-to-use tools” available to patients and healthcare professionals to carry out telematic visits, remote monitoring and data integration, as well as to be able to carry out an agile analysis of the evolution of the latter.
Other measures they propose are the incorporation of expert patients with this pathology, as well as health professionals, in the design and decision – making of the new healthcare model for the management of this disease; as well as the strengthening of unified criteria for the treatment of diabetes, regardless of where the medical act occurs.
Likewise, these experts also advocate showing the savings and investment that an individualized and correct monitoring of diabetes supposes, which contributes, on the one hand, to reducing the appearance of complications in the short and long term and, on the other, to reducing both costs and healthcare pressure.
On the other hand, according to these specialists, it is also necessary to establish an online and face-to-face model, for which such care would have to be planned and the time needed to prepare and carry out telematic visits should be established. In this regard, these should be considered equivalent to face-to-face in terms of effort on the part of health professionals.
Likewise, they consider it necessary to have remote monitoring mechanisms, such as interstitial fluid glucose monitoring systems, in order to ensure the effectiveness of teleconsultation. In this area, they also propose to integrate data from remote monitoring devices into the patient’s electronic medical record, making the information generated by the different tools and platforms available to healthcare professionals in a common repository.
