2016 Issues   /   November 2016

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

USM By U.S. Medicine
November 13, 2016

IHS Telemedicine

While the Army deals with a relatively small number of patients with diabetes, the condition is twice as common among American Indians and Alaska Natives (AI/AN) as among non-Hispanic whites, according to the national Centers for Disease Control and Prevention. In addition, the vast rural areas in which many AI/AN patients live makes regular clinic visits for disease management challenging.

In 2012, 15.5% of AI/AN adults had a diagnosis of diabetes, compared to the 9.3% rate seen in the general population. To reach the large number of patients, the Indian Health Service has stepped in to provide remote care via telemedicine.

Since 2001, the IHS has offered retinal screenings for individuals with diabetes via teleophthalmology. To date, more than 130,000 total examinations have been performed remotely in more than 100 clinics in 25 states. In 2015 alone, the IHS program provided 20,000 retinal examinations, said April Hale, IHS spokesperson.

In late September, the IHS announced a new contract for $6.8 million to provide telemedicine services in the Great Plains Area service units, which serves approximately 130,000 American Indians and Alaska Natives, Hale said.

The new service will enable “IHS facilities to offer additional specialty services and appointments to ensure patients have the fastest possible access to the health care they need,” including critical diabetes services, Hale told U.S. Medicine.

“Given the range of specialties that will become accessible through the new telehealth contract, patients with diabetes will have increased access far beyond teleophthalmology, which is important since patients with diabetes experience higher rates of cardiac, renal, and dermatologic complications,” Hale said.

  1. Choi YS, Cucura J, Jain R, Berry-Caban C. Telemdicine in U.S. Army soldiers with Type 1 diabetes. Journal of Telemedicine and Telecare. 2015. 21(7):392-395.
  2. Malasanos T, Ramnitz MS. Diabetes Clinic at a Distance: Telemedicine Bridges the Gap. Diabetes Spectrum 2013 Nov;26(4):226-231.

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