Abstract: The Division of Pediatric Endocrinology at Stanford Children’s Health has been working closely with the Division of Information Systems to develop a diabetes telehealth program. Standard of care in diabetes care requires 4 clinic visits per year. Some patients travel over 300 miles each way to obtain diabetes care. This can result in missed school days for children, missed work for caregivers, and transportation costs. Telehealth has the opportunity to reduce the burden of diabetes care for patients and their caregivers. We offered telehealth as an alternative to clinic visits for patients wtih high speed internet access and a willingness to download their diabetes devices. We performed a time saved and costs saved analysis for patients who had telehealth visits in both the diabetes clinics and the diabetes behavioral health clinics. Our diabetes behavioral health team offered telehealth to select patients felt to be appropriate by their primary psychologist.

A total of 92 diabetes telehealth visits and 31 diabetes behavioral health visits performed in the last year. There were 26 patients who had multiple telehealth visits. Patients who performed telehealth for clinic appointments traveled for greater distances (211 miles/visit) compared to those who had diabetes behavioral health appointments (105 miles). Patients who elected telehealth in place of a diabetes clinic visit saved an average of 6.2 hours of travel time and $122/visit. Those who elected telehealth for behavioral health visits saved an average of 2.9 hours of travel time and $61 per visit. Individuals who are typically seen in our behavioral health clinics live closer to our clinic site since they are often seen weekly to monthly, which may explain some of the differences in costs saved and time saved between the two groups.

Telehealth has the opportunity to decrease the burden of chronic disease management. In our experience, replacing clinic visits with telehealth visits resulted in significantly decreased travel time which led to less missed school for children and missed work for caregivers. We were also able to deliver mental health services to patients via telehealth which also resulted in cost and time savings.

Describe the new knowledge and additional skills the participant will gain after attending your presentation.: 1. Understand the benefits of telehealth visits for patients
2. Understand the workflow for setting up successful telehealth visits

Authors:

Priya Prahalad (Presenter)
Stanford University

Natalie Pageler, Stanford University