mHealth Congress: Joslin goes virtual for diabetes management

BOSTON—The Joslin Diabetes Center in Boston has been able to demonstrably improve patient outcomes with its diabetes management model, but with a finite set of resources, how can the center move beyond the approximately 250,000 patients that it and its more than 40 affiliates currently treat? By moving to the virtual space, said Chief Medical Officer Martin Abraham at a July 26 panel at the 4th Annual mHealth World Congress.

Joslin takes a multidisciplinary, patient-centered approach to managing diabetes that produces positive results. Patients begin treatment at the clinic with a mean A1C level of 7.5, but the average patient is able to reduce that number in short time and maintain a lower level for a long time, according to 10 years of data pulled from Joslin’s EHRs.  

The quarter of a million patients benefiting from the delivery model at Joslin or one of its 47 affiliates is “really a drop in the bucket when you look at the tsunami of diabetes coming at us,” according to manager of web care at Joslin, Paul Penta, MBA.

“We are using the Joslin center in Boston as a test bed, a place to experiment and understand what works for patients,” Penta said. “We’ve been doing that for over 100 years and we have a pretty good handle on how to do that in a personal environment. We need to evolve and begin to understand how we can export that."

“We feel that we have a model of care that is sustainable, but needs to be exported and made available to more people in more places at anyt ime they wish to take advantage of it,” added Abrahamson.

To expand its influence, Joslin will begin to share its various resources and health management tools through Joslin Everywhere, a web-based service, and Joslin Inside, a mobile application-based service. These services will be made available to providers and patients alike, and intend to support primary care providers who see more diabetics than specialists without the specialized knowledge and to engage patients.

Hosting these services in the virtual realm makes sense because they will be easily accessible and they will not take up too many of Joslin’s resources nor many of a provider’s, the panelists said, keenly aware that they should not be introducing additional burdens to clinical workflow.

The services have yet to launch, but Joslin will begin piloting an app-based weight management tool later this summer and hopes to begin analyzing results as soon as possible.

“The first stage of this system is patient engagement, getting them involved whether it's via mobile device or the web,” said CIO Edward Charbonneau. “Longer term, it’s about behavior change. We need to do something with the data patients are giving us… so that they can be actionable with that information and take better control of their lives. That really is what Joslin has been about during its history, empowering patients to take care of their own diabetes and we’re taking that to the virtual stage.”