Telemedicine Allows Army, Indian Health Service to Expand Range of Diabetes Care

By Annette M. Boyle

Dwight D. Eisenhower Army Medical Center and Blanchfield Army Community Hospital launched the Army's first pilot Telehealth primary care services within BACH's Emergency Center earlier this year. In this photo, Spc. Nathan Dye prepares 1st Lt. Maxx Maumla as Gen. Daniel B. Allyn, the Vice Chief of Staff of the Army observes. Army Medicine photo by Laura Boyd

Dwight D. Eisenhower Army Medical Center and Blanchfield Army Community Hospital launched the Army’s first pilot Telehealth primary care services within BACH’s Emergency Center earlier this year. In this photo, Spc. Nathan Dye prepares 1st Lt. Maxx Maumla as Gen. Daniel B. Allyn, the Vice Chief of Staff of the Army observes. Army Medicine photo by Laura Boyd

FALLS CHURCH, VA—To reach the growing number of individuals in their care who have diabetes, both the Army and the Indian Health Service have aggressively adopted telemedicine, with excellent results. Their efforts have increased in importance with the dramatic rise in the number of Americans diagnosed with diabetes.

For the Army, telemedicine is making a difference in the lives of soldiers with diabetes as well as those whose dependents have the disease. While the number of active duty soldiers with diabetes has fallen from 249 to 186 in the last five years, a combination of improved treatments and better access to care means a diabetes diagnosis is no longer the career-ending event it was a few decades ago.

Telemedicine has been a major factor in improving access to care for soldiers and their families, whether stationed in the U.S. or abroad. “One of the benefits of telemedicine is the ability to provide the best health care Army Medicine has to offer, wherever the provider and the patient are,” said Colleen Rye, PhD, chief, Army Virtual Health.

Army Medicine spends more than $10 million annually on telemedicine, according to Rye. That investment “has built an integrated global system of telemedicine/virtual care covering our beneficiaries in over 30 countries and territories, 18 time zones and in over 30 clinical specialties,” she told U.S. Medicine.

Remote health monitoring (RHM) addresses one of the major concerns with managing diabetes among active duty personnel: How does it affect readiness?

A retrospective study of a telemedicine clinic at the Womack Army Medical Center, Fort Bragg, North Carolina, published in the Journal of Telemedicine and Telecare, tackled that question. It found that with remote monitoring,  very physically active patients with Type 1 diabetes “could attain acceptable [hemoglobin] A1c targets without compromise of military duties. Furthermore, through advanced monitoring techniques, we were able to verify that participation in extreme forms of activity was safe.”1

The range of activities studied included military deployments, airborne operations, high-altitude low-opening parachute jumps, 400-mile cycling events, and ultra-marathons as well as airborne and jumpmaster training programs.

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