Remote health care doesn't just mean Zoom appointments.
Diabetic amputations are impacting the lives of veterans on a massive scale, but they’re a huge problem hiding in plain sight. Diabetes is the most common reason a veteran is admitted to a Veterans Affairs hospital. In fact, one in four veterans in the VA health system have diabetes, and many are familiar with these statistics.
But it’s not just diabetes that causes strain on veterans, it’s the lower extremity amputations that can come along with it.
Up to 34% of people with diabetes have a lifetime risk of developing a diabetic foot ulcer, which can lead to an amputation. Many don’t realize 80% of non-traumatic amputations are caused by diabetes, particularly diabetic foot ulcers.
Once you have one amputation, you’re likely to have another. In fact, approximately 40% of individuals who have an amputation will endure another within five years. These amputations radically alter lives, and the mortality rate following them is extraordinarily high (over half of patients with amputations will die within five years).
But surgical amputations of lower extremities can be prevented through the use of technology. Some VAs are already using programs that can detect signs of foot inflammation up to five weeks before it would typically present—allowing VA providers to intervene with enough time to avoid diabetic amputations.
This technology is critical. For many, it’s hard to notice symptoms of diabetic foot ulcers on their own. Due to diabetic retinopathy, many veterans are unable to catch early signs of wounds or inflammation that could lead to lower-extremity amputations. The foot is difficult to inspect, even with a caretaker to help. Changes can be so slow that problems seem to arise out of nowhere.
It’s also difficult to find consistent foot care. Veterans tend to live further from health care facilities. In fact, rural veterans represent 34% of those enrolled in the VA system. These veterans might have a hard time making appointments and finding transportation, or they may lack internet access, live alone or struggle with mobility issues.
When the COVID-19 pandemic began, the shift to at-home medical care and telehealth services began to accelerate quickly. However, this type of remote care isn’t limited to Zoom appointments.
To address this major problem with diabetic amputations, the VA created The Initiative to End Diabetic Limb Loss in partnership with a company that developed a Food and Drug Administration-cleared and cellular-connected mat that resembles a bathroom scale. Veterans that are at risk of developing diabetic foot complications simply step on it every day for just 20 seconds. The mat scans their feet and records the foot temperatures, monitoring for any signs of inflammation. A virtual care support team then also reviews these scans and offers support to the veteran, ensuring that any warning signs are caught early. From there, the VA provider is notified if any additional intervention is needed. The program has earned engagement rates of over 85%, generating adherence and patient satisfaction scores that are rare among at-home remote monitoring solutions.
With technological innovation, at-risk veterans can be monitored safely at home to help prevent unnecessary amputations. The program has already rolled out in many VA locations, but every veteran deserves the option. More VAs should integrate this program and others like it, bringing the advancements of technology into the everyday lives of those that need it most.
Bob Kerrey is a former U.S. senator and governor of Nebraska, as well as a Navy SEAL and Medal of Honor recipient, and Jon Bloom is the co-founder and CEO of Podimetrics.
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