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Will telehealth impact diabetes care for Medicare patients?

(Photo of Dr. Lizheng Shi, endowed Regents Professor and interim chair of the Department of Health Policy and Management at Tulane)

How do you care for a chronic disease when visiting a doctor in person could be risky or not an option  at all due to the COVID-19 pandemic? That’s a concern for many people living with diabetes now.

Researchers at Tulane University School of Public Health and Tropical Medicine, the Louisiana Public Health Institute (LPHI), Ochsner Health System and Pennington Biomedical Research Center are studying how telehealth practices are being adopted and implemented during the pandemic for patients with diabetes on Medicare.

The Patient-Centered Outcomes Research Institute (PCORI) awarded the team $421,629 as an enhancement to an existing grant awarded in 2016. That grant was designed as a series of natural experiments to evaluate targeted health policies to prevent diabetes and its complications.

Louisiana has among the of highest prevalence diabetes, hypertension and other chronic conditions in the U.S. These same conditions increase patients’ risk for severe COVID-19 illness and death.

In early March, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services during the pandemic. As a result, Medicare beneficiaries can receive a wider range of services from their doctors without having to visit a healthcare facility.

The research team will use their existing relationships, through the Research Action for Health Network (REACHnet), to examine availability and scope of telehealth services offered by Louisiana providers. The team will also look at how patients with diabetes used the services.

Researchers will study whether telehealth patients experienced better diabetes management than peers who are not offered telehealth services or who do not have the means to participate.

“This enhancement will contribute timely information to better understand health systems’ responsiveness and challenges in terms of telehealth delivery for high risk populations including patients with diabetes and cardiovascular disease,” said Dr. Lizheng Shi, endowed Regents Professor and interim chair of the Department of Health Policy and Management at Tulane. “We will also focus our analyses on health disparities and health literacy in the access to telehealth.”

“The COVID-19 pandemic has caused changes and adaptation within the healthcare landscape,” said Dr. Beth Nauman, managing director of LPHI and co-principal investigator of the study. “This study will generate evidence to inform better strategies for patient-centered care and enhanced support services.”.

The study was initially funded in June and researchers plan to perform an interim analysis on study outcomes around November of this year, with a final study report to be released in the summer of 2021.