Maternity Hospital runs virtual clinics for pregnant women with diabetes

THE Diabetes in Pregnancy service at University Maternity Hospital Limerick (UMHL) has served mums and mums-to-be throughout the Covid-19 pandemic, thanks to innovative ‘virtual clinics’.

According to the UL Hospitals’ Group, these clinics provide convenient access to health services at a time when social and physical distancing remains so central to minimising the threat to public health of the coronavirus.

A virtual clinic is one in which the patient and clinician interact in real time, via a video link or phone call instead of the traditional face-to-face appointment.

Staff and patients of the Diabetes in Pregnancy Service at UMHL are using the ‘Attend Anywhere’ video platform and telephone calls to conduct a total of 92 virtual consultations every week.

This technology is enabling the Diabetes in Pregnancy service to host four Gestational Diabetes clinics every week with a total of 24 patient ‘slots; one weekly clinic in Insulin Initiation with six patient slots; while also allowing for 20 scheduled calls for two RAMP-led telephone clinics, as well as up to five additional RAMP-led telephone clinics with some 28 telephone slots.

UMHL has been using the telephone for distance consultations since 2002, scheduling contacts with patients on the IPMS system to provide a more structured service. The Attend Anywhere video platform has been use since May 2020, as part of UL Hospital’s Group’s strategy for resumption of services by using virtual clinics as a safe means of contact and consultation for patients.

Karen O’Brien, a schoolteacher living in Cappamore, County Limerick, approximately 30 minutes’ car journey away from the hospital, has Type One diabetes and has a son aged two-and-a-half years.

Currently attending the Diabetes in Pregnancy Service at UMHL for her second pregnancy, she says she finds the virtual clinics much easier to organise and fit into her life than the face to face consultations she had to organise during her first pregnancy.

“I feel much safer, obviously, during the pandemic, and I find it great for my work because I teach, and it can be difficult to organise times for the clinics. It’s much easier to schedule a virtual clinic for a time to suit you.

“It only takes about 15 or 20 minutes to organise, and you’re done until your next clinic. It’s great. It’s definitely much more convenient,” Karen said.

“In the past, I would have had to go for a consultation after school, so it could be after 3.30 before I would get to the hospital, and perhaps as late as 7.30 before I got out. What happens now is, I get a letter in the post as usual, but as well as the date and time, there is also a link. When the time comes, you log onto that link, there is a short logging on process, and you are through to your doctor or nurse more or less straight away,” she explained.

“I have a Flash monitoring device, and because of that, they have all my charts and everything online, and they can see the results, and they talk you through your results, you get the opportunity to talk about any difficulties you might be having, and it’s all done in 15 or 20 minutes,” she said.

“It’s just the same as going to a regular clinic, really, except that it takes all the inconvenience out of it,” she said.

Yvonne Moloney, a registered advanced midwife practitioner on the service, said that the video calls had proved very successful for a broad cross-section of patients.

“Certain patients have engaged very well with video calls, including non-Irish patients, patients who are nervous of becoming infected with COVID-19, patients travelling long distances, patients with child-minding difficulties, and with difficulties accessing public transports.

“Patients who speak another language and have a friend or family member of their choosing on the video call, which is particularly useful at a time when family and friends cannot join them for appointments at the hospitals.

“Interpreters can also join the calls if necessary, and if the language barrier poses too great a difficulty on the video call, a face to face appointment can be arranged,” she said.

Dan Danaher