Diabetes technology has amazing potential to help improve a patient’s outcomes and quality of life. However, the technology that works for one person with diabetes (PWD), may not work for another. Therefore, it’s critical to first identify a person’s individual interests, needs and concerns. The Identify, Configure, Collaborate (ICC) Framework does just that.1 This model advises to begin with a conversation in order to provide the PWD with an opportunity to learn more about their technology options. The goal is to foster a partnership between the health care provider (HCP) and PWD that ultimately helps the PWD determine the technology that best fits their lifestyle.
As diabetes technology continues to quickly evolve and a patient’s desires, feelings, and experiences toward technology changes, their needs should also be reassessed. Think of the ICC model as a circular and ongoing intervention that aims to guide the PWD to help choose the right technology for them at the right time and subsequently reduce the stagnation of therapeutic inertia.
So, how do you begin this conversation around diabetes technology?
Medtronic partnered with ADCES to develop a technology assessment tool that aims to uncover a patient’s interests and barriers.2 The tool can help kick start this conversation and includes two questions that the PWD can answer. The first question provides a list of items and asks the patient to pick those they’re most interested in learning about. The list includes: keeping track of diabetes data, knowing how much insulin to take and when, and fitting diabetes into daily life, among others. The second question asks the patient to consider what’s preventing them from using technology and once again provides a list of items to choose from. Options include: I don’t know enough about what’s available, I’m concerned it might add more work to my daily diabetes routine, and I’m not sure I can afford diabetes technology.
Based on the boxes checked from the first question, the tool identifies which technology may be important for the patient. For example, if the patient is interested in knowing how much insulin to take and when the assessment tool leads to the associated technology of smart insulin pen or smart insulin pump. The conversation then can be centered around the patient’s interests and how the suggested technology can support their specific diabetes needs.
It’s equally important for the clinician to assess the boxes checked around concerns or barriers with technology. For example, this patient may have already thought of using a smart insulin pump, but in question two they may have checked ‘I’m not sure I can afford diabetes technology’. This provides further insight and allows the clinician the opportunity to discuss financial assistance programs that may be available.
Having the conversation around technology concerns can also help to decrease assumptions made by the healthcare provider (HCP). Convenience, for example, can mean very different things to different people. While one person may think ‘I don’t want something attached to me’ another may think ‘It’s so much easier to bolus through a pump than to give another injection’. As you can see, this new technology assessment tool focuses on patients and aims to foster shared decision-making. It allows patients to engage in conversation, leads to adoption of different diabetes technologies, and enables patients to gain momentum in improving their diabetes outcomes and quality of life.
Greenwood, D. A., Howell, F., Scher, et al. A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education: The Role of the Diabetes Care and Education Specialist. 2020 The Diabetes Educator, 46(4), 315–322.
Association of Diabetes Care and Education Specialists (ADCES); sponsored by Medtronic. Talking About Diabetes Technology With Your Diabetes Care Team! Available at https://www.diabeteseducator.org/practice/practice-tools/educator-guidance/technology-integration