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Analysis

Pandemic Fuels Telemedicine Growth at NYU Langone

By John Commins  
   September 21, 2020

NYU Langone's Center for Diabetes and Metabolic Health was among the nation's first outpatient diabetes practices to switch primarily to remote visits as the pandemic accelerated.

When government and private insurers this spring eased restrictions on telemedicine coverage in response to the pandemic, NYU Langone jumped to expand telemedicine access for the health system's diabetes patients.

"With diabetes emerging as a major risk factor for COVID-19, we felt it was crucial to spare our patients the potential exposures that in-person visits would entail," said Lauren H. Golden, MD, director of Langone's Center for Diabetes and Metabolic Health.

Pre-pandemic, Langone's outpatient diabetes practice had the technical infrastructure for video visits and was training patients to monitor their blood sugar and insulin dosing from personal devices to reduce office visits.

Because of that prearrangement, Golden said, the transition to virtual visits went smoothly.

"We sent patients links to software downloads, and most of them were able to figure out how to transmit readings to us online," she said. "We emailed logs to the others, so that they could fill them out and send them back."

The transition to virtual care came as many of the center's clinicians were working in the health system's "COVID Army," The video visits allowed the remaining clinicians to manage the outpatient services of their colleagues.  

A small crew of clinicians and support staff stayed in the office part-time for occasional in-person visits, but by the last week of March, the vast majority of visits were taking place via video.

Langone's use of telemedicine for diabetes management relies on a multidisciplinary approach, Golden said, with endocrinologists, nurse practitioners, diabetes educators, and nutritionists focused on treating the whole patient. In fact, Golden said, video visits are a better access point for diabetes management because much of the regimen centers around lifestyle coaching.

"Because visits don't require travel, patients can check in more frequently than they would have before. Many have told us they're thankful for that enhanced access to care," Golden said.

The video visits also allowed Langone clinicians to support patients’ evolving needs and help them cope with emotional turmoil prompted by the pandemic and social isolation.

"One of the greatest stressors during the pandemic has been dealing with the unknown," Golden said. "We've found that patients benefit from focusing on what they can control, including their own role in staying healthy. It's empowering for them to understand that regulating their blood sugars not only mitigates their diabetes, but also puts them in a better position if they do become infected with the coronavirus."

"If people need a new exercise routine, we’ll send links to workout videos tailored to their age and fitness level," Golden said. "We talk to them about yoga, meditation, and other stress-relieving techniques, and help them find resources online. If they have unmet mental health needs, we try to arrange treatment for those issues as well."

The pandemic is waning in New York City – for now – but Golden said the lessons learned will not be forgotten. In-person visits are returning, but Golden expect telemedicine to remain a popular option with patients post-pandemic.

"The pandemic has shone a spotlight on the things that were or weren't working for people previously," she said. "We want every person we care for to take something positive from this crisis and use it to improve things when we return to whatever the new normal is going to be."

“With diabetes emerging as a major risk factor for COVID-19, we felt it was crucial to spare our patients the potential exposures that in-person visits would entail. ”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

The transition to virtual care came as many of the center's clinicians were working in the health system's "COVID Army."

The video visits allowed the remaining clinicians to manage the outpatient services of their colleagues.  

A small crew of clinicians and support staff stayed in the office part-time for occasional in-person visits, but by the last week of March, the vast majority of visits were taking place via video.

Langone's use of telemedicine relies on a multidisciplinary approach with endocrinologists, nurse practitioners, diabetes educators, and nutritionists focused on treating the whole patient. 

Video visits also allowed Langone clinicians to support patients’ evolving needs and help them cope with emotional turmoil prompted by the pandemic and social isolation.


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