Our experience with telemedicine — What we learned and how to prepare for yours

Each and every one of us has a story of something that changed dramatically because of this pandemic. In fact, there are likely daily stories of adapting to new scenarios with virtual learning, working from home, social distancing, telemedicine visits, and more.

In early March, I was prepping for an upcoming endocrinologist appointment for my daughter, Maddie, after she was diagnosed one year ago. As we were preparing for our visit we were also starting to really grasp the severity of COVID-19, schools were starting to move towards home learning, cities were beginning to issue stay-at-home orders, and we received a notice from our clinic that they were reducing in-person visits. Which was quickly updated to say all but new on-set patients would be seen virtually.

When we learned that Maddie would have a telemedicine visit, we were both relieved and sad. Relieved because we were starting to get wary about being out of the house. Sad because this was our one-year visit, we were looking forward to seeing her entire healthcare team to celebrate what we have accomplished in the past 12 months. We wanted to embrace them and shower them with gratitude for holding us up during some of our hardest days. Instead, we found ourselves preparing to “see” them through a computer screen and we weren’t entirely sure what to expect.

What I learned is that you can still have a meaningful telemedicine appointment but being prepared is key to making sure that everyone has the information critical to making that happen.

After speaking with some other Tidepool team members who recently had telemedicine appointments of their own, we’ve compiled a list of tips to help you prepare for your upcoming diabetes telemedicine visit:

1. Upload your data. It’s almost impossible for your healthcare team to review trends, make updates to settings, and provide valuable medical advice without the data to inform those medical decisions. We recommend attempting to upload your data a few days prior to your appointment to make sure you have everything you need to get all of your data (continuous glucose monitor, insulin pump, blood glucose meter) uploaded. If you are using Tidepool, here is a handy Tidepool Uploader guide to help you with all of your different devices. When it is time to upload for your appointment, most clinics are recommending you upload 24-hours ahead of time. This ensures that your diabetes clinician receives up-to-date information but also allows the clinic time prior to your appointment to get the data to your entire care team.
2. Review your data. Take time to analyze your data and make notes on trends that you see that you want to discuss with your endocrinologist or CDE (Certified Diabetes Educator). The data can tell you a lot, but the whole story isn’t apparent without your notes and feedback about what was happening on particular days, so be prepared to share that anecdotal information. Making notes with Tidepool Mobile is a great way to document important details about what was happening during a particular date and time.
3. Prepare all of your questions. This is important for any appointment but especially with a telemedicine visit where you may not have as much social interaction and your clinician may not have the same opportunity to pull out questions. Being prepared with what you want to talk about will help immensely.
4. Get comfortable with the technology. Your clinic will likely send messages via email or through your patient portal with links to how you will join your telemedicine appointment. These links should include a “test your system” or similar prompt. Be sure to do this at least a day ahead of time so that you can join the meeting and don’t end up turning your telemedicine visit into an IT session.
5. Get clear on follow up steps. If it wasn’t already covered, be sure to understand how you will get prescriptions refilled or schedule your next visit. Do you need to check in after making settings changes? Often these questions are answered at the end of the visit with the office staff, but with a telemedicine visit, take the extra step to make sure you have all the follow up information that you need.

In the end, we were incredibly impressed with how prepared Maddie’s healthcare team was for her visit. They seamlessly passed us from her endocrinologist, to her CDE, nutritionist, and social worker without issue. We were able to connect with every member of her healthcare team and even though they were each in separate locations it was clear they were updating each other behind the scenes so that we didn’t have to repeat answers and details to each person.

For our family, telemedicine won’t replace the emotional support that we receive from our in-person visits, but when COVID-19 has passed I look forward to a combined approach between telemedicine and in-person appointments to offer innovative ways for us to continue to connect meaningfully and innovatively as a team in Maddie’s healthcare.