At the beginning of the covid19 pandemic and the Irish lockdown restrictions, I was one of many people who was looking forward to my diabetes clinic moving into the virtual world. However, finding this little positive in a negative was very short lived.
I've had 2 telephone appointments with my clinic and I feel they fell short. I feel that a video consult would be far more satisfying and it's that's not going to happen I'd prefer to make the trek to my physical clinic.
Diabetes Clinic Before COVID-19
Before COVID-19, I drove one hour to my diabetes clinic with a 20 minute wait upon arrival to get a parking space, sit in the clinic waiting room for about two hours while spending about 30 to 45 minutes, tops, with healthcare professionals and because my clinic always seemed to finish at rush out, a 90 minute drive home.
You can imagine my delight when I saw on national news that my clinic was launching a pilot video conferencing consultation.
So, when I got a text message to let me know that my first appointment during pandemic times would be conducted by telephone I was a little disappointed, but still happy to 1) not have to put myself in a clinic waiting room with other high risk people and 2) not have to spend the 2 and half hours travelling there and back.
Diabetes Service Postcode Lottery
Before I go any further in this post I want to acknowledge how lucky I have been in my diabetes journey to have so much access to diabetes education: first in the form of one to one sessions with a diabetes educator who taught me how to carb count and to adjust my insulin for normal living before I was pregnant with my eldest, and then when I got my insulin pump 10 years ago to have such great training. I was so lucky to have transferred my diabetes care to where I attend now when I did because the waiting list was only 18 months. I have also had two (TWO) telephone consultations with my team since April 2020!!!!
Many of my friends with diabetes from our local support groups have not had any access to their diabetes clinic at all since March 2020 and STILL don’t have access to diabetes education such as carb counting or DAFNE or access to insulin pumps. One of my friends will have a 20 month gap between her last appointment and her next, another person with type 1 diabetes has been on the waiting list for a first appointment at his diabetes clinic for three years, another person diagnosed with type 1 just 18 months ago and is still coming to terms with their new life and how to manage it doesn’t know when they’re next appointment will be since January 2020.
I remember the one time I had to wait 12 months for my diabetes appointment and how anxious and stressed out I got about not having any blood labs done, worried about the first signs of diabetes complications being missed and not having anyone to reach out to for help with my diabetes management. It was awful and yet many people I know are having to live with this indefinitely.
My Telephone Consultation Experiences
My telephone consultations fell a little short of satisfactory. I had sent my data in advance of my appointment but I couldn’t see what my provider was looking at on my reports and I got quite confused. My second telephone consultation was a little better but my provider didn’t have my data in advance of the appointment so most of the consultation was done through emails afterwards.
I really, really would appreciate having my next appointment through a video consultation where we could share a screen and I would be able to see what exactly in my data my provider is looking at. I’m beginning to miss my trek to the physical clinic.
Video Consultations are not being used
However all in the virtual world of diabetes care is not what it seems!!!! As people with diabetes chatted with each other in our online support groups, it seems that very few people were discussing video consults and most were having telephone appointments rather than face to face, which is good but I was curious about all the talk we had about having access to video consultations and the heralding in a new era. So I did a very brief poll in our group which revealed out of 282 responses:
138 people had Telephone Appointments
66 people had Face to Face Clinic Appointments
65 people have had their clinic appointments cancelled
Only 13 people Video Appointments
This is so surprising! Why are video consultations not happening given that there is a structure there and guidelines for use for health care professionals.
“The National COVID-19 Telehealth Steering Committee has approved the following solutions, made available during the pandemic, to support communication and collaboration across the health service. Usage should comply with HSE IT policy and standards (PDF) and the document Secure Video and Audio Clinical Consultations: Clinical Aspects During the Emergency Measures to address Covid 19 (PDF) may be of use.” From https://healthservice.hse.ie/staff/coronavirus/working-from-home/virtual-health/virtual-health.html
Where is are the “Video Consultations” happening because they are certainly not happening in diabetes care. Alas, it would seem that Irish healthcare lags behind again
