With Technology being at the forefront of Diabetes Education, more Diabetes Educators are seeing patients utilize pumps and CGMs. Patients may be seeking these devices with different objectives in mind but most have a goal that these devices will help alleviate the burden of diabetes and improve their quality of life. Whether a patient is seeking an alternative to needles, a better way to control their insulin delivery, the ability to view their glucose in real-time or wearing a device that stores data to eliminate manual log keeping; people with diabetes want to have successful outcomes. And we, as Diabetes Educators, love seeing our patients be successful! Having protocols in place starting from the very beginning when a patient is deciding which device is best for them can be key in their success. Protocols help ensure that the patient chooses the right product, maintains a smooth process in the ordering and shipping of the product as well as good training and follow-up.
At our Center, our Endocrinology department makes a referral to our office so that we can review all the pumps and CGMs devices with the patient before they choose their device. It’s important to allow patients to share what their biggest challenges are in managing their diabetes and why they believe a specific product can help them. This information, intertwined with the healthcare providers goals for their patient, can allow for a win-win situation. Many times, our goals are not our patients’ goals. For example, if an Educator is focusing solely on lowering a patient’s A1c with a device and the patient’s goal is to find a device that has no tubing or a CGM that talks to their phone and does not require finger sticks, it’s a good time to stop and really listen to the patient. For example, a patient works in a Powder Metal plant where he wear overalls that completely covers his regular clothes, he is covered in black powder/dust and cannot easily leave his work area and wash his hands for testing, then we must try to understand how their wants for a particular device alleviates their stress and improves their quality of life. Being able to have these types of discussions with our patients are valuable. Not that these devices he is seeking can’t help him lower his A1C, it does help to understand their situation and what each product requires for maximum benefit.
Next, we obtain a signed Assignment of Benefits or Patient Information Form and send it to our local representative for processing. This allows us to stay in contact with the company’s representative. Sometimes, we do this with several companies for one patient so the patient can look at their out of pocket costs for different devices. In today’s world of different contracts and pricing, costs can vary with each product and many times out of pocket expenses is the determining factor. Just remember to not allow one company to tell a patient what it will cost for another company’s product. Allowing each company to verify benefits can be very helpful. And making sure you have control of the paperwork is critical so that a patient is shipped the correct product.
Our local reps have been great about communicating with our Diabetes Center so we know where the patient is in the process. Patients will call us when a product ships or it will be assigned to us in a training portal with a contracted company. With a busy center and limited time, we have been utilizing the help from company representatives for some of our insulin pump trainings. Many of the CGMs have become so simple, that patients may train themselves or we bring them and utilize training videos on the company’s website. Good training, follow-up and management to get patients to their goal and allow them to master technology to better manage their diabetes and improve their quality of life will help your patients be successful with their insulin pump and/or CGM.
What’s the process at your Center/office? I would love to hear what others are doing so we can all learn from each other.
Joyce Kulick, RD, LDN, CDE
NWPLNG Co-Chair