Half a year into the COVID-19 pandemic, community health centers nationwide have faced nearly every imaginable challenge in providing continuity of care for patients with underlying health conditions.
Missed wellness visits and other factors are especially concerning for diabetes patients
Health centers have experienced a dramatic rise in patients missing their wellness appointments and shortages of staff with competency in providing virtual care while many patients lack internet access. Despite these barriers, health centers have responded rapidly and creatively to serve their clients. In particular, health centers have been concerned about patients living with diabetes who, due to quarantine orders or limited services, lost their ability to regularly monitor their condition or receive nutrition and other educational supports.
Though diabetes impacts about 11 percent of the general U.S. population, the disease is almost twice as prevalent among community health center patients. Health centers understand that proactive diabetes care management is key to producing meaningful improvements, in both patient outcomes and cost savings.
This is why health center leaders are continuing to prioritize proactive care management while also adapting their systems to cope with the pandemic. As a result, health centers nationwide are moving toward significant — and potentially permanent — changes in how they treat underlying conditions such as diabetes.
Expanded use of telehealth visits to help patients manage their diabetes
The most obvious example is that centers are, whenever possible, going virtual. The pandemic has expanded opportunities for health centers to leverage telehealth as a safer alternative for chronic care management. While some health centers had already developed systems for virtual care in recent years, others had to pivot quickly. Centers that serve rural areas where Wi-Fi was unavailable, for example, set up hotspots in their parking lots so patients could engage in telehealth discussions with center staff. Many health centers report discovering some unexpected benefits, including a significant reduction in the number of missed appointments.
Giving patients tools to monitor their health at home
Monitoring weight, blood pressure, and A1C levels in diabetic patients has proved particularly difficult during quarantine, but health centers have found creative options. Some have given patients scales, blood pressure cuffs, and glucometers that remotely send data to nurses when used. Other centers set up tents outside, not for COVID-19 testing, but for preventative measures such as patient education and lab work so that patients with chronic health conditions feel safe to continue wellness check-ups.
People with underlying health issues such as diabetes face a higher chance of experiencing serious complications from COVID-19. As a result, the pandemic has spotlighted the need to address more directly, and holistically, chronic conditions, as well as emphasized the importance of prevention. Many health centers, thanks to increased efforts to re-connect with diabetes patients most at risk, have been able to establish well visits after long absences and find primary care providers for identified patients who did not have one previously.
Renewing strategic partnerships to help patients access healthy food and PPE
The pandemic has also inspired a renewed commitment to strategic partnerships and investment in public health. Community health centers have worked with local food banks to provide diabetic patients with healthy food options, received donor support to provide patients with masks and sanitation kits, and even recruited medical students to conduct outreach calls.
For more specific examples, you can view NACHC’s recent three-part webinar series, Returning to Primary Care: Diabetes Care during a Public Health Crisis. Many of these community health centers have utilized NACHC’s Diabetes Change Package, available as a downloadable publication and an e-module, which is essentially an evidence-based playbook to help readily identify which areas are in need of systems change. The change package includes action tools to quickly implement interventions, as well as resources and templates.
With community health centers serving 30 million people nationwide, the need for chronic care management is just as essential as a rapid response to COVID-19. After the worst of the pandemic is behind us, the right tools and a bit of creativity could result in long-term improvements in patient care for those living with diabetes and other chronic conditions.