Utilizing A Technology Framework to Reduce Disparities and Therapeutic Inertia
Sep 27, 2021, 23:34 PM
By LaurieAnn Scher, MS, RD, CDCES
Technology solutions are an incredibly useful tool for the management of diabetes, but only when all people who need and want them have access. The Identify, Configure, Collaborate (ICC) Framework is an approach that supports technology-enabled decision making to improve outcomes and decrease therapeutic inertia. The hope is that this standardized framework also enables healthcare professionals to avoid bias in the provision of technology to people with diabetes. The recent article developed by ADCES entitled Technology Disparities and Therapeutic Inertia - A Call to Action for the Diabetes Care and Education Specialist will help you integrate 3 critical actions into your practice:
- Address disparities in the care of people with diabetes utilizing the ICC Framework.
- Tackle the problem of therapeutic inertia.
- Create change that will lead to equitable care for all people with diabetes, prediabetes and other cardio-metabolic conditions.
The Role of the DCES in Application of the ICC Model
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IDENTIFY
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Help every person with diabetes make informed decisions regarding technology, recognizing choices will evolve over time as the diabetes journey continues. Advocate on behalf of people with diabetes, prediabetes and other cardiometabolic conditions when barriers are uncovered or, when identifying larger, systemic barriers to technology use (e.g., social determinants of health including broadband access), bring to the attention of appropriate professional organizations, healthcare systems, industry or policy makers.
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CONFIGURE
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Help individuals get off to a strong start with their chosen technology tools by configuring services and tools to match their care plan, preferences and life circumstances and developing a plan for integrating the tools into daily self-management. The DCES can lead in creating and optimizing use of technology for all.
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COLLABORATE
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Use the resulting data on an ongoing basis in partnership with individuals and their care team to assess and optimize the care plan. Collaborative use of the data leading to persistent, incremental adjustments in the diabetes care plan, and identifying and addressing the barriers to following the care plan is critical to timely therapy optimization.
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Understanding the Value of Technology to Improve Outcomes
In 2019, the America Diabetes Association added a dedicated section on diabetes technology to the Standard of Medical Care for the first time. Technology solutions include:
- Wellness applications.
- Digital therapeutics.
- Virtual care and education.
- Medication delivery systems (pumps and smart pens).
- Food, exercise and medication tracking and journaling products.
- Connected glucose monitoring devices.
- Remote health/vital sign monitors.
These products provide support and collect data on uptake, usage and other various diabetes metrics that can be used to individualize care and improve outcomes based on the lived experience. Technology has the potential to monitor and deliver intervention and provide data to the care team and the person with diabetes to act on to improve outcomes, but it is not being provided equitably.
Working Towards Equitable Solutions
Health equity means that everyone has the opportunity to be as healthy as possible, but disparities have been observed that prevent health equity from being a reality. The application of the ICC framework by the diabetes care and education specialist can be used as a systematic tool to ensure the provision of technology choices for every person living with diabetes as a standard of care. When policies, programs, and systems that support health are equitable, poor health outcomes can be reduced and health disparities can be prevented. You can make a difference. You can follow 3 steps to apply this model in your practice and share your experiences.
Call to Action: Implementing the ICC Framework in Diabetes Care and Education Services to Reduce Disparities
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Step 1
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Lead in implementing the ICC model in your practice setting. Use this technology discussion guide to lead the conversation. Also available in Spanish.
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Step 2
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As you identify barriers, attempt to resolve them. Share the barriers you identified and how you resolved them through the ADCES Technology Community of Interest.
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Step 3
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If you identify larger barriers to technology access and optimal use that you cannot resolve, share these through the ADCES Technology Community of Interest above. These will be reviewed by the ADCES Technology work group and ADCES Advocacy Community of Interest to identify ways to address them at a system, policy or organizational level.
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This call to action will allow you to help decrease the technological (digital) divide for people with diabetes from at-risk communities. Through the systematic application of the ICC Framework, you can identify and help address health inequities that are associated with race, ethnicity, physical limitations, socioeconomic status and sociocultural factors. You can advocate on your own and as part of ADCES for broader policy changes at the local, state, and federal level to reduce barriers to diabetes technology. You can help create a future of increased technology access and improved health outcomes for all people living with diabetes.
For additional tools and resources on integrating technology into your practice, visit DiabetesEducator.org/TechnologyIntegration.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
Copyright is owned or held by the Association of Diabetes Care & Education Specialists and all rights are reserved. Permission is granted, at no cost and without need for further request, to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered, and proper attribution is made to the Association of Diabetes Care & Education Specialists.
HEALTHCARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or healthcare provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit DiabetesEducator.org/Find.