International Diabetes Center: COVID-19 Won’t Stop Us From Fulfilling Our Mission

Over the past six weeks, challenged by the threat and disruption of COVID-19, all three divisions of the International Diabetes Center (IDC, part of HealthPartners, a consumer-governed, nonprofit health care organization) have brainstormed, adapted, innovated, cried, laughed, and struggled. However, we’ve remained determined to continue to fulfill our mission of ensuring that every person with diabetes receives the best possible care.

In IDC Patient Services, we have learned that free video instruction for patients needing to learn how to safely measure and inject insulin can play a vital role, especially when in-person patient-clinician interaction is limited, as with the COVID-19 pandemic. Video education saves time, as patients don’t have to take time off work and travel to a clinic, and minimizes virus exposure and transmission for all. Videos found available online, however, were outdated or presented incorrect information from our perspective, or were cost-prohibitive for licensing, so we developed our own set. The YouTube videos enable a broad population of English-, Spanish-, and Somali-speaking patients to access accurate instructions for how to measure and inject insulin doses, whether using one or two types of insulin with a syringe, or an insulin pen. We predict providing patients safe education via free e-learning will become standard practice, beyond times of shelter-in-place requirements.

In IDC Clinical Research, we have learned moving to phone or video visits as much as possible, using services that support Health Insurance Portability and Accountability Act (HIPAA) compliance (such as Google Duo or Google Voice), was essential. Strong relationships built in the past between our sponsors and our principal investigators and study coordinators, along with the trust we built with our Institutional Review Board (IRB), paved the way for a smooth transition. For staff to work remotely, we converted paper documents to “fillable” forms that could be completed electronically. We also implemented HIPAA-authorized electronic signatory methods, avoiding the print-and-sign routine. Our institution’s IT department facilitated remote auditing of electronic health record documents by sponsor monitors. Patients quickly learned to download data from their diabetes devices at home, with clinicians using cloud-based programs to review remotely. When seeing research participants cleared for essential in-clinic visits, we conducted only necessary face-to-face procedures (eg, phlebotomy, EKG, etc.); we gathered all other study information remotely. All sponsors amended protocols to allow for remote visits, and our IRB quickly responded to such amendments. We predict that research studies in the future will include more remote visits, utilizing more electronic documentation, with on-site information limited to collecting critical study-outcome data. By reducing the burden of time away from work and school, a strong remote component of future research studies will likely result in more individuals volunteering to participate in IDC clinical research.

In IDC Professional Training, we have learned that no matter what, educators love to educate. Despite the disruption caused by the outbreak of COVID-19, a strong desire remains for continuing education (CE), especially in how to leverage diabetes technology to enhance virtual visits. After canceling our live (in-person) CE programs, we had to pivot quickly to create web-based programs. We needed to make decisions regarding live streaming versus archived (enduring) CE programs, rapid completion of revised CE applications, ongoing communication to faculty and registered participants, and establishment of a refund policy. Frequent team communication via email and WebEx was essential in establishing new agendas, learning objectives, timelines, program pricing, marketing strategies, and web-hosting capabilities. Our faculty was willing to transition from a live to web-based presentation and the CE accrediting organizations were flexible. We predict we will continue to expand web-based CE programs and offer fewer live programs. This will allow us to expand our CE reach beyond those who are able to attend a live program. A key factor will be determining standard pricing for high-quality web-based CE programs given the availability of free CE opportunities on the Web.

The COVID-19 pandemic has challenged all three divisions of the IDC to work together more than ever. We needed to find innovative ways to support our patients and their families living with diabetes. While the coronavirus has demanded many levels of physical separation, heartfelt concern along with rapidly deployed advances in technology are keeping us emotionally connected to our patients and to our colleagues at the IDC and nationwide as we strive to continue our mission of providing high-quality diabetes care and education.