Saturday, 23 March 2019

Virtual diabetes clinic has an impact on awareness

ALBANY — Blue Cross and Blue Shield of Georgia launched a different approach to helping its consumers who have been diagnosed with Type 2 diabetes manage their condition and improve their health.

A new virtual diabetes clinic with a smartphone app and monitoring tools, developed by Onduo, is available at no out-of-pocket cost to consumers with Type 2 diabetes who participate in individual and most employer-sponsored insurance plans in the state.

“We see people in the ER with diabetes all the time (asking how to manage it),” Onduo CEO Dr. Josh Riff said. “We think diabetics need support. This disease does not follow an appointment schedule.”

Georgia is the first state nationwide to utilize the virtual clinic. The intention, officials say, is to spark conversations about how lifestyle impacts blood sugar, initiated largely by coaches with whom consumers are connected, so diabetics know why regular blood sugar checks help keep their condition stable.

“We are taking the conversation of technology and bringing it to behavioral change,” Kathy Rowerdink, clinical strategy leader for Blue Cross Blue Shield, said.

Chelsea Anderson, an Albany woman who uses the clinic, said she got connected to the tool through a postcard that came in the mail. She has been using it for roughly two months.

“It was really easy to set up,” she said.

The clinic combines a smartphone app, wearable devices and on-demand expert support so that diabetics can see spikes and patterns in their glucose readings and get advice to guide their choices at critical moments during the day. Consumers who participate receive a connected blood glucose monitor, an at-home A1C kit and test strips.

Those who qualify can also receive a continuous glucose monitor, a small device worn on their body that reads glucose frequently and gives a picture of what their sugar levels do throughout the entire day as it relates to the choices they make concerning food, activities and medications.

“They can take a picture of the food and put it into Onduo system,” Rowerdink said.

Participants in Onduo’s virtual diabetes clinic can learn more about their body’s response to meals, medication and exercise by tracking their glucose readings in almost real time and seeing patterns that could explain the spikes and dips in their reading numbers. Consumers have ongoing access to a care team — the coaches as well as diabetes educators and doctors — for support in managing their diabetes.

“Instead of a one-size-fits-all, this can have a really customized approach for the individual,” Riff said.

Anderson takes steroids every day for another medical condition and developed Type 2 diabetes from the medication. She was not measuring her blood sugar regularly, and ate just about anything she wanted. The clinic, through its reminders and meal and exercise logs, have helped her to remain accountable.

“It makes me do it (the blood sugar checks) every day,” she said.

Anderson’s coach checks in with her daily, and she is able to see the trends in her blood sugar levels. She said the kit contains everything that is needed, and the blood sugar readings are logged automatically.

“It is stored for you so you don’t have to write everything down,” she said. “The lancing device, you can adjust it so it doesn’t stick you too hard or too deep.”

Anderson is complimentary of her coach’s ability to do her job.

“She is great,” she said. “She is very respectful of my time. If I haven’t done what I need to do, she makes sure I do it.

“It is helping me to have a better understanding of what I was eating (to contribute to) high blood sugar. Once I eat certain things, and I see that it went high or I see it increase, I know that is something I need to eat in moderation.”

Now, Anderson said she feels good, and that a tool like this can help make a big difference in terms of awareness and preventing complications in the long run.

“I’ve had diabetics in my family when I was younger,” she said. “They didn’t understand anything other than they had it and needed to take insulin.

“Definitely give it (the clinic) a try.”

The support system offered by the clinic is meant to ensure urgent issues are resolved before the appointment with the endocrinologist six months later. Consumers can talk or text their coaches when something does not feel right, so overall management of their condition is improved.

This can be of particular importance in a rural area where there is not immediate access to a health care provider, the individual’s provider is too overwhelmed to provide the necessary level of care or the presence of a “food desert” makes healthy food less accessible than in urban areas.

“If they stay in a well-managed range, they have a (better quality of life),” Rowerdink said. “They are not fixing the symptoms, but they are able to understand a way to live life more effectively. They see reduced costs and improved quality of life.”

Indeed, there is an effort to cater to the needs of a rural population.

“We are mapping out endocrinologists. We look at Albany, and there are a handful but a number of diabetics,” Rowerdink said. “We definitely want to make sure we have quality of care.”

Riff said the idea is to assist the primary care doctors rather than replace them.

“All care should go through primary care, we just supplement,” he said.

The Onduo CEO added that feedback so far has been positive, particularly in terms of increased awareness.

“The most important things they are learning is how to control it,” Riff said. “It’s been really great to see. At the end of the day, it is not a disease that impacts (just) the individual, it impacts those around them.”

Consumers of Anthem Federal Employee Program plans who reside in Georgia can also participate. Rowerdink said Blue Cross Blue Shield is working with provider groups to refer members who would benefit, starter kits are being given to providers and there is the option for consumers to enroll themselves.

To qualify for the virtual diabetes clinic, consumers must have a smartphone, be at least 18 years of age, have a diagnosis of Type 2 diabetes and be part of a participating Blue Cross and Blue Shield employer-sponsored plan. Blue Cross and Blue Shield of Georgia consumers can register at or learn more about eligibility by calling (833) 446-6386.

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