Grand Forks doctor uses technology to reach patients

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Katie Tharaldson of Roseau, Minn., has three little faces at home, the result of pregnancies well-managed despite challenges from diabetes and the fact that her doctor is two hours away.

She and Dr. Eric Johnson, of Grand Forks, a family physician and assistant medical director of the Diabetes Center at Altru Health System, overcame those hurdles by using technology that allowed him to closely monitor her condition.

Tharaldson, whose children are 5, 2, and 9 months, was diagnosed at age 10 with Type I diabetes, a disease that can pose significant risk in pregnancy.

During her pregnancies, she would see Johnson once a month in person in Grand Forks.

But between visits, every week, she downloaded her blood-sugar readings to a computer and sent them to Johnson for review.

If adjustments were needed, he would call or email her the same day, she said.

“It was short and fast (communication). For the doctor, there’s no better control than being able to do that.”

The data were captured and stored in a sensor that was attached to a pump which continuously delivered insulin to her bloodstream.

Doing the work of a pancreas, the pump releases dosages of short-acting insulin which kicks in consistently, she said.

“You can set the settings (on the pump) for times when you have a greater need” for insulin.

Johnson kept a close eye on her blood-sugar levels, in part, because she would have extreme lows, which is unusual in pregnant women, she said.

The chief advantage of being able to keep such frequent contact with the doctor was fast turnaround, so as “to not let things spiral out of control,” she said. “You’re not playing catch-up. The care is consistent.”

Diabetic women can have large babies. Health professionals watch the developing fetus closely for any signs of risk, she said. “I had all safe pregnancies. They were all 8 pounds-plus and three weeks early.”

In the years since her first pregnancy, diabetes-related technology has come a long way, she said. With each pregnancy, she grew more comfortable and secure about using it.

She was one of the first to communicate her diabetes data this way to Johnson, she said. “With the second pregnancy, I didn’t have as many questions. And with the third, I was laid back and was doing more self-monitoring.”

This type of communication is “much more slick,” she said. “I have no complaints.

Embracing technology

While some physicians may shun technology or social media to connect with patients, others, like Johnson, are embracing it.

He connects with patients via email, as long as they understand it may not be secure, he said. “They may be having trouble understanding a complicated data set or question on an insulin pump.”

He also communicates via Facebook which features information about diabetes.

He does not use Twitter, but does text-message his patients who are having problems, he said. His patients can also reach him on his personal cellphone.

Altru’s comprehensive electronic health record, “from an efficiency and consistency standpoint, is outstanding,” he said. “It helps us with the chronic disease management process.”

He can remote-access the system from anywhere there’s an internet connection or laptop, he said, and review medication lists, lab values and chart notes from other providers.

“Soon, we’ll be able to access the record on smartphones as well.”

Altru patients can access aspects of their own health records through a secure portal called MyHealth. They can also communicate through that system.

“If there’s something they don’t understand, say, a question about lab values, they can find out through messaging,” he said.

Launched about a year ago, MyHealth provides lab results, immunization records, appointment scheduling, prescription renewal, growth charts, among other features.

Johnson also produces “very focused” educational pieces for providers and students on iTunes which can be accessed on a personal computer, iPhone or iPad, he said.

He covers a dozen diabetes topics, each running five to 10 minutes in length.

Johnson also expects more use of telemedicine for diabetes care, he said. That technology is not good for an initial evaluation but is useful for typical chronic disease management.

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