Telemedicine's Impact on Diabetes Care During the COVID-19 Pandemic: A Cohort Study in a Large Integrated Healthcare System

Abstract

Aims

To examine whether patients exposed to primary care telemedicine (telephone or video) early in the COVID-19 pandemic had higher rates of downstream HbA_1c measurement and improved HbA_1c levels in the second year of the pandemic.

Methods

In a cohort of 242,848 Kaiser Permanente Northern California patients with diabetes, we examined associations between early-pandemic patient-initiated telemedicine visits and downstream HbA_1c monitoring and results during the second year of the pandemic.

Results

Adjusted HbA_1c measurement rates were significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (91.0% testing for patients with video visits, 90.5% for telephone visits, visits, 86.7% for no visits, p < 0.05). Among those with HbA_1c measured, the rates of having an HbA_1c < 8% in the second year of the COVID-19 pandemic were also statistically significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (68.5% with HbA_1c < 8% for video visits, 67.3% for telephone visits, 66.6% for no visits, p < 0.05).

Conclusions

Access to telephone and video telemedicine throughout the early COVID-19 pandemic was associated with patients' continued engagement in recommended diabetes care. Although our study analyzed telemedicine use during a pandemic, telemedicine visits may continue to support ongoing health care access and positive clinical outcomes.