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Telemedicine via Continuous Remote Care: A Proactive, Patient-Centered Approach to Improve Clinical Outcomes

HumanInsight Telemedicine via Continuous Remote Care: A Proactive, Patient-Centered Approach to Improve Clinical Outcomes

JMIR Diabetes. 2021 Aug 31. doi: 10.2196/23646. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has revolutionized healthcare for patients and providers alike. Telemedicine moved from the periphery of our healthcare system to center stage more rapidly than anyone could have envisioned. In order to swiftly deliver virtual care during the pandemic, we have replicated our episodic care paradigm that has been used for decades. However, we can and should do more with the connectedness and convenience that telemedicine technology makes possible. An option for a more patient-centered telemedicine experience is Continuous Remote Care (CRC). This approach includes data-driven, proactive outreach to patients, which in contrast to today's episodic, reactive, patient-initiated care, represents a decisive step forward. CRC is ideally implemented in chronic diseases such as diabetes, where patients need assistance with medication dosing, acute care issues, and lifestyle changes multiple times per day. In these cases, patient-driven episodic care falls short of day-to-day patient needs. Our CRC was created with multifaceted, holistic patient support, ranging from medication adjustments to transformational lifestyle changes. Physicians are alerted by algorithmic prioritization to situations that may be a safety concern or where medications need to be adjusted based on incoming biomarkers, allowing proactive outreach to patients. Health coaches operate in pods so that many specialties (nursing, behavioral health, dietician, exercise physiologist) allow for specialized and personalized care for each individual using the same prioritization system as physicians to guide lifestyle interventions. Barriers to widespread use include appropriate CPT codes for proactive outreach and lack of universal connectivity, especially in vulnerable patient populations. A Continuous Remote Care paradigm, beyond merely providing the greater convenience and lower cost of episodic telemedicine, brings the opportunity for improved patient care and outcomes.

PMID:34505578 | DOI:10.2196/23646

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