New direction for enhancing quality in diabetes care: utilizing telecommunications and paraprofessional outreach workers backed by an expert medical team.

Authors: Mayes PA, Silvers A, Prendergast JJ.

This article assesses the value of using telecommunications with Promotoras (paraprofessional outreach workers) and an expert medical team of registered nurses (RNs) and endocrinologists in an at-risk type 2 diabetic Hispanic population recruited for a telemedicine feasibility project from a free clinic. A Promotoras is the primary educator and the point of communication to patient or medical personnel overseeing each patient’s home glucose monitoring, medical records, and medications, regularly communicating by telephone and e-mail with patients and diabetes specialists. Estimates of means, correlations, t-tests, and slopes of the repeated measures were obtained, and comparisons were made between first and last values. The most important sign of improvement in the patients’ situation was the significant decrease in HbA1c to 7.2% from 9.6% (p = 0.001).