UM tests virtual diabetes management

The University of Miami and technology partners Microsoft and Resolute Solutions Corp. are teaming up to see if patients with diabetes can self manage their disease virtually while replicating the traditional patient-provider relationship.

The Overtown (Florida) Health Education Access Through Information Technology Utilization Project (Overtown HEAT-IT-UP) is a feasibility test designed to enhance and nurture the relationship between 25 targeted patients, most of them on Medicaid, with mildly-controlled type 2 diabetes mellitus, and their providers.

Participants in this feasibility test will be given computers and trained on how to use the Internet. The will be able to communicate with a nurse practitioner and doctors about what is happening with their condition through a Web-based portal. Patients can test blood sugar levels and record the data and inform UM of changes in their weight while using the portal to learn about diabetes care, nutrition and exercise.

Patients also are able to instant message and e-mail the nurse practitioner or doctor, as well as access discussion boards to facilitate information sharing.

“The family physician concept of waiting on my patients to contact me when they are ill is outmoded,” says Robert Schwartz, MD, professor and chair, Department of Family Medicine and Community Health, University of Miami Miller School of Medicine. “This patient population often ends up in the emergency room for acute care when the majority of them have chronic illnesses.”

UM will be examining specific clinical measures for type 2 diabetes mellitus such as glycosylated hemoglobin levels and blood glucose levels.

“We also will implement periodic screening for depression and collect periodic measures of functional status,” says John G. Ryan, DrPH, associate professor, Department of Family Medicine and Community Health, University of Miami Miller School of Medicine. “However, our primary metrics for evaluating the feasibility of this concept will be connectivity, utilization and patient satisfaction. By tracking on these three types of measures, we’ll be better capable of fine-tuning the project for a scaled-up pilot project, in which UM would look for clinical improvements as a result of participation in the intervention. The goal is to empower and motivate patients to participate in self-management of Type 2 diabetes mellitus.”

Payers are becoming more and more interested in the concept of managing disease states in the home-especially the uninsured population, according to Microsoft Healthcare Technology Strategist Shawn Remacle.

“Providers in safety net or state hospitals are incentivized to reduce acute care costs, and keeping disease states in check,” Remacle says.

Funding for this project is provided directly by the Department of Family Medicine and Community Health, of the University of Miami Miller School of Medicine, with funds provided by the United Health Foundation.

sremacle@microsoft.comrschwartz@miami.edujohngryan@miami.edu

Robert Schwartz M.D. Professor and Chair, Department of Family Medicine and Community Health, University of Miami Miller School of Medicine305-243-1242 Martha