The changing role of CDE’s
As Diabetic Investor gets set to head to hot and steamy New Orleans for the annual conference of diabetes educators its worth examining the role these people play in not just diabetes management but which drugs and devices a patient uses. Even with all the fancy whiz bang technology now available to patients companies in this wacky world would be remiss to ignore the impact a Certified Diabetes Educator (CDE) has on a patient.
As we’ve been noting with regularity when it comes to interconnected diabetes management (IDM) gathering the data and transmitting it to the cloud is the easy part. Interrupting the data and getting the patient to act on it is the hard part. This the role we see the CDE filling in the future, a role which thanks to technology will not be limited by geography.
In the past CDE’s were largely employed by physician groups and hospitals. In the future we can envision CDE’s being employed by pharmacy retailers such as Walgreens or CVS, payors, device and drug companies. As we transition to outcomes based reimbursement which will drive IDM adoption everyone will want an edge when it comes to helping patients. They will need professionals who are not only well versed in the physical aspects of diabetes but also the psychological aspects. As we have noted many times good diabetes management is 24x7x365 job with no days off and carries with it a heavy psychological burden. Who better than to help the patient using IDM then a CDE.
Thanks to technology such as Skype, a tool already being used by some device companies on a limited basis, a CDE is no longer limited to specific geographical territory. Using such technology a CDE located in Montana could train and/or assist patients virtually anywhere in the world. This is not just practical it’s also very cost effective as companies would not have to pay for any travel related expenses plus the CDE could actually fit more patients into their schedule because they do not have to travel. It’s also practical from the patient’s perspective who also does not have to travel or take time off work.
In the past a major concern was the exploding diabetes population and the limited number of CDE’s. Back in the day if a patient lived in a major city such as Chicago it wasn’t a problem finding a CDE, yet for a patient living in Wyoming it was a much different story. Well thanks to technology it doesn’t matter where the patient is located all they need is an internet connection or smartphone, physical location is meaningless.
Given the transition to outcomes based reimbursement we also see physicians, payors, device and drug companies becoming even more dependent on CDE’s. A CDE can quickly identify which patients need help and which do not. IDM makes this possible as physicians just don’t have the time to analyze all the data nor does anyone else for that matter. Additionally the CDE using IDM can communicate with the patient helping them more effectively manage their diabetes. In effect the CDE is providing personalized assistance thanks to IDM.
While the days of face to face interactions between a CDE and a patient are not going away, these type of interactions will become the exception not the norm. The best part is this is actually a positive for diabetes overall. Technology will actually expand the role and influence of CDE’s, it will allow a greater percentage of the diabetes population access to CDE’s. This to Diabetic Investor is why we see IDM becoming the standard of care in the future.
Now there are certain things a CDE cannot do. They cannot force patients to test their glucose regularly, nor can they make patients be compliant with their therapy regimen or actually use IDM. Yet Diabetic Investor sees IDM becoming more widely adopted as patients will be basically bribed to use it. This bribe will likely come in the form of lower health insurance premiums, lower or the elimination of co-payments or perhaps contributions to the patients’ health savings account. Basically a patient with diabetes will be no different than a driver who attaches a monitoring device to their car who then receives lower premiums based on good driving habits.
Thanks to IDM the same principle applies, patients who use this technology can then be rewarded for achieving better outcomes.
CDE’s have always played a vital role and the need for CDE’s is greater than ever. Yet the role of the CDE like just about everything else in diabetes is being reshaped due to technology.