Context
’ diabetes, hypoglycemic, diabetes
EVENTS, DIABETES
Many questions remain about how to optimize the use of RPM with population analytics for diabetes patients and providers alike. Challenges for practices who seek to implement RPM programs include: 1) utilizing a single data platform for all patients’ diabetes devices, 2) determining which metrics should trigger clinician outreach, 3) building the necessary staffing and workflows to support this type of unscheduled care, and 4) ensuring financial We are aware of one commercially available population analytic platform for diabetes data that is compatible with a majority of (but not all) commercially available diabetes devices (The metrics used to trigger clinician outreach in an RPM program will depend on staffing, anticipated frequency of review, and clinical goals at a population level. These three factors are highly interdependent. For example, if the clinical goal is to assist patients who are not self-monitoring closely enough, metrics should focus on frequency of CGM or BGM data and outreach should be frequent (perhaps weekly) to promote stepwise behavior change. In contrast, an RPM program aiming to reduce hypoglycemic events would choose metrics focused on frequency of glucose values <70 mg/dl or <54 mg/dl and might structure outreach on a monthly or twice monthly basis in order to capture persistent patient-level trends that warrant attention. The criteria for outreach (e.g., <3 BGM values per day, >5% CGM time <70 mg/dl) should then be selected in light of staff availability and the anticipated data profile of the target population, but may need to change over time to maintain a feasible workload. For example, in the current study, outreach was initially planned for all individuals not meeting published CGM targets (By tailoring the outreach threshold(s) to the patient population and provider time available, RPM programs are more likely to be successful. Starting with a targeted goal allows practices to build RPM workflows on a pilot basis that can later be scaled up to support larger population-wide programs. Pilot programs also enable practices to explore financial 