A comparison of characteristics of patients seen in a tertiary hospital diabetes telehealth service versus specialist face-to-face outpatients

This study aimed to describe patient-related characteristics of those attending the diabetes telehealth service delivered from a tertiary hospital and compare these with the characteristics of patients attending face-to-face visits at the same hospital’s diabetes outpatient service. This analysis could inform diabetes telehealth service improvements. To our knowledge, there has been no prior evaluation of a diabetes telehealth service in Australia. A cross-sectional survey was conducted as part of the Australian National Diabetes Audit in May 2016 for all patients attending the diabetes telehealth service and diabetes outpatient service. The diabetes telehealth service was serving a greater proportion of females, indigenous people and patients with a longer mean duration of type 2 diabetes mellitus. Type 2 diabetes mellitus patients in the diabetes telehealth service group had a higher average glycated haemoglobin of 9.1% (76 mmol/mol) vs 8.1% (65 mmol/mol) in the diabetes outpatient service group. The diabetes telehealth service had more people with initial visits; had higher self-reported smoking rates in type 2 diabetes mellitus patients; and had adequate access to allied health supports as recommended for diabetes management. Diabetes telehealth service patients had more complex diabetes as evidenced by a higher proportion of indigenous clients, higher glycated haemoglobin and longer mean duration of diabetes.

[1]  D. Aron,et al.  Telemedicine consultation for patients with diabetes mellitus: a cluster randomised controlled trial , 2017, Journal of telemedicine and telecare.

[2]  K. Lucas,et al.  Establishing a centralised telehealth service increases telehealth activity at a tertiary hospital , 2015, BMC Health Services Research.

[3]  Farhad Fatehi,et al.  Patient satisfaction with video teleconsultation in a virtual diabetes outreach clinic. , 2015, Diabetes technology & therapeutics.

[4]  Yun-kai Zhai,et al.  Clinical- and Cost-effectiveness of Telemedicine in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis , 2014, Medicine.

[5]  J. Soar,et al.  Uptake of telehealth services funded by Medicare in Australia. , 2014, Australian health review : a publication of the Australian Hospital Association.

[6]  S. Nepal,et al.  Barriers for delivering telehealth in rural australia: a review based on Australian trials and studies. , 2014, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[7]  Farhad Fatehi,et al.  A clinimetric study of outpatient diabetes consultations: the potential for telemedicine substitution. , 2014, Diabetes technology & therapeutics.

[8]  A. Ribeiro,et al.  Telemedicine Application in the Care of Diabetes Patients: Systematic Review and Meta-Analysis , 2013, PloS one.

[9]  Farhad Fatehi,et al.  Telemedicine for clinical management of diabetes – a process analysis of video consultations , 2013, Journal of telemedicine and telecare.

[10]  S. Bursell,et al.  Telehealth in Australia: an evolution in health care services , 2013, The Medical journal of Australia.

[11]  F. Pouwer,et al.  Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES--Australia. , 2013, Diabetes research and clinical practice.

[12]  W. Polonsky,et al.  When Is Diabetes Distress Clinically Meaningful? , 2012, Diabetes Care.

[13]  R. Glasgow,et al.  Development of a Brief Diabetes Distress Screening Instrument , 2008, The Annals of Family Medicine.

[14]  W. Polonsky,et al.  Assessing psychosocial distress in diabetes: development of the diabetes distress scale. , 2005, Diabetes care.

[15]  S. Perry Reports from the Australian Institute of Health and Welfare (AIHW) , 1995, International Journal of Technology Assessment in Health Care.

[16]  D. McKenzie,et al.  The construction of a brief case-finding instrument for depression in the physically ill , 1994 .

[17]  N. Gusi,et al.  The EQ-5D Health-Related Quality of Life Questionnaire , 2010 .