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Telecare for Diabetes at Barnstable Brown
Laura Hieronymus discusses telecare for diabetes patients at Barnstable Brown.
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Learn more about Laura Hieronymus, DNP
Laura Hieronymus, DNP
Laura Hieronymus earned a bachelor’s degree in nursing, master’s degree in allied health and education and doctor of nursing practice from the University of Kentucky. She is board certified in advanced diabetes management, a master licensed diabetes educator and a certified diabetes educator. She is also a fellow of the American Association of Diabetes Educators, where she served as diabetes educator of the year in 2006-2007.Learn more about Laura Hieronymus, DNP
Transcription:
Telecare for Diabetes at Barnstable Brown
Melanie: Welcome to UK HealthCast with the University of Kentucky Healthcare. I'm Melanie Cole, and I invite you to listen in, as we discuss Telecare for diabetes at Barnstable Brown.
Joining me is Dr. Laura Hieronymus. She's an Associate Director of Education and Quality Services at Barnstable Brown Diabetes Center at UK HealthCare. Dr. Hieronymus, it's a pleasure to have you join us today. How has this pandemic encouraged healthcare systems to be creative and innovative in your ability to deliver care to your patients? What's happened since we've been in this pandemic?
Dr Laura Hieronymus: Well, since the pandemic began, I think that all healthcare providers and their staff have been thinking through very quickly how can we meet our patients' needs? And for Barnstable Brown Diabetes Center, we literally turned to telehealth full-time on a dime. In other words, we knew that we had to continue seeing our patients and our particular state really had to shut down for a window of time. So we were able to leverage the telehealth, the Telecare platform to actually see our patients, both for diabetes medical care as well as diabetes self-management education.
Melanie: Well then, tell us what services are available through Barnstable Brown Diabetes Center, offering through Telecare when you say self-management. And while you're answering that, tell us some of the challenges that your patients with diabetes are facing during this pandemic.
Dr Laura Hieronymus: First off, UK Healthcare Barnstable Brown Diabetes Center offers all services using the Telecare platform. The Barnstable Brown Diabetes Center providers see both adult and pediatric patients for diabetes as well as endocrinology visits for their medical care using telecare. Also providers across the University of Kentucky Healthcare enterprise as well as providers outside of the University of Kentucky can refer a patient to diabetes education services.
So we partner with all diabetes care providers to educate their patients. If a person has diabetes for example, if they're newly diagnosed, have a complicating factor related to diabetes, become pregnant, have treatment plan changes or develop gestational diabetes during pregnancy, we partner with that patient's healthcare provider to provide diabetes self-management education. We also work with individuals who have pre-diabetes as well. So I guess when you mentioned challenges, the challenge is these things don't stop for the pandemic. So we continued these services in an innovative way for individuals with diabetes.
Melanie: That is just such a great program. Dr. Hieronymus. So tell us about some of the benefits of utilizing Telecare and what these education services really do entail for people with diabetes. And while you're doing that, tell us a little bit about what they can expect at an appointment.
Dr Laura Hieronymus: Well, that's several questions rolled into one. So let's start with the benefits of utilizing Telecare for diabetes education services. It's an alternative to individuals with diabetes, not only in this unprecedented time, but moving forward as well.
Benefits of Telecare include accessibility. Telecare visits can be done on a smartphone, a tablet, a laptop with internet capability. They're also convenient. They can be done virtually anywhere, anytime with the appropriate privacy considerations. Telecare can actually save time and money. Logging on for a visit limits the time you might need to take off work, for example, for a diabetes care appointment as well as create savings on items such as money for gas, parking and even bus fare.
And finally safety, Telecare visits allow a person to be seen by their diabetes care team member for medical care, for diabetes self-management education without worry of being in contact with others who might be ill. And in this case, the ongoing pandemic that we've been faced with for almost a year.
Melanie: Well, it certainly is challenging. And tell us a little bit about how you would like people with diabetes to make sure their appointment is as successful and informational as possible. What would you like them to think about before an appointment?
Dr Laura Hieronymus: Well, to make their Telecare appointment as successful and informational as possible, the person may want to start by making a list and prioritizing what it is they want to discuss at their particular visit. Just like an in-person visit, a Telecare session is scheduled in limited in time. So it's important to be sure to arrive for the session on time. If the allotted time does not allow that person to discuss all of their questions, we want them to be sure and schedule a follow-up session. It's important to discuss any concerns, any unusual symptoms or lack of understanding you have about a particular diabetes topic. The more information that your diabetes care team has, the better he or she can help you.
When visiting with your provider, it's important you have your blood glucose, blood pressure, weight logs, and any other health records along with the date and time of the records for your provider to review at the session. So very important from the patient perspective. We have some patients that use software to download their glucose records from their sensor device or their data from insulin pumps. It's ideal to send, to download those records prior to the visit so that the provider can review them and discuss them during that Telecare visit.
Melanie: Dr. Hieronymus, aside from physical health, there's a concern across the board of our mental health, which can be especially challenging for people with diabetes. How are you helping your patients remain calm and manage the emotional challenges of the pandemic and the strains of isolation along with continuing their care and medications during this time? Kind of reinforce for us how this continuum of care is so important for people that have diabetes and self-care really is extra important at this time.
Dr Laura Hieronymus: I agree with that. I will tell you from a diabetes self-management education perspective, we work with individuals on what's called the AADE7. In other words, seven self-care behaviors that are important for diabetes care. At the top of that list is healthy coping, so that's all the time regardless of a pandemic.
So one of the things that we do is we assess our patient's coping skills, because really without that they can't manage or be successful at the other self-care behaviors. So we assess their coping skills, talk them through, talk to them about what might be an issue or an anxiety for them. We work with the licensed clinical social worker to address any issues that might be of detriment, if you will, to their physical and mental health. So very important to include, I'm glad you asked, the mental health component. It's essential for diabetes care.
Melanie: It certainly is. As we wrap up, do you have any final thoughts you'd like your patients with diabetes to know about treatment for their condition at Barnstable Brown and UK Healthcare and the Telecare services that you're offering?
Dr Laura Hieronymus: Well, just as there's different medications to meet the needs of people with diabetes, Telecare is an alternative. It's not the only way that diabetes care can be provided. So it's important the patient along with their provider to determine whether Telecare is the right option.
Important to consider the following questions: Does the person have a smartphone, a tablet, or a computer that's able to connect to the team for the Telecare session? Sometimes an older device, which is more than a few years old, the ability to connect is compromised. Does the person have access to the internet? Very important for a Telecare visit along with being able to see and hear during that visit. Does the device allow the patient to have the necessary data and/or minutes? Even a brief Telecare session can take 15 minutes, might use a large amount of data. So if the data plan's limited, it may not be the best option.
Is there a private location? I've heard stories about individuals driving through the carwash or driving through the drive-thru multitasking during a telehealth session. Not a good idea. So we recommend that when that patient connects, it's just like when you show up for your appointment face to face in person, very important to be there and be present. And last but not least, being competent with that technology. It works relatively well. We've had great success, but important for those individuals that would like to connect via telehealth to have those parameters in place.
Melanie: Great information. Thank you so much for joining us and sharing your expertise on this topic today. And to learn more about these services and more at Barnstable Brown, please visit our website at ukhealthcare.uky.edu to get connected with one of our providers. And that concludes this episode of UK HealthCast with the University of Kentucky Healthcare.
Please remember to subscribe, rate and review this podcast and all the other University of Kentucky Healthcare podcasts. Until next time. I'm Melanie Cole. Thanks so much for listening.
Telecare for Diabetes at Barnstable Brown
Melanie: Welcome to UK HealthCast with the University of Kentucky Healthcare. I'm Melanie Cole, and I invite you to listen in, as we discuss Telecare for diabetes at Barnstable Brown.
Joining me is Dr. Laura Hieronymus. She's an Associate Director of Education and Quality Services at Barnstable Brown Diabetes Center at UK HealthCare. Dr. Hieronymus, it's a pleasure to have you join us today. How has this pandemic encouraged healthcare systems to be creative and innovative in your ability to deliver care to your patients? What's happened since we've been in this pandemic?
Dr Laura Hieronymus: Well, since the pandemic began, I think that all healthcare providers and their staff have been thinking through very quickly how can we meet our patients' needs? And for Barnstable Brown Diabetes Center, we literally turned to telehealth full-time on a dime. In other words, we knew that we had to continue seeing our patients and our particular state really had to shut down for a window of time. So we were able to leverage the telehealth, the Telecare platform to actually see our patients, both for diabetes medical care as well as diabetes self-management education.
Melanie: Well then, tell us what services are available through Barnstable Brown Diabetes Center, offering through Telecare when you say self-management. And while you're answering that, tell us some of the challenges that your patients with diabetes are facing during this pandemic.
Dr Laura Hieronymus: First off, UK Healthcare Barnstable Brown Diabetes Center offers all services using the Telecare platform. The Barnstable Brown Diabetes Center providers see both adult and pediatric patients for diabetes as well as endocrinology visits for their medical care using telecare. Also providers across the University of Kentucky Healthcare enterprise as well as providers outside of the University of Kentucky can refer a patient to diabetes education services.
So we partner with all diabetes care providers to educate their patients. If a person has diabetes for example, if they're newly diagnosed, have a complicating factor related to diabetes, become pregnant, have treatment plan changes or develop gestational diabetes during pregnancy, we partner with that patient's healthcare provider to provide diabetes self-management education. We also work with individuals who have pre-diabetes as well. So I guess when you mentioned challenges, the challenge is these things don't stop for the pandemic. So we continued these services in an innovative way for individuals with diabetes.
Melanie: That is just such a great program. Dr. Hieronymus. So tell us about some of the benefits of utilizing Telecare and what these education services really do entail for people with diabetes. And while you're doing that, tell us a little bit about what they can expect at an appointment.
Dr Laura Hieronymus: Well, that's several questions rolled into one. So let's start with the benefits of utilizing Telecare for diabetes education services. It's an alternative to individuals with diabetes, not only in this unprecedented time, but moving forward as well.
Benefits of Telecare include accessibility. Telecare visits can be done on a smartphone, a tablet, a laptop with internet capability. They're also convenient. They can be done virtually anywhere, anytime with the appropriate privacy considerations. Telecare can actually save time and money. Logging on for a visit limits the time you might need to take off work, for example, for a diabetes care appointment as well as create savings on items such as money for gas, parking and even bus fare.
And finally safety, Telecare visits allow a person to be seen by their diabetes care team member for medical care, for diabetes self-management education without worry of being in contact with others who might be ill. And in this case, the ongoing pandemic that we've been faced with for almost a year.
Melanie: Well, it certainly is challenging. And tell us a little bit about how you would like people with diabetes to make sure their appointment is as successful and informational as possible. What would you like them to think about before an appointment?
Dr Laura Hieronymus: Well, to make their Telecare appointment as successful and informational as possible, the person may want to start by making a list and prioritizing what it is they want to discuss at their particular visit. Just like an in-person visit, a Telecare session is scheduled in limited in time. So it's important to be sure to arrive for the session on time. If the allotted time does not allow that person to discuss all of their questions, we want them to be sure and schedule a follow-up session. It's important to discuss any concerns, any unusual symptoms or lack of understanding you have about a particular diabetes topic. The more information that your diabetes care team has, the better he or she can help you.
When visiting with your provider, it's important you have your blood glucose, blood pressure, weight logs, and any other health records along with the date and time of the records for your provider to review at the session. So very important from the patient perspective. We have some patients that use software to download their glucose records from their sensor device or their data from insulin pumps. It's ideal to send, to download those records prior to the visit so that the provider can review them and discuss them during that Telecare visit.
Melanie: Dr. Hieronymus, aside from physical health, there's a concern across the board of our mental health, which can be especially challenging for people with diabetes. How are you helping your patients remain calm and manage the emotional challenges of the pandemic and the strains of isolation along with continuing their care and medications during this time? Kind of reinforce for us how this continuum of care is so important for people that have diabetes and self-care really is extra important at this time.
Dr Laura Hieronymus: I agree with that. I will tell you from a diabetes self-management education perspective, we work with individuals on what's called the AADE7. In other words, seven self-care behaviors that are important for diabetes care. At the top of that list is healthy coping, so that's all the time regardless of a pandemic.
So one of the things that we do is we assess our patient's coping skills, because really without that they can't manage or be successful at the other self-care behaviors. So we assess their coping skills, talk them through, talk to them about what might be an issue or an anxiety for them. We work with the licensed clinical social worker to address any issues that might be of detriment, if you will, to their physical and mental health. So very important to include, I'm glad you asked, the mental health component. It's essential for diabetes care.
Melanie: It certainly is. As we wrap up, do you have any final thoughts you'd like your patients with diabetes to know about treatment for their condition at Barnstable Brown and UK Healthcare and the Telecare services that you're offering?
Dr Laura Hieronymus: Well, just as there's different medications to meet the needs of people with diabetes, Telecare is an alternative. It's not the only way that diabetes care can be provided. So it's important the patient along with their provider to determine whether Telecare is the right option.
Important to consider the following questions: Does the person have a smartphone, a tablet, or a computer that's able to connect to the team for the Telecare session? Sometimes an older device, which is more than a few years old, the ability to connect is compromised. Does the person have access to the internet? Very important for a Telecare visit along with being able to see and hear during that visit. Does the device allow the patient to have the necessary data and/or minutes? Even a brief Telecare session can take 15 minutes, might use a large amount of data. So if the data plan's limited, it may not be the best option.
Is there a private location? I've heard stories about individuals driving through the carwash or driving through the drive-thru multitasking during a telehealth session. Not a good idea. So we recommend that when that patient connects, it's just like when you show up for your appointment face to face in person, very important to be there and be present. And last but not least, being competent with that technology. It works relatively well. We've had great success, but important for those individuals that would like to connect via telehealth to have those parameters in place.
Melanie: Great information. Thank you so much for joining us and sharing your expertise on this topic today. And to learn more about these services and more at Barnstable Brown, please visit our website at ukhealthcare.uky.edu to get connected with one of our providers. And that concludes this episode of UK HealthCast with the University of Kentucky Healthcare.
Please remember to subscribe, rate and review this podcast and all the other University of Kentucky Healthcare podcasts. Until next time. I'm Melanie Cole. Thanks so much for listening.