Modified Patient Intake Process and its Effectiveness in Timely Access to Patient Data in Endocrinology Telemedicine Visits

Abstract

Specific Aims: To determine the frequency of timely and accurate completion of a chart preparation checklist (CPCL), to assess the frequency of timely access to insulin pump and/or CGM data and lab results during the telemedicine visits, and to evaluate the relationship between timely and accurate completion of the CPCL and timely access to data and results. Methods: This was a descriptive, observational, and retrospective cohort study conducted via chart review of clinic visits at the Endocrinology and Diabetes Clinic at Banner - University Medical Center South. Telemedicine clinic visits from June 1, 2020 to December 31, 2020, in which patients ≥ 18 years old with diagnosis of diabetes were seen for diabetes management were included. A CPCL was used as a modified patient intake process for telemedicine visits. In this checklist, patients were asked if they used an insulin pump and or a continuous glucose monitor (CGM), what brand, and if they had recent labs drawn to be able to obtain and have those data available for the visits. CPCL completion and availability of data were deemed to be timely if done/accessible by the time of the visit. CPCL was considered accurate if patient has the noted devices or has had recent labs drawn. Descriptive statistics were used to assess the specific aims as noted above. Results: Out of 293 clinic visits, 80 were included in the analysis. Only 17 (21%) had a completed CPCL by the start of their visits and 31(39%) of the visits had an insulin pump and/or CGM. Of those 31, 19 (61%) had timely data availability with 15 (48%) of those being from visits without CPCL. Of the total 51 patients with laboratory results, 42 (82.3%) had those results uploaded in the chart in a timely manner. Conclusions: This study suggests that CPCL utilization does not have added benefit in timely access to insulin pump/CGM data. As per very low CPCL utilization and the study limitations, further investigations are needed to assess the effectiveness of CPCL and if the checklist and its use need to be revised.