Rural communities can use telehealth and telemedicine to support diabetes care and management. Telehealth is defined as:
“The use of electronic information and telecommunication technologies to support and promote
long-distance clinical health care, patient and professional health-related education, public health and health
administration. Technologies include video conferencing, internet-based services and communication,
store-and-forward imaging, streaming media, and terrestrial and wireless communications.”
refers specifically to the delivery of clinical services via technology.
Telehealth and telemedicine use a range of technologies — such as live video, mobile devices and
applications (apps), and computers — to overcome rural barriers to healthcare
access and improve care. RHIhub's Telehealth
Use in Rural Healthcare topic guide provides information on how telehealth can help healthcare providers
in rural communities.
Telehealth and telemedicine can be used to deliver diabetes education, management, and monitoring services. This
Diabetes self-management – Telehealth can support diabetes self-management activities
such as blood sugar (glucose) monitoring and tracking. For example, the Community
Preventive Services Task Force (CPSTF) recommends the use
of mobile phone apps in healthcare
settings for the self-management of type 2 diabetes. These interventions can improve communication. Patients
can enter data into mobile apps and receive automated or tailored feedback from healthcare providers.
Medication adherence – Taking medications as prescribed is important for diabetes
management. Telehealth can help people with diabetes to take their medications correctly — at the
correct dose and frequency — and remember to fill prescriptions. Text
messages are one way to improve medication adherence among patients with chronic disease, as
recommended by the CPSTF.
Specialty care consultations – Telehealth can help rural patients to connect with
specialty care providers remotely. This helps rural patients because they are no longer required to travel
long distances. Video conferencing can be used to provide endocrinology consultations, for
example. An endocrinologist may perform clinical assessments, review or order laboratory tests, adjust
medications, or make other recommendations regarding clinical treatment plans using telehealth.
For more information about identifying and implementing telehealth programs in rural communities, see the Rural Telehealth Toolkit.
Examples of Rural Diabetes Telehealth Programs
The Catalina Island Telemedicine Center was established to help
residents of Santa Catalina Island, located off the coast of California, to access specialty care
electronically. Some telemedicine services offered include diabetic education and eye screenings. To help
residents see specialist providers, the telemedicine center partnered with Loma Linda University Medical
Center, the Los Angeles County Department of Mental Health, and a private psychiatry company.
Project ECHO provides evidence-based programs for managing complex
conditions, including diabetes. This model extends care to rural patients through videoconferencing and is
used in communities across the country.
The Mississippi Diabetes Telehealth Network, a program of the University of
Mississippi Medical Center's Center for Telehealth, was launched in 2014 to improve care for people
with diabetes in Mississippi's Delta region. The program provides remote patient monitoring, using
telehealth to deliver health education, coaching, and interventions to patients in their homes. Evaluation
results indicate that providing
remote patient monitoring through telehealth is effective for diabetes management in rural areas.
The University of Virginia Diabetes
Tele-Education Program uses video conferencing technology to deliver diabetes education to people
who have, or are at high risk for developing, diabetes. The diabetes education courses address diabetes
basics, nutrition, self-management, and lifestyle changes.
Many rural communities rely on clinical partnerships to
deliver telehealth services. Identifying partnership opportunities can help address the cost barriers of
implementing telehealth programs. It can also help broaden the range of services available to patients. When
using telehealth, it is also important to ensure patient comfort with using technology. Strategies for
supporting patients who are less comfortable with using telehealth technology include enlisting support from
friends, or caregivers. Additionally, programs should communicate the benefit of telehealth to patients and
ensure that telehealth programs meet patient needs related to diabetes care.
Program Clearinghouse Examples
Resources to Learn More
in Rural Communities
Describes how telehealth programs can provide better access to chronic disease prevention and management
programs, and to specialty care including heart disease and stroke, diabetes, and diabetic retinopathy.
Organization(s): National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease
Control and Prevention