Implementation Plan for a High-Frequency, Low-Touch Care Model at Specialized Type 1 Diabetes Clinics: Model...

Area of Science:

• Endocrinology and Diabetes Care
• Digital Health Interventions
• Healthcare Management

Background:

• Optimal glycemic control in type 1 diabetes (T1D) is associated with frequent healthcare team interactions.
• Telemedicine interventions offer a potential strategy to improve hemoglobin A1c (HbA1c) levels in T1D patients.

Purpose of the Study:

• To identify provider- and system-level factors influencing the successful implementation of virtual care in T1D clinics.
• To understand the facilitators and barriers to adopting high-frequency virtual care models for T1D management.

Main Methods:

• Semistructured interviews with clinic managers and certified diabetes educators (CDEs) were conducted.
• Deductive analysis using the Theoretical Domains Framework informed implementation strategies.
• Behavior change techniques were mapped to address identified barriers.

Main Results:

• Clinics expressed strong interest in high-frequency virtual care, anticipating improved patient outcomes and engagement.
• Increased workload for CDEs and insufficient resources were identified as potential barriers.
• During the pandemic, clinics developed adaptive strategies to overcome resource limitations for virtual care adoption.

Conclusions:

• Existing strengths can be utilized to support high-frequency virtual care for T1D.
• Targeted clinical incentives and support are crucial for overcoming implementation barriers.
• Virtual care models hold potential for enhancing T1D management and patient outcomes.