Telemedicine: the past, present, and future

Pre-2020, telemedicine was not for everyone. With the restrictions that surrounded the COVID-19 pandemic, telemedicine became necessary to provide continuity of care for people living with diabetes. The ability to upload your data at home, regardless of what combination of devices you might use, was of paramount importance. Post-2020, the opportunities to leverage tools and technology when we can’t connect face-to-face to manage diabetes together are gaining momentum. Telemedicine allows diabetes care to stretch across zip codes and county lines and gives patients access to the care they need, even when in-person visits are not an option.

There are wide disparities in access to care, one of which manifests in the unequal distribution of access to endocrinology clinics. The number of people living with diabetes in comparison to the number of endocrinologists, diabetologists, and clinical pharmacists providing care is disproportionate. If we look at the work being done by some of our partner clinics participating in ECHO diabetes, we see that proximity need not limit the kind of care that people living with diabetes receive. We can still have helpful and meaningful exchanges remotely if providers can see diabetes device data and help people make therapy decisions, whether because of threats to public health or because of disparities in access to care.

Limiting diabetes care to in-person visits means that on top of everything else it takes to manage living with diabetes, patients have to schedule appointments, travel to their closest healthcare facility (which can be over 3 hours away depending on where you live) and sometimes wait for hours to see your healthcare team. It means limited access to specialty care, and disruptions to daily life. Telemedicine brings specialized care closer to meeting patients where they are, enabling consultations via video calls, phone calls, or even text messages. It also limits the time spent getting to a facility, and time taken off from work or school. Telemedicine also enables remote monitoring, because we all know diabetes still exists outside of your routine 3 or 4 month visit allowing a more comprehensive view of patients' care in an intuitive and convenient way.

As we look to the future, telemedicine is poised to play an even more significant role in diabetes care with some exciting possibilities including custom clinic dashboards, automation and even machine-learning to help providers be more efficient and personalized in the care they provide. With broader access to diabetes technology, remote monitoring can be more routine and provide better insights for care teams on what is and isn’t working for their patients. In time, it may even become a standard of care for people with diabetes.

The past, present, and future of telemedicine in diabetes care have seen remarkable progress. Technology has revolutionized the way we manage diabetes as people living with diabetes and providers, making care more accessible, convenient, and individualized. While telemedicine still isn’t for everyone, the possibilities of how else it can be leveraged brings hope for a brighter future for diabetes management. At Tidepool, we look forward to continuing to being a resource for providers that lean on telemedicine to provide equitable access to care and to expand the ways in which we serve as a partner to healthcare providers.