Abstract

Chronic disease management is over whelming the Unites States Healthcare System. Often the barriers to care in chronic disease include limited access, inadequately trained caregivers, travel costs, lack of real time data, and the limitations of office time for education. The novel use of digital health seeks to optimize care and address many of the social barriers to quality care. At the same time, the new requirements of health care regulation in the United States, challenge health care organizations to improve population management. The Distance Health team and Shared Medical Appointment (SMA) team, in an effort to positively affect population management of type 2 diabetics across practices, developed a work effort to compare two telehealth platforms for the delivery of group education and medication management. The utilization of smart devices for real time data collection in the management of diabetes and associated chronic diseases was also implemented. The team sought to compare the American Well platform with the TruClinic platform for delivery of group education translating traditional SMA in office visits to virtual delivery engaging multiple patients. The participants were identified through care gap registries, internal medicine provider referrals for diabetes education and patient self-referral. The patients were randomly assigned. A family nurse practitioner with CDE certification followed and engaged the patients monthly in SMA education sessions through one of the digital platforms, over a 4 month period using change in A1C and qualitative patient satisfaction data to review SMA engagement, improved disease state and platform usability. The process from patient identification, digital consent, appointment invitation, and qualitative data review of provider satisfaction, patient engagement, and A1C improvement is described in detail comparing the two platforms’ usability. Disclosure M. Faiman: None. L.K. Hustak: None. A.J. Maggiore: None. M. Sumego: None.

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