Use of connected health technology to optimize outcomes for high risk pediatric patients with type 1 diabetes

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PROJECT SUMMARY / ABSTRACT This project investigates the utility and cost-effectiveness of patient-to-provider home-based video encounters, as well as the feasibility of remote monitoring of patient-collected health data for children and adolescents with type 1 diabetes (T1D). Although therapeutic options for T1D have advanced phenomenally in the last decade, measures of glycemic control in youth with T1D have not improved over this time frame. This gap between the potential efficacy of current treatments and their effectiveness in the clinical population illustrates a need for improved delivery of care. The current availability of secure, HIPAA-compliant platforms for video conferencing and remote data-sharing between patients and providers – combined with widespread patient access to “smart devices” with internet, Bluetooth and audio-video capabilities – presents the opportunity to develop innovative new models for delivery of T1D care. This proposal will investigate two such models via the following Specific Aims: AIM 1 – Conduct a randomized trial to evaluate the impact of supplemental home-based video visits on glycemic control, healthcare utilization, and patient experience for pediatric patients with T1D and suboptimal glycemic control. AIM 2 – Model the cost-effectiveness of supplemental home-based video visits for pediatric T1D patients with suboptimal glycemic control. AIM 3 – Evaluate the feasibility of remote monitoring – including automated analysis of patient-generated diabetes data to identify high-risk indicators between in-person visits – for pediatric patients with T1D. The long-term goal of this research is to establish how telehealth technology can best be used to supplement in-person care in ways that improve patient experience, cost-effectiveness, and health outcomes for pediatric patients with T1D. In parallel to completion of these research aims, the candidate will undertake an individualized course of study to attain key skills in the arenas of health informatics, cost-effectiveness analysis, psychometrics and survey methods, patient-centered care delivery, and leadership and mentoring. This training, in combination with an outstanding mentorship team and strong institutional support, will position the candidate ideally to compete subsequently for independent research funding at an R01 level, and to establish herself as a leading researcher in the arena of telehealth technology for pediatric T1D management.