Technology was the tipping point in it all: insulin pumps, glucose meters and continuous glucose monitoring started it all for us. Pattern management is the way to take the numbers and create actions to correct the abnormal and proactively develop a plan to anticipate the future. By looking at these patterns, we determine changes to the treatment plan. Medication, food, physical activity, stress, and illness all contribute to changes in glucose management.
For me, it started with patients bringing in their print-outs or their glucose logs. I was looking for the highs and lows, asking what could be a cause of it and what can we could do do to treat it and prevent it. Later it got more complicated, as a dietitian I needed to work with patients to determine the eating pattern that best produces desirable outcomes. Some patients were ready to improve their eating, while some were not, and consequently we adjusted insulin, medications or physical activity to existing eating habits…healthy or not.
Pattern management takes time. It requires we communicate with our patients either weekly or daily. The goal is to determine if each weekday is similar, if evenings and weekend routines have a pattern. It requires honesty and willingness to communicate on both ends – patient and clinician. It requires a real time response to the challenge presented as well as celebrate the normalcy of it all.
The response rate to a patient contacting us creates another challenge. Typically, calling a patient within 24 hours is a norm but for sure not always real time. Consequently, being more reactive to the challenge. As a result, patients are getting more real time support from eHeath like Internet, social media and online communities, telehealth, mHealth (mobile apps and wearable devices) and electronic health records with a patient portal access.
Eighty-seven percent of all American adults from every demographics and age range are using the Internet as per Pew Research Center. Three out of four American Internet users use some form of a social media. Older adults and people of color are adopting eHealth at a faster pace than the general population.
This is where my personal journey with helping patients with eHealth has continued: helping them to use it in a way that it improves their well being, not to complicate it. Also, making sure that my role as a clinician will not be replaced with access to the Internet.
As diabetes educators, we are becoming more of case managers, helping patients to choose technologies, information and interpretation strategies that best fit their needs. We are becoming coaches who inform, inspire, motivate, monitor progress and celebrate successes as well as address challenges. Our role is no longer to just educate but to take the complex information and create a positive change.
What is your personal journey with eHealth? What are your challenges and opportunities?