18-OR: Implementation of a Hybrid Screening and Monitoring Model in Colorado—Autoimmunity Screening for Kids (ASK)

Abstract

Objective: Screening for type 1 diabetes (T1D) in the general population is becoming more accessible. We examined facilitators and barriers to implementing a hybrid screening and monitoring model utilizing telehealth in Colorado. Methods: Qualitative, semi-structured interviews to define key factors for establishing a telehealth T1D screening and monitoring program were conducted with 14 parents who had a child identified as high risk of developing T1D participating in the ASK study and 10 ASK providers. Purposeful sampling was used to identify participants. Interviews explored opinions regarding a hybrid model that includes cloud-based glucose monitoring, education via telehealth, parental placement of continuous glucose monitors, home finger pokes to check for islet autoantibody status and glucose, use of home oral glucose tolerance tests, as well as engagement of primary health care providers for monitoring across stages of T1D. Results: Between 1/2020 and 9/2022, 133 participants in the ASK study participated in the ASK hybrid screening and monitoring model completing at least two remote telehealth visits. Thematic analysis from parent interviews (n=14; 71% female, 79% had no family history of T1D) identified two key themes:1) appreciation for flexibility offered through hybrid monitoring, and 2) importance of coordinated communication between provider team regardless of location. Provider interviews (n=10; 70% female) identified three key themes:1) interest in hybrid model that was not time intensive to implement, 2) access to monitoring and educational resources to support clinic team and patients with remote care, and 3) for rural areas, potential constraints regarding access to consistent broadband that could interfere with telehealth visits. Conclusion: The use of a hybrid care model may be warranted to support clinics and families with screening and monitoring for early stages of T1D toward translation into standard practice regardless of location. Disclosure C.Geno rasmussen: None. K.A.Bautista: None. R.Karban: None. R.Bedoy: None. D.Felipe-morales: None. M.Rewers: Research Support; Provention Bio, Juvenile Diabetes Research Foundation (JDRF), Hemsley Charitable Trust, Dexcom, Inc., Janssen Research & Development, LLC. Funding The Leona M. and Harry B. Helmsley Charitable Trust (2109-04818)