Diabetes

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A patient with uncontrolled diabetes and peripheral vascular disease is being monitored by a HomeCare agency utilizing Meditel360's two-way televideo, a glucometer, a blood pressure monitor and a general scope. The Registered Nurse (RN) Telecare manager conducts a 2-way televideo remote assessment. She watches the patient take his blood pressure and notices he has been misapplying the cuff.  She corrects the patient’s technique, and watches until the patient can demonstrate correct procedure. After this, the patient tells the RN he’s concerned about a potential skin lesion on his abdomen. The RN asks to see it, but discovers the patient is having difficulty judging the camera’s field of view. She then remotely turns on a picture-within-a-picture displaying video from a general scope on the patient’s televideo screen to afford him a view of what he’s showing the RN and instructing the patient to point the scope at the lesion (or any other are of interest, e.g. his foot). The patient now understands that he needs to adjust the camera angle (or his body position) and does so. The RN now sees the suspected lesion, but determines this is not of concern. Nevertheless, the patient needs to be educated about what true skin decubiti looks like, and tells the patient she will push a short video down to the patient for him to watch on the televideo screen after their session. He replies that the last time she did this, he found it confusing, and would prefer that they watch it together. She agrees, and she embeds the educational video in their session, pausing it when the patient has a question.

Prior to ending the call, the patient tells her he will be staying with his daughter for a few days and is concerned he may repeat the poor cuff technique. The RN agrees to send a proper blood pressure technique video to the daughter’s iPhone or computer so that patient and daughter can review it together at her home.