Connecting From Afar: Implementation of Remote Data-Sharing for Patients With Type 1 Diabetes on Insulin Pump Therapy

The coronavirus disease 2019 (COVID-19) pandemic led to a rapid expansion in the use of telemedicine for treating many conditions, including type 1 diabetes. In the T1DX-QI, we reported a rapid adoption of telemedicine during the pandemic (2). We described interventions for and barriers to telemedicine practice in type 1 diabetes care and identified access to technology tools as one of the key drivers of adoption (2).

After the increased adoption of telemedicine in our clinics, we identified a quality gap in accessing insulin pump data remotely. The Tandem t:slim X2 insulin pump was most used pump used by our patients attending the two clinics. As part of the activities supported by the T1DX-QI, we started a quality improvement (QI) project aimed at increasing the percentage of patients with type 1 diabetes using the t:slim X2 insulin pump who were able to share data remotely. Patients have different options for sharing data when they are not in the clinic, but the process requires a good understanding of the manufacturer’s online data-sharing platform (t:connect) (Supplementary Figure S1). First, patients need a t:connect account. Then, if their account is not linked to the t:connect health care provider (HCP) portal, they must upload their pump data using cables to connect the pump to the computer, generate the report, and send it (e.g., by e-mail) to the clinic. This process is time consuming, requires patients to take several actions, and in our experience, is prone to failure. Instead, if patients’ t:connect account is linked to the HCP portal, uploaded data are readily available on the platform for HCPs to access. Finally, in the ideal scenario, patients can share data through the t:connect mobile app, which became available in August 2020. In this case, no cables are needed and pump data can be easily accessed remotely at any time on the manufacturer platform, as long as a patient’s account is linked to the HCP portal and the t:connect mobile app is open and transferring data. For this project, we sought to increase the percentage of patients with type 1 diabetes using the t:slim X2 insulin pump who were able to share data from a baseline of 40% to 80% in 6 months. The measured primary outcome was the percentage of patients with an established t:connect account linked to the HCP portal, and the secondary outcome was the percentage of patients using the t:connect mobile app.