Perspectives on Diabetes Care

This is the official blog of the Association of Diabetes Care & Education Specialists where we share recent research and professional opinions on diabetes care and education.

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If you're looking for professional opinions on diabetes care and education, you're in the right place. Perspectives on Diabetes Care is the official ADCES® diabetes care and education blog that shares helpful views on diabetes care and education. 

This is where you'll find practical tips on working with people affected by prediabetes, diabetes and related cardiometabolic conditions and the latest research and viewpoints on issues facing diabetes care and education specialists and the people they serve.

 

 

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Embrace Technology — It Will Transform Your Patients’ Lives and Modernize Your Practice

Apr 4, 2019, 10:29 AM

AADE President Elect Kellie Antinori-Lent

by Kellie Antinori-Lent, MSN, RN, ACNS-BC, BC-ADM, CDE, FAADE 

 

Embrace. It means to hold closely, to accept, support, or to include, as a part of something. That is exactly what I encourage diabetes educators do with technology.

Technology is no longer the future. It has arrived and is revolutionizing the work we do, the way we do that work, and the service we provide.

We know, however, that technology can be quite overwhelming. Each passing day brings more innovation — another app, a new device, a different platform, a first-of-its kind treatment. Individually and collectively, however, these technologies have the power to dramatically improve the lives of those living with diabetes by reducing the care burden. As an educator, we pride ourselves on providing our patients the best care, training and support. Without embracing technology, is that truly possible?

Throughout the development of AADE’s Project Vision, the Board of Directors clearly understood the impact of technology on our specialty. As such, it was recognized not only as an overarching influence across and within each strategy but was singled out as one of six key pillars.

Putting Technology into My Practice

Being transparent, I am a late adopter when it comes to modernized technology for personal use. Decades ago, my college friends teased me for being the last to buy an answering machine. More recently, I snubbed the idea of carrying a phone around 24/7. Once I purchased a cell phone, I did not upgrade to a smart phone until I realized it would allow me to keep closer tabs on my teenage daughters. When it comes to technology use in practice, however, I was completely different.

In the 1980’s, I welcomed blood glucose meters—anything to replace urine testing. When insulin pumps entered the care arena, I practically begged to be the “pump nurse” at our diabetes center. That led to developing pump classes, pump support groups, and eventually a job with a pump company.

Today I work in an academic hospital setting within the nursing education & research department. Although I still see patients in the hospital, it is not the place to start patients on pumps or sensors. I do, as expected, teach quite a few patients self-blood glucose monitoring though. Fortunately, the meter covered by most local insurances and stocked in our pharmacy has an app. It permits the meter to sync with smart phones via Bluetooth and helps manage results. I have to say, when able to do this with a patient, it infuses a tiny bit of excitement into the visit.

Another part of my visit is spent discussing resources. For the appropriate patient, I dive into a discussion about online peer and social media support opportunities. To supplement the conversation, I provide a color copy of the “Learn, Support, Engage” peer support tip sheet on AADE’s peer support webpage. Filed neatly in my “diabetes tote,” the document highlights the various ways to participate in the peer support communities recommended by AADE.


Embracing technology can also mean creating your own opportunities.


Training with diabetes technology

After working for a year in the inpatient setting, I began to miss working with pump patients. To fill the void, I wrote a business plan in collaboration with the chief of endocrinology that would enable me to develop an out-patient pump and continuous glucose monitoring (CGM) program. Once granted permission, I worked with billing to build a charge template that maximized reimbursement. This was a true blessing because helping these patients was the most rewarding and memorable work of my career.

Embracing technology can also mean creating your own opportunities. I recently worked across departments to create Diabetes Boot Camp 2: insulin pumps, continuous glucose monitors and leveraging technology. This class was created for nurses — not patients. When you work in the hospital setting, patients are not your only “customer.” Nurses are as well. To address their growing interest in learning more about diabetes technology, I developed the class. The team that teaches the class includes a pharmacist, a diabetes educator who works for a durable medical equipment company, and me. The content focuses on what nurses need to know to safely care for patients wearing these devices during hospitalization. The curriculum includes pump and CGM basics, hospital policies, procedures, order-sets and proper charting. It also includes interactive, hands-on sessions with each pump and CGM on the market.Embracing Technology

Diabetes educators from every pump and CGM company attend the class and provide the hands-on experience with their product. Although we are not permitted to provide CE’s for most of the class, attendees do not care. They are more interested in learning more about the technology than receiving credits. This class is so popular that each class fills quickly and there is always a waiting list. Pharmacists and dietitians are also attending as are nurses from across the system. To get a better sense of the class, here’s my outline

Technology: A Key Player in the New Vision and Practice

My story is just one of so many others, all of us embracing technology in new ways. We know that it is more than teaching your patients how to use a glucose meter, insulin pump or CGM. It also includes integration of these devices, uploading/downloading for efficient care collaboration and data interpretation. It requires us to discuss web-based and mobile diabetes coaching and support systems (also known as digital therapeutics), provide guidance on diabetes apps and steer our patients to helpful peer support and social media communities. It’s also expanded to include incorporation of prescription-only decision support systems for insulin titration, and of course, smart pens and telemedicine.

This list will undoubtedly proliferate, so welcome them, learn about them, and build them into your practice. Technological expertise is instrumental to quality diabetes education today and expands our roles and competencies. Quite simply, it makes us priceless members of the diabetes care team. To guarantee a sustainable future for our specialty — and practice — we must embrace technology now.

AADE is Here to Help

A discussion about technology would not be complete without mentioning DANA, AADE’s website (DANAtech.org) dedicated to providing diabetes educators with a complete source for technology information and resources. Whether you are a technology expert or a novice, DANA has something for you: online learning and video training, up-to-date composite of products, publications and latest news, calendar of live events, teaching tools, focus groups and polls.


Some educators teach with DANA, showing patients different devices and apps on an iPad or smart phone. Others print off information for patients or cut and paste them into patient instructions. 


How are diabetes educators using DANA? Some educators teach with DANA, showing patients different devices and apps on an iPad or smart phone. Others print off information for patients or cut and paste them into patient instructions. Looking for a quality app to recommend? Many educators use the DANA App Review to find the newest and best. For me, the Education section is my favorite part. I am always looking for quality CE’s on current topics and DANA has a lot to pick from.

DANA is brilliant and amazing, right? And, it is available to all AADE members as an exclusive benefit! 

The Time is Now

In closing, I would like to share a quote from Andrea Scaramuzza, MD, who spoke about predictive low glucose management at the Advanced Technologies & Treatments for Diabetes (ATTD) Conference in Berlin. “Education can be the human factor that helps technology perform best.” Diabetes educators are the human factor. Are you ready? Embrace technology now. Learn more about the AADE vision for the specialty at DiabetesEducator.org/Vision.

The training on diabetes technology is incredibly popular

Association of Diabetes Care & Education Specialists

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