Telemedicine is defined as “healing from a distance” in its literal sense. According to the World Health Organization, it is the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment, and prevention of disease and injuries, research, and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.
What are the types of telemedicine?
This can be categorized in accordance with the communication’s mode, timing, purpose, and participants.
1. Communication method:
a) Text: Emails, faxes, short message services, chat platforms like WhatsApp, Google Hangout, and Facebook Messenger, as well as chat-based telemedicine systems.
b) Video: Facetime, Microsoft Team, Zoom, and Skype (iPhone).
c) Audio: Voice over internet protocol, audio programs, and the phone.
2. Communication period:
a) Video, audio, and text are all real-time/synchronous.
b) email is asynchronous.
3. Purpose of consult:
a) First consultation: Any patient seeking consultation for the first time, any follow-up patient who has not seen them in more than six months, or any follow-up patient seeking a consultation for a condition unrelated to the one they previously sought.
b) Patients who have had a follow-up consult within the past six months.
4. Participants in teleconsultation:
d) Healthcare worker to doctor.
Telemedicine and diabetes
Diabetes is a chronic condition that necessitates periodic doctor visits for lifestyle recommendations and treatment alterations. Telemedicine enables patients to consult with their doctor at home, reducing the risk of coronavirus infection and keeping them away from hospitals. Medical professionals can consult with patients, review their medical history, examine their self-monitored blood glucose, and blood pressure charts, and offer advice.
The MOHFW guidelines suggest a video mode of communication for initial consultations; however, the initial consultation for diabetic patients should ideally be face-to-face if at all feasible. This is because telemedicine cannot replace physical examinations unless another healthcare professional physically close to the patient can relay through telemedicine platforms. Telemedicine is used by diabetic patients, according to scientific studies. A pooled cohort (n, 3514) that received telemedicine during a three to sixty-month period was used in a meta-analysis of 35 randomized controlled trials (RCTs) of telemedicine (video, phone, and email) from China. According to this study, the telemedicine group’s HbA1c decreased by 0.37 percent (p 0.001) compared to the controls. A Cochrane review conducted by Flodgren and colleagues  looked at 21 RCTs involving 2768 diabetes patients. In contrast to conventional care alone, these patients received interactive telemedicine (remote monitoring or real-time video) in addition to, as an alternative to, or partially in place of normal care. According to this study, telemedicine patients’ HbA1c levels decreased by about 0.31 percent (p 0.001) compared to controls. Different telemedicine delivery methods were investigated in a recently published analysis of 46 trials that included patients with type 2 diabetes mellitus (T2DM, n, 24000), as well as type 1 diabetes mellitus (T1DM, n, 2052). Both T1DM (0.12-0.86%) and T2DM (0.01-0.113%) individuals in the telemedicine intervention group had an overall mean reduction in HbA1c.
There is little information regarding telemedicine and diabetes in India. In a recently released article, we can see that, they have demonstrated the use of a specially designed mobile van with telemedicine capabilities (using a computer and the Skype video app to transmit retinal images to an ophthalmologist and to consult with a diabetes foot specialist and diabetologist at a tertiary care center) in underprivileged areas of Delhi. In this study, they successfully used telemedicine to test for and treat diabetes.
Telemedicine during Covid 19 for diabetes
During the coronavirus pandemic, getting to the doctor’s office may be difficult if you have diabetes. Your immune system may deteriorate if you have diabetes. If you have an infection like COVID-19, it can increase your risk of developing significant consequences.
Telemedicine is a fantastic method to stay up with your medical care while lowering your risk.
How to Get Ready for Your Consultation
Make sure a telemedicine visit is permitted before scheduling an appointment with your doctor over the phone or online. A lot of medical professionals employ telemedicine for follow-up visits. Most newcomers and certain cases require in-person appointments.
There are several things you can do to make the most of your virtual experience if telemedicine is the correct decision for you:
Understand the technique. To ensure that both you and the person you are meeting with can see and hear each other, check the camera and sound on your computer, phone, or tablet. Your tester can be a friend. Also:
- A program that your doctor wants you to use for the call should be available to you, so be sure of it. Your doctor’s office can help with this.
- Make sure you have a calm, well-lit area for the visit and that your gadget is charged or plugged in.
- Ask family members to refrain from interjecting.
- Use the location in your home with the best telephone reception or the strongest Wi-Fi. Your audio and video will have the greatest quality as a result.
- To find out if telemedicine is covered, contact your insurance. Ask if your co-pay will remain the same if it is. Ask your doctor what the expense would be if it is not.
- Just like you would for a real-life doctor’s appointment, prepare for your virtual visit. Any symptoms or inquiries should be noted down. Before you begin, upload your glucose readings or any other data and have your medications nearby.
What happens during or after your appointment?
While at your appointment and when it is complete, you should take care of a few crucial tasks.
Make a note. After your appointment, you will not receive a printed copy of the directions or a prescription. However, you might be able to print these.
Whether or not your doctor uses telemedicine will depend on the program. To ensure that you remember any instructions from your doctor, you might also write them down. Later, if you have any inquiries, you can email the patient portal.
Additionally, be aware that through their telemedicine program, your doctor can email your prescriptions straight to your pharmacy. Give criticism. You might receive a call asking how it went after your appointment. Inform your team whether everything went smoothly and if there is anything that could simplify future visits.
Telemedicine Is Not Always the Solution
Your doctor might need to see you in person occasionally. You require blood work, or this is your first time visiting the doctor. If you exhibit symptoms or if your doctor feels that you require a physical examination, they may wish to see you.
Be sure to exercise extra caution in those circumstances. The chairs in your doctor’s office will undoubtedly be farther apart, they will require you to wear a cotton mask, and they will take your temperature as soon as you walk in. When you are there, try to avoid touching anything, and keep your hands out of your lips, eyes, and nose. As soon as you leave the office, wash your hands, or apply hand sanitizer.
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