Telemedicine for Diabetes Management - Research Paper Example

Telemedicine Impacts or Benefits on Diabetes Introduction: A. Diabetes Type 2 Prevalence, Incidence: Diabetes is a disease caused as a result of troubles that arise in the use of insulin by the human body and, thus, disturbs the level of sugar in the body. When the levels of sugar or glucose become very high leading to persistent problem, then it is referred to as Type 2 diabetes. The fat, liver and muscle cells of a person suffering from this disease stop working towards insulin reactions making blood sugar unable to get stored in these cells in the form of energy. The Type 2 diabetes has been found to occur gradually within the body and is a lifelong disease (Type 2 diabetes, 2011). B. Diabetes Management Best Practices: The treatment of diabetes necessitates care of high quality and effective management that might be provided by efficient human resources. Self management education and proper support are significantly required for best practices against diabetes. This initiates the need for more health workers who can contribute in the educational programs that would include education and management of the disease by individuals (Promoting Best Practice in Diabetes Education, 2011). C. Health Literacy Disparities: However, a major cause of concern is associated with the high rates of illiteracy among the minority or poor people in regard to diseases and their prevention. More diversity is required among health care providers and the hiding of diseases by individuals needs to be overcome. These factors creating the discrepancies in the health literacy lead to poorer health than any other reason (Disparities in Health Literacy, 2004). D. Bridging the Gap with Telemedicine: The advancement of technology has come up with the technique of telemedicine that provides with medicinal help through the use of telephone or other communication processes. Electronic communication is utilized to substitute the diagnosis, treatment and care of patients through telemedicine. In present time, the use of telecommunication being highly relevant and increasing, the scope of telemedicine can be expected to improve further over the years (Makin, 2011). This particular study is focused on the impacts or benefits of telemedicine on the diagnosis and treatment of diabetes. I. Telemedicine Uses for Chronic Disease Management: A. Improved Access to Care (A2C) with Remote Monitoring: The concept of A2C has been initiated in order to improve the status of the individuals suffering from chronic diseases, the AIDS or diabetes for instance, who do not receive proper treatment. The process acts by providing such individuals with greater attention and care towards improving their health conditions without being ignored (Access to Care (A2C), n. d.). With the initiation of the technology of telemedicine, this process has been greatly improved. Clinical management of chronic diseases has been made possible through the use of telehealth remote monitoring techniques. Considering the case of the United States, there are millions of people who are patients of Diabetes Mellitus (Stachura & Khasanshina, n. d., p. 9-11). For these patients the primary treatment includes the insulin therapy that enables the normal control of sugar level in the body. This therapy is known to give effective results accompanied with lesser complications and costs. Improvements through telehealth care or remote monitoring have been obtained since the technique assists individuals in gaining proper knowledge regarding the disease as well as the self-management processes that they can follow for their effective treatments. The positive results are gained through the improved psychology of the patients concerning the disease thus improving their self-monitoring. This would include monitoring the blood glucose levels and accordingly taking preventive measures such that the patients can be protected from the high levels of glucose (Stachura & Khasanshina, n. d., p. 9-11). B. Improved Patient Compliance/Adherence: The technique of telemedicine has the ability to improve the logic and reasoning of patients in relation to the disease and its care. The process of communication enhances the level of confidence of the individuals on the technique and patients are also well-informed about the details of the disease and its treatment. Telemedicine improves the access of the patients to specialists and the relation is promoted more towards a positive level of confidence. The greater number of interactions influences an understanding between the two parties that assists the patients to believe in the motives of the technique and thus learn the self management practices (Po, 2000, p. 264). The practice of telemedicine is significantly focused on improving the care provided to the patients. Not only are the advanced technologies being used for the purpose, but the difficulties of the patients, for example in reading or following instructions, are also effectively considered. Moreover, the process tends to motivate the patients towards self-management, a process that increases patients’ adherence or compliance with the program. Studies have obtained that patients following the telemedicine techniques have obtained reduction in their high levels of glucose in the body and proved capable of improved self-management by adhering and complying with the program successfully (Po, 2000, p. 265). C. Improved Patient Self-Reliance: When the technology of telemedicine is applied for the treatment of diabetes, the process allows direct interaction between the patients and the healthcare service providers who might also be the specialists. Such interactions being quite frequent in nature, the patients feel confident to clear their doubts and also in following the practices that the healthcare service providers suggest. With improvements in these conversations, the patients get more adhered to the programs of self management thus achieving improved control over their blood glucose level as have been obtained through studies. Improved attention and support from the health care providers enable the patients to be more confident and, thus, rely more on their own selves towards betterment of their health status (Po, 2000, p. 264). Moreover, in the process the knowledge of the patients is also improved and, thus, they become capable of gaining enhanced skills of managing their diabetes disease themselves. The telemedicine technique involving monitoring measures can keep the providers aware of the steps undertaken by the patients and guide them accordingly. Feedbacks and advices can thus effectively be exchanged between the two parties. Also, with improved relationships, the management goals invite the cooperation of both the parties together that provide the patients with a sense of responsibility as well (Po, 2000, p. 265). Thus, as a whole, the patients feel self-reliant and confident in managing and improving their health from the severe effects of diabetes. D. Reduced Health Disparities: Health disparities have been significantly found in the diabetes disease among cultural minorities associated with the care quality and the outcomes of health. Disparities lead to higher rates of diabetes incidents, poor levels of control or management as well as several obstacles in improvements. The lower value of care has been reflected as one of the most significant factors affecting the disparity among the individuals (Peek, Cargill & Huang, 2007). It can be realized that with increasing rates of the disease, measures are tried to be considered to reduce these disparities. The use of telemedicine proves to be beneficial to great extents in this regard. Since telemedicine makes use of the communication technology and directly interacts with patients educating them regarding the disease as well as providing them with suggestions for self management and treatment, it is an essential tool to affect the minds of the patients across the world towards a cooperative approach of reducing the severe effects of the disease. With such efforts, telemedicine proves to be an effectual measure towards reducing disparities associated with diabetes disease. A study conducted by the United Health also reflected on the capability of telemedicine to reduce health disparities related to chronic diseases like diabetes and thus lessen the differences between rural and the urban and suburban areas (Terry, 2011). E. Improved Patient Wellness: Studies reveal that the use of telemedicine has been able to positively affect the treatments of several diabetic patients. Patients who were known to undergo the technique of telemedicine have been highly satisfactory. The education on the disease and its treatment and the self-management practices of individuals as explained by the program through the use of communication technologies have proved to be effective in controlling the high sugar or glucose levels in the blood of patients. The wellness of the patients can be reflected from their being comfortable with the teleconferencing or the successful relationships they had with the healthcare service providers. Moreover, since physical contacts are absent in the process, patients are more comfortable with confiding in the technique and achieve the positive effects of treatment (Izquierdo et al., 2003, p.1002-1007). Another study that assessed the effect of telemedicine digital retinal imaging strategy on diabetic retinopathy rates of screening reflected that screening rates had improve with the techniques of telemedicine. Diabetic retinopathy that causes trouble to eye sights in the adults in particular could be provided with improved measures of treatments through the telemedicine technology, digital imaging technology. Although the use of the technique is still not widespread, the positive results of the process have been obtained (Taylor et al., 2007, p.574-578). Thus, this section reflects on how telemedicine could and can spread wellness among the diabetes patients. II. Telemedicine Barriers/Limitations: A. Computer Literacy Disparities: Computer literacy has been found to be highly significant in the success of the use of telemedicine. However, in the developing countries the infrastructures are not efficient enough to educate people on computing which, on the other hand, prove to be a major barrier to telemedicine. The effective use of the current technology of the Internet is also lacking in many developing countries. Barriers associated with computing arise from the lack of sufficient supplies of power, unavailability of proper internet connection apart from large cities only, as well as equipments for information and communication not suiting to different climatic regions. Moreover, often the connections are not reliable in nature, viruses are obtained in the computers, bandwidths are limited that also create difficulties for the telemedicine processes (Telemedicine Opportunities and Developments in Member States, 2010, p. 18). In regard to the above mentioned problems, there occurs significant need of skilled and expert workers who can manage these challenges and effectively implement the programs of telemedicine in a region. However, lack of such computer workers creates more hindrances to the process. With the absence of such skills, the educational programs are not possible to be implemented effectively (Telemedicine Opportunities and Developments in Member States, 2010, p. 19). The use of computers can be understood to be highly relevant in the processes of telemedicine. If computer workers lack literacy, it is no doubt a huge barrier for the technology particularly in developing countries. B. Remote Access: The lack of proper regulations, inefficient systems of payments, and concerns for clinical standards act as barriers or limitations in the use of the techniques of telemedicine across remote areas. Three major human rules have been obtained to create the barriers. These include the financial policies, the regulatory systems, and the cultural aspects. The first two of these factors have been found to be more affecting than the third issue. Difficulties arise with the cost affordability in getting hold of licenses for every remote places that telemedicine would like to serve. Moreover, governments do not fully accept and support the processes (Keyser, 2012). Hence, the healthcare providers are forced to encounter with the financial troubles, which if not being able to be resolved, remain as barriers for the process to reach remote areas. Cultural limitations also affect the process since several specialists are not comfortable with the contemporary techniques of telemedicine but rather prefer to follow the traditional methods of treatment only. Effective need and desire might be lacking in many cases followed by an unsuccessful implementation of the telemedicine programs in the remote areas (Keyser, 2012). Therefore, it can be realized from this section of the study that the access to remote areas is primarily hindered by the lack of desire and cooperation that if the governments of different locations focus on might resolve these factors. C. Security: Security issues related to the use of telemedicine services primarily occur with the privacy of the patients and their information. Different legislative rules as under the jurisdiction of courts have taken concern over this subject. When telemedicine services plan for a program for the purpose of diagnosis and treatment of diseases like diabetes, concerns associated with the questions and details of patient privacy are a must to be considered. Often it might be obtained that the patients do not have the options or rights to select their own preferred team of healthcare service providers or the specialists for treatments. Thus the control generally remains with the service providers that might create doubts in the minds of the users in regard to their privacy maintenance by the team of workers (Overcoming the Psychological Barriers to Telemedicine: Empowering Older Americans’ to Use Remote Health Monitoring Services, 2007, p. 6). Concerns of security also arise since such workers might be involved in the process of conferencing or the treatment methods which the users cannot visibly see. Guarantees are often not provided for the security or protection of the patient information that are electronically registered or stored by the healthcare service providers. Thus, these factors create difficulties and barriers in the telemedicine processes since a balance needs to be maintained for both privacy and safety along with effectively providing the treatment methods (Overcoming the Psychological Barriers to Telemedicine: Empowering Older Americans’ to Use Remote Health Monitoring Services, 2007, p. 6). III. Telemedicine Adoption: Not much information is available regarding the adoption of telemedicine as part of routine healthcare services. However, initiatives have been obtained in North America or other parts of the United States as well over several years. The widespread effects of these initiatives have not been reflected although valuable results were obtained within the settings of particular organizations. Studies have been found to assume that the adoption of telemedicine over the years has been similar to the adoption of other technologies related to health. Factors like relative advantage, compatibility, trailability, observability and complexity lead to lesser rates of adoption than what can actually be predicted. Several theories, including Theory of Planned Behavior and Theory of Interpersonal Behavior, have been used for the determination of the telemedicine adoption. The qualitative analysis have obtained that certain requirements are necessary for successful adoption of telemedicine that include positive associations with policy makers, thriving structural incorporation, cooperative working teams, and integrated professional skills, knowledge and practice (Zanaboni & Wootton, 2012, p. 4-5). IV. Future Innovations in Telemedicine: The rising trends in the use of telemedicine practices and the federal studies have focused on the change that can be expected in the future of healthcare. Presently, the use of telehealth has been mostly concerned with the education of diseases and their treatments. With the passage of time, it is expected that the use of telemedicine would support a complete change in the field of diagnosis and treatments of diseases. The rates of telemedicine uses are expected to increase with the increasing support of acts like the American Recovery and Reinvestment Act (ARRA) and Health Information Technology for Economic Clinical Health (HITECH) that are focused on improved investment policies for the advanced future of telemedicine practices. The future is also expected to witness the integration of telehealth, and electronic health records. The telehealth organizations prevailing currently in the world had initiated their efforts from scratch and proved to be successful till date that hints towards further achievement in another few years across the global world (Thielst, 2010, pp. 2-9). V. Conclusion: The study has been focused on the impacts or benefits of telemedicine on treatments of diabetes. Diabetes being a chronic disease is of serious concern both for the patients as well as for the healthcare service providers. The use of telemedicine being in the process over several years have proved to be significant in the diagnosis and treatment of the disease, along with bringing improvement in patient compliance with the process, increasing their levels of self-reliance, reducing the disparities that prevail between rural and other areas, as well as improving the wellness of the individuals. It has also been obtained that patients have shown their satisfaction and improvement with their associations with the techniques of telemedicine. However, certain barriers are also pertinent with the telemedicine practices as have been learnt from the study. Thus, as a conclusion for the study, it can be said that the improvements of the telemedicine practices and their future prospects reflect that telemedicine has a long way to go in the effective treatments for chronic diseases like diabetes and similar other diseases, provided the barriers are significantly focused and tried to be overcome. References Access to Care (A2C), (n.d.). Retrieved on 25 March, 2012. from: http://www.cdcnpin.org/Display/FundDisplay.asp?FundNbr=4180 Disparities in Health Literacy, (2004). American Public Health Association. Medscape. Retrieved on 25 March, 2012, from: http://www.medscape.com/viewarticle/472719 Izquierdo, R. E., et al. (2003). A Comparison of Diabetes Education Administered Through Telemedicine Versus in Person. Diabetes Care, 26(4), p. 1002-1007. Retrieved on 27 March, 2012, from: http://care.diabetesjournals.org/content/26/4/1002.full Keyser, H. (2012). Barriers to Telemedicine Limit Patient Access to Quality Care. Retrieved on 27 March, 2012, from: http://www.telepresenceoptions.com/2012/01/barriers_to_telemedicine_limit/ Makin, S. (2011). Telemedicine: Bridging Gap Between Technology and Treatment. Retrieved on 25 March, 2012 from: http://ehealth.eletsonline.com/2011/04/telemedicine-bridging-gap-between-technology-and-treatment/ Overcoming the Psychological Barriers to Telemedicine: Empowering Older Americans’ to Use Remote Health Monitoring Services (2007). Retrieved on 27 March, 2012, from: http://www.newmillenniumresearch.org/archive/Telemedicine_Report_022607.pdf Peek, M. E., Cargill, A., & Huang, E. S. (2007). Diabetes Health Disparities. Medical Care Research and Review, 64(5). Retrieved on 26 March, 2012, from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367214/ Po, Y. M. (2000). Telemedicine to improve patients’ self-efficacy in managing diabetes, Journal of Telemedicine and Telecare, 6, p. 263-267. Retrieved on 26 March, 2012 from: http://www.jtt.rsmjournals.com/content/6/5/263.full.pdf Promoting Best Practice in Diabetes Education. (2011). IDF. Retrieved on 25 March, 2012, from: http://www.idf.org/diabetesatlas/5e/promoting-best-practice-in-diabetes-education Stachura, M. E., & Khasanshina, E. V. (n.d.). Telehomecare and Remote Monitoring: An Outcomes Overview. Retrieved on 25 March, 2012, from: http://www.viterion.com/web_docs/Telehomecarereport%20Diabetes%20and%20CHR%20Meta%20Analyses.pdf Taylor, C. R. (2007). Improving Diabetic Retinopathy Screening Ratios Using Telemedicine-Based Digital Retinal Imaging Technology. Diabetes Care, 30(3), p. 574-578. Retrieved on 27 March, 2012, from: http://care.diabetesjournals.org/content/30/3/574.full Telemedicine Opportunities and Developments in Member States. (2010). WHO. Retrieved on 27 March, 2012, from: http://www.who.int/goe/publications/goe_telemedicine_2010.pdf Terry, K. (2011). Telemedicine Reduces Rural Health Disparities, Says United Health. Retrieved on 26 March, 2012, from: http://www.informationweek.com/news/healthcare/mobile-wireless/231002835 Thielst, C. B. (2010). The Crossroads of Telehealth, Electronic Health Records & Health Information Exchange. Retrieved on 27 March, 2012, from: http://thielst.typepad.com/files/crossroads-of-telehealth-white-paper.pdf Type 2 diabetes. (2011). NCBI. Retrieved on 25 March, 2012, from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001356/ Zanaboni, P., & Wootton, R. (2012). Adoption of telemedicine: from pilot stage to routine delivery. BMC Medical Informatics and Decision Making, 12(1), p. 1-9, Retrieved on 27 March, 2012, from: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=7&hid=25&sid=7d94235c-727a-4e72-a706-716c58ae4af5%40sessionmgr15 Read More