• Fresh Views

    8 Tips to Take Into 2022 With You

    Taking a memory into 2022 of a beautiful sunset on Hilton Head Island, SC

    What the New Year brings to you will depend a great deal on what you bring to the New Year. – Vern McClellan

    WHO ARE WE? 

    In this new year, if you are new to our blog, we are solution-focused diabetes care and education specialists. We are passionate about doing diabetes care and education differently. Too much of life is spent focusing on problems. Instead, we believe in turning attention to possibilities, opportunities, and a fresh vision for the future. We see the benefit in stepping alongside our clients as “think partners” to focus on what’s important to them, what’s already going well, and build upon that to reach their goals so that they may live life to the fullest. We invite you to join us in doing the same if this is a new paradigm for you. We are advocates for person-centered, strengths-based language, and believe that self-compassion is essential when living with a chronic condition. 

    OUR MISSION

    As we welcome the new year, our Mission continues to be that We guide healthcare professionals in taking a solution-focused approach to practice to enable clients with diabetes to embrace possibilities, opportunities, and a fresh vision for the future.

    Our interest and passion around taking a solution-focused approach to practice (and life), means acknowledging what has gone well, acknowledging how that success was achieved, then identifying how to do more of that and build upon that moving forward.

    8 TIPS TO TAKE INTO 2022 WITH YOU:

    With the start of the new year we’ve been doing alot of reflection. We’ve pondered what has gone well for us, how we were able to achieve that, and how we can build on that. Today we’re sharing  8 tips that we’re taking into 2022 with us and we challenge you to do the same as well as share with your clients:

    1. Make yourself a priority once in a while. It’s not selfish. It’s necessary. Skimping on personal needs can be harmful to our overall well-being. When we don’t put ourselves first and take care of ourselves, certain mental and physical risks can develop and lead down an unhealthy path.
    1. Smile often and laugh more. Finding humor and laughter in the everyday world is a key opportunity to reduce stress. It can also decrease anxiety, fear, and help people cope with challenging situations. Personally, we often feel rejuvenated and ready to face the world again after a good belly laugh or a few silly moments. Suddenly the weight of the world is lifted off our shoulders. Learn more in our blog here.    
    1. Learn something new. Many studies show that learning new skills is a way to improve your life. Learning something new can even tie in with #1 above. It may be an “excuse” you need for some “me time”. An appointment with yourself – so to speak – and a break from work or family. Our big “learning something new” in the new year is learning how to host a podcast! Stay tuned, more to come on that!
    1. Take a daily gratitude walk. As you walk, reflect on and express gratitude for what you are thankful for in the day. It can help you feel less stressed and focus on the good. Find other tips to get started with daily gratitude practice in oru blog here.
    1. Talk positive to yourself, instead of listening to yourself. Rather than listening to your mind’s fears, doubts, and complaints, speak to yourself with words of affirmation and encouragement. Learn more about the power of self-acceptance and helping cultivate it in others in our blog here, and positive affirmations here.
    1. Focus on “get to” rather than “have to” each day.  It’s not about what we have to do. It’s about what we get to do. It’s easy to act as if we don’t have a choice, but in reality we DO have a choice on a great many things in life. We can choose our attitude, our actions, and how we view life. 
    1. Remember your “WHY”. Remember WHY you do what you do. When we forget the WHY, it’s easy to get burnt out.
    1. Look for ways to serve and care. Referring back to #2, smiling is an easy way to show you care and takes nothing but a little effort.  Maybe it’s helping someone achieve their goals or shovel their walk (this is top of mind for Tami as we write with 6-inches of snow outside her window). Think about it, if we do one act of kindness each day of the year, that can change 365 lives! 

    We were hoping to add “Travel whenever possible” to this list since we both were avid travelers before the pandemic. But not this year with yet another Covid-19 surge. So we’ll save that one for next year (fingers crossed)! 

    WHAT’S TO COME? 

    Throughout 2021 we launched a series of posts related to applying a solution-focused approach to diabetes technology. What will we write about in 2022? To start off, we will be sharing practical tips to transform primary care visits by incorporating solution-focused tactics to support diabetes management.

    We hope that  2022 will be kinder to all of us and that together we can learn how to help people with diabetes live their best life!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Happy Holidays from A Fresh POV for You!

    Wishing you a happy and healthy holiday season from us here at A Fresh POV for You!

    We’re taking a few weeks off but will be back in the new year on January 12 with more fresh points of view to guide and support healthcare professionals in implementing a solution-focused approach to practice so clients can embrace possibilities, opportunities, and a fresh vision for the future. You won’t want to miss our new series packed full of practical tips on implementing this approach in a primary care setting!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: 3 Gratitude Apps to Use

    Gratitude and attitude are not challenges; they are choices.- Robert Braathe

    Tami was expressing gratitude for this stunning sunset on a recent weekend escape to Isle of Palms, SC.

    Expressing Gratitude is a topic we have written about several times as a tool that can be used in solution-focused encounters with clients. And it is a practice that we both embrace regularly. Expressing gratitude has been shown to help people improve their health, deal with challenges, and feel more positive. Really any time is a great time to develop and express gratitude –  from the big things in life to the tiniest things (like the sunbeams coming in the window as we write this).

    Following on this “season of thanksgiving” and closing out our year-long series on “Diabetes Technology and Solution-Focused Practice”, today we’re sharing 3 Gratitude Apps that you may wish to recommend to your clients (or use yourself).  

    Gratitude: Journal App

    Rating 4.9
    Price: Free & paid versions
    System: iOS, macOS
    Features/Content: Daily journal, affirmations, reminders, prompts, vision board

    We love that this app incorporates both the practice of gratitude and using positive affirmations (which we wrote more about in a previous blog here.) The user can journal in the app what they’re grateful for and add images. Plus, the app sends prompts as a reminder to record what you’re grateful for – for instance, “What made you smile today?” The user can also write their own positive affirmations to practice positive self-talk. Some of Tami’s favorites are, “I am kind. I will not worry. I am created for a purpose.” And from there, the user can create a vision board to focus on their goals and live life with intention. Deb also likes the fact that this app allows you to easily share with friends. To reinforce gratitude practice, Deb started sending text messages to friends to express appreciation. You can also easily post to social media channels.

    365 Gratitude Journal

    • Rating 4.7
    • Price: Free & paid versions
    • System: iOS, macOS
    • Features/Content: Journal, virtual gratitude jar,  prompts, sharing gratitude with others

    This is a science-based gratitude journal that guides the user to see the world in a more positive light. The app sends daily gratitude prompts that are thought-provoking and shares stories that cultivate self-love, positivity, and joy (another aspect that we fully appreciate. See our blog about finding joy here.) One gratitude strategy we’ve recommended in our previous gratitude blogs is having a gratitude box (or jar) and this app incorporates a virtual gratitude jar for the user to fill with things they’re grateful for. The app even lets the user write and send a little gratitude card to someone.

    Grateful: A Gratitude Journal

    • Rating 4.6
    • Price: Free & paid versions
    • System: iOS
    • Features/Content: Journal,  prompts, reminders, easily review past entries & customize timeline

    This app is simple and is designed to make reflection and giving thanks easy. The app will send a daily prompt/question to answer to start you off.  It’s at the ready to capture a grateful moment on the go. For reflection, the app allows the user to easily navigate past entries by timeline (such as to check frame of mind last December) or by prompt (such as to see the things that made you smile this year). This app is helpful in changing the mindset to look at the good, rather than focusing on the negative in the day.

    We hope that you find these gratitude apps helpful to you and your clients!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Small Steps, Big Difference: Celebrating National Diabetes Awareness Month

    Great things are not done by impulse, but by a series of small things drought together. – Vincent Van Gogh

    It’s National #DiabetesMonth! The activities and events that take place throughout this month create an opportunity to heighten awareness of diabetes prevention, care, education, and health outcomes. The theme this year is Small Steps, Big Difference: Preventing diabetes is within your reach. We love the emphasis on small steps. We often write about focusing on small changes, exploring how a client was able to achieve those changes, and then leveraging that success to build upon it to see more success. 

    When it comes to preventing diabetes, here are 7 tips from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for National #Diabetes Month about how to manage and even put prediabetes in remission:

    1.  Start with small changes to your lifestyle and daily habits.
    2.  Move more.
    3.  Choose healthier foods and drinks most of the time.
    4.  Lose weight and keep it off.
    5.  Seek health support from your health care team.
    6.  Stay up to date on vaccinations.

    When talking with our clients we’ve seen and heard the visible “exhale” of relief when acknowledging that changing choices, patterns and daily habits can be hard, and it’s okay to start small. They  don’t have to change everything at once.  As solution-focused diabetes care and education specialists we  have written about  #DiabetesMonth events and in particular,  taking small steps in the direction of “doing what works”  and then doing “more of what works”.  Beyond #DiabetesMonth we also have written about #WDD (World Diabetes Day) multiple times and #NDAM (National Diabetes Awareness Month). Regardless of the event that moves you to engage, we encourage you to take your own “small steps” to move towards a #solutionfocused practice as you help your clients make small changes to prevent or delay diabetes.

    What special activities do you have going on? We’d love to hear about them and share on Twitter @AFreshPOVforYou!  Help spread the word about managing diabetes!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Finding Solutions When They’re Not Obvious

    We are big fans of musicals, and wrote about a special musical on December 7, 2018.  A somewhat unlikely musical that received rave reviews (and a Tony Award!). A musical which really requires one to think differently about the interpretation of life’s events. The show is “Come From Away” . Maybe you’ve heard of it? What’s exciting is that now it’s a movie streaming on Apple TV+, (and it excites us that streaming apps can even play a role in solution-focused practice!) So we wanted to share this post again and encourage you to watch, enjoy, and think about how you can find solutions when they’re not obvious!

    At the core, it is a story about the power of kindness and generosity of strangers during a horrific time in the world, the first 5 days following the September 11, 2001 terrorist attack on the United States.

    To briefly recap, the setting is Gander, Newfoundland – a remote island with a “retired” military post from WWII and an old refueling station for transatlantic flights (before planes were large enough to carry all needed fuel). When the U.S. airspace was closed to inbound flights following the 9/11 terrorist attacks, 38 jumbo jets were diverted to Gander. This town of 9,000 nearly doubled in population as an additional 6,759 passengers became refugees so to speak  – unable to leave or to even get their luggage off the planes for 5 days. Along with them were 9 cats, 11 dogs, and 2 rare apes (one who was pregnant). The town affectionately called these individuals the “Plane People”, and put aside their worries and issues to care for these tired and terrified fellow humans. Local residents cooked food all night long. Stores donated medicine, supplies, diapers and toilet paper, while others donated clothing. School buses provided transportation to shelters and even private homes. During this horrific time, while deep sadness was everywhere (one woman lost her son, a New York City Firefighter), friendships were formed. One couple would even later marry and return to Gander for their honeymoon. When the time came to leave, the “Plane People” asked how much money they owed the people of Gander, and were told, “Nothing. You’d do the same for us!”

    This tragic event in U.S. history was translated into a certainly unlikely – and yet successful – Broadway musical. How did the creator, Michael Rubinoff, think this would work? According to Mr. Rubinoff, “Well, not many people shared that vision to turn this into a musical. It’s not obvious.” Building on that, when times are challenging and solutions are not obvious, it’s easy to feel down. One of those challenging and stressful times can be the start of the holiday season. (It’s hard to believe the stores are already in full holiday decoration mode!) Add onto that the continued impact of the COVID 19 pandemic, as well as daily diabetes management, and life can be downright overwhelming. Yet during this upcoming, often stressful holiday “season of thanksgiving and giving”, there is some encouraging news. Did you know that giving to others may actually be good for your health? Giving is linked with reduced stress, less depression, lower blood pressure, and feeling happy. Giving back can be a helpful strategy or solution to manage holiday stress. A solution that may not seem obvious. We believe giving can help build resilience.  

    We witness giving in the diabetes community all of the time. So many people living with diabetes are advocates and educate others. They create fundraising campaigns like Life for a Child  to provide insulin for children across the world without access. And we’ve seen posts on social media where someone runs out of diabetes supplies and within minutes, a stranger in a far off state connects with that person to share and provide support. When you have a couple of minutes, take a look at this special video from Diabetes What to Know about “paying it forward” and sharing the gift of education as well as the benefits of learning from others living with diabetes. 

    Will you join us in reflecting on the impact of the people of Gander and channel that in some small way by giving back? Whether giving back to the diabetes community, or others you cross paths with that are facing life challenges.  How can we all support, help, or encourage, as did the residents of Gander? There are many opportunities. It can be as simple as calling a friend and meeting them for coffee, even when you are feeling short on time. Or donating to a worthy organization that means something to you. We’ll all feel better in the end!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Language Matters Global Summit

    We’re taking a bit of a detour this week in our “Diabetes Technology and Solution-Focused Practice” series to focus on a special event – a Facebook Livestream Language Matters Global Summit. 

    We @AFreshPOVForYou have been supporters of the #LanguageMatters movement in diabetes care and education since early on. You can read previous blog posts here and here.

    Initially, when the Diabetes Australia Language Guidance Paper was published here, we were off and running, trying to incorporate strength-based, person-first language into all that we did. Deb was working at Sutter Health at the time and started a National Diabetes Month/World Diabetes Day campaign to educate healthcare professionals within the system about the rationale behind the movement and the meaning behind the words.

    Soon after the United States guidelines were published jointly by both the Association of Diabetes Care and Education Specialists (ADCES- formerly AADE) and the American Diabetes Association (ADA) the Use of Language in Diabetes Care and Education (Dickinson, JK, 2017) here. We were then even more inspired.

    As we’ve written about before, we were involved in the script development and production of the Telly Award winning video “Changing the Conversation,” with a purpose to raise awareness of the power of language and the impact language can have on a person’s well-being, quality of life and overall sense of self while living with diabetes. We’re so proud that this video has been shown around the world!

    And the use of language is the foundation of this solution-focused blog. We believe and live these principles every day and work to help others embrace the important messages and translate them into their relationships with their clients and co-workers.

    Yesterday, October 19, 2021 Diabetes Australia celebrated 10 years of moving the needle forward in the #LanguageMatters movement by hosting a Facebook Livestream Language Matters Global Summit. We were thrilled that this event included a showing of the Changing the Conversation video and Deb was so humbled to introduce the video once again to new audiences.

    As October turns to November and Diabetes Month activities, please consider sharing the YouTube link to this event and continue to raise awareness about the importance of and need to change the way we talk about diabetes to help stop the stigma, shame and blame often associated with a lack of knowledge combined with media hype around diabetes.

    We can all make a difference when we believe that #LanguageMatters!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    3 Solution-Focused Fresh Starts for Fall

    “Step out of the history that is holding you back. Step into the new story you are willing to create.” —Oprah Winfrey

    Lake Nevin at Bernheim Forest and Arboretum

    Fall has arrived! While some consider Fall an “ending” with the wrap-up of the glorious long days of summer, we here @AFreshPOVforYou think of Fall as a time for new “beginnings”. The air takes on a crispness. The trees magnificently change colors and leaves begin to fall. And it’s the perfect time for a solution-focused fresh start or two (or three)!

    Today we’re sharing 3 solution-focused fresh starts for Fall that you in turn can share with your clients/patients: 

    1. Fit a few more steps into the day. With shorter days and cooler temperatures it can be easy to become more sedentary. We know walking is good for us, and doesn’t require any equipment other than some well-fitting walking shoes. A favorite way to fit in more steps is to intentionally stand up every 30 minutes or so during the day and walk around for 2-3 minutes. That activity has been shown to benefit blood glucose and heart health. We’re also big fans of fitness trackers to keep up with how many steps are accumulated during the day, then try to bump that average up by 500 per day. Once that’s achieved, try adding another 500, and so on, working toward a goal of 10,000 steps each day. Read more about solution-focused practice applied to activity tracker conversations in a previous post here.
    1. Enjoy Fall vegetables (of the non-starchy variety). In fact, try filling half of your plate with these! Flavorful fall bounty includes arugula, carrots, broccoli, Brussels sprouts, cauliflower, kale, radishes, and spinach. These are all very low in carbohydrate (only 5 grams in a 1-cup serving raw or ½ cup cooked), so can help keep post-meal BGs in target and help bring more time in range. Plus, these veggies are packed with fiber to help fill you up. One of our favorites is roasted Brussels sprouts. Roasted radishes and roasted broccoli are pretty fantastic too! While Tami’s not a fan of raw radishes, roasted radishes are a different story. She’s found they become sweet and lose the bitterness when roasted. If you’ve never roasted vegetables, here’s the simple “how to” here. 
    1. Check-in on those New Year’s “solutions” (rather than resolutions) that you set 9 months ago. You can read more about our take on setting New Year’s “solutions” rather than “resolutions” here. This solution-focused approach focuses on things that have gone well in the past, and pinpointing how you can do more of that (rather than trying to change in the new year). Autumn is the perfect time to see what you have accomplished and had success with, and look ahead to what you want to do before the year closes out. 

    Find 3 more solution-focused fresh starts for Fall in our blog here from 2019.

    Stop back by in 2 weeks when we’ll share a few favorite apps that can be used in solution-focused practice. 

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Noom App

    Noom messaging to support healthy thinking!

    We at A Fresh POV for You hope you enjoyed summer and are now heading into fall with excitement and initiative!  As we continue our series on diabetes technology, today we’re sharing Deb’s experience with the Noom app. Both of us have used many different apps for healthy living, some of which we’ve written about in past blog posts. 

    Deb started using Noom recently because of all of the great things she was reading and hearing about the psychology behind behavior change.  While our goal as diabetes care and education specialists is to incorporate behavioral techniques into practice, including solution-focused practice, it’s often challenging to have enough time to teach the skills needed to embrace the behavior change. That’s where Noom comes in. 

    What’s interesting about Noom is that you answer many survey questions including history, habits and desires, then Noom crafts an ideal plan for weight loss or making healthy choices before you have to decide to commit to the cost. Noom incorporates several behavior techniques including Cognitive Behavioral Therapy. The overarching premise of Noom is to help people set small, achievable goals, so that as those are reached one will stay motivated, thus building  self-efficacy, which helps boost motivation.

    Noom has several statistics they share regarding their success rate. We only have the reports and can’t share personal experience as we are new to this app and technique. Some insurance plans will cover the Noom program and Noom will facilitate the process.

    What’s different about the Noom app is the psychology lessons each day – you choose how many minutes you want to engage, Deb’s been doing 10 minutes a day. The app encourages taking notes, writing down calls to action, setting goals and documenting them. Overall the theme of Noom is “I believe I can change my behavior”.  And it’s encouraged that the user reminds himself as time goes on.

    Noom also creates a social connection. There are Noom community groups as well as a Noom coach if one chooses to engage. The language used in the app is very encouraging, person first, and a questioning approach is used.

    So what does this have to do with a solution-focused approach? The psychology behind Noom assumes that the user has the power they need, but they need support and coaching to help develop positive thinking. That is a key component of a solution-focused approach – to start with the strengths of the individual and then build upon them. And as stated, they use a questioning approach, encouraging the individual to think about what might work for them as opposed to setting a strict plan.

    If you’ve been reading our blog you know we’ve written about the WW app (the old Weight Watchers) and some of the positive messaging we’ve seen from that app. We would say that Noom goes one step farther in teaching the mini-lessons focused on psychology.

    As with any healthy living app, the best app is often the one that resonates with you or your clients. If your clients are looking for something new, this might be an option, depending on costs.

     Please note that this blog is our personal experience and we receive no financial incentives from Noom.

    We plan to continue to write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Celebrating Labor Day Weekend!

    One of a few remaining Sunflowers in a field at the end of summer in Santa, Fe, New Mexico

    With the start of September and Fall on the horizon we @AFreshPOVforYou took a much needed break to celebrate this long weekend. Deb finally got to see her daughter walk across the stage during a very delayed 2020 college graduation ceremony. And Tami enjoyed a low-key “staycation” with her hubby…dinner outing with friends, family picnic, hanging out on the back porch in the cooler temps, appreciating the last of the sunflowers in her garden, binging Netflix, and bringing out the fall decor!

    Sunflowers in Tami’s backyard

    So we invite you to enjoy reading a past blog post from 2019 A Fresh Start in the Fall where we share 3 solution-focused fresh starts for Fall. In upcoming posts we’ll share some of our current approaches and what we’re doing to gain a fresh start. Deb recently started using the Noom app and she’ll be sharing her views on their strategies to make technology support healthy choices. Tami is renewing her focus on mindfulness, being present in the moment and practicing gratitude. 

    We hope you too took some time this long weekend with friends, family, nature or whatever makes you smile and rejuvenates you!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    Telehealth: A solution-focused practice

    Lorena Drago, MS, RDN, CDN, CDCES

    As telehealth continues to be a key aspect of healthcare, we reached out to our friend and fellow diabetes care and education specialist Lorena Drago MS, RDN, CDN, CDCES, owner of Hispanic Foodways LLC, to share her experience and solution-focused approach to engaging in successful telehealth visits.

    Here is what Lorena shared with us….

    Many health professionals have now adopted telehealth visits as part of diabetes care and education. I must admit that it has been a bumpy ride for health care providers and patients. Many of us have experienced technical issues. We are familiar with the “Can you hear me now?” plight as we connect to audio or have fallen victim to nostril intimacy when the patient moves the camera too close to the face. Let’s not mention those patients who believe pants are optional.

    Overall, there are many advantages to telehealth, such as convenience, saving time, and saving money on travel. Despite working out some kinks, there are still some challenges, such as lack of internet, poor connectivity, and low digital health literacy.

    After a year and a half of telehealth visits, I would like to share my solution-focused practice approach to optimizing virtual visits.

    BEFORE THE VISIT: PREPARATION IS KEY

    FOR THE PATIENT

    Create a checklist and review with patient prior to the appointment.

    • Does the patient have access to a computer, laptop, tablet, or phone?
    • Does the patient have internet access? 
    • Have they downloaded the application they will use for the telehealth appointment? Do they need help? Do they know how to use it?
    • Do they have a quiet designated space for the telehealth appointment?
    • Has the patient completed labs, if required?
    • Does the patient have his/her anthropometric measurements?
    • Does the patient have his/her blood glucose results available?
      • Is the patient able to upload his/her results into the hospital/clinic portal?
      • Is the patient’s meter, CGM, smart insulin pens, and pump connected to a platform where the health care team can access the information?
    • Have they completed the required patient forms prior to the appointment? 
    • Do they have insurance information?
    • If it is a nutrition appointment, do they have foods and labels they would like to discuss?

    A patient navigator or administrative staff can compile this information and help prepare the patient for the visit. For patients who experience some of the aforementioned challenges, a telephone visit may be preferable.

    FOR THE DIABETES CARE AND EDUCATION SPECIALIST

    Prepare the agenda for the visit.

    What does the patient want to know? I ask the patient:

    • What are 1-2 questions you would like answered before the end of this appointment?
    • What would you like to learn today?
    • What is going well with your diabetes management?

    Build on what the patient already knows.

    If you can share the screen, show the patient a list of foods. Ask, “which of these foods raise your blood glucose the most? If you are not sure, just tell me you are not sure.” After the individual selects the foods, I know what the knowledge gaps are, and I shift the education to bridging the gaps in knowledge.  For example, I provide a handout with pictures of whole wheat bread, skim milk, whole milk, fish, carrots, nuts. If the patient says that whole milk raises blood sugar and skim milk does not, then I focus on discussing the difference between carbohydrates and fat.

    Focus on the wins.

    When you discuss glucose management, it is common to focus on out-of-range results. After all, it is paramount to identify and manage hypoglycemic events. However, there is an inherent fear that the healthcare provider will admonish the patient for poor results. To avoid this, I ask:

    What do you think happened?

    This question invites exploration and reflection. Allow the patient to pause and reflect. Usually, patients will say, “I forgot to eat, or I did not eat enough carbohydrates.” Ask,

    What have you done in the past that has worked for you to remind you to do something?

    This question will allow the patient to recall past effective strategies and positive outcomes.  If the patient doesn’t come up with any answers, then offer suggestions that have worked for other patients.

    Make sure to use teach-back. Ask: 

    Can you tell me or show me in your own words.  Can you summarize the key points of today’s visit?

    Goal setting

    Establishing goals is often tricky for some patients. I usually create a list of goals and ask the patient to select an easy win. This way, it is easy to achieve, and the patient will be more likely to move forward. For those patients who are goal driven, formulate more complex goals and adapt to the patient.

    AFTER THE VISIT: DATA REVIEW IS REIMBURSABLE

    CPT Code & Service Provided

    • 95249: Patient equipment, CGM placement, hook-up, calibration, training, sensor removal, and printout recording.
    • Service performed by: MD, NP, PA, RN, PharmD, RDN, CDCES
    • Reimbursement: Medicare: ~$55, Commercial ~$127

    95251: CGM data interpretation

    • Service performed by: MD, NP, PA
    • Reimbursement: Medicare ~$40, Commercial: ~$100

    99457, 99091: Remote patient monitoring; collection and interpretation of physiologic data

    • Service performed by: MD or other qualified health professional
    • Reimbursement: Medicare: ~$50-$60

    Lorena created the Diabetes Teaching Tools for your Virtual Practice to help diabetes educators:

    • Reduce consultation time
    • In less than 3 minutes, identify what the client doesn’t know so you can focus on what the client needs to know.
    • Engage the client in the learning process using “real-life examples.”

    The diabetes teaching tool kit includes:

    • 13 topics presented in a simplified-visually rich style
    • 8 interactive activities with real-life examples to help patients use newly acquired information
    • Tried and true carbohydrate knowledge assessment tool so you know what your patients know and don’t know about foods with carbohydrate
    • Download and share with your patients: https://rd2rd.com/downloads/diabetes-teaching-tools-for-your-virtual-practice/ 

    We thank Lorena for the multitude of solution-focused practice pearls she shared with us and our readers in this week’s blog!

    Stop back by in 2 weeks to see what we write about as we continue to share about a variety of other technologies that impact and influence diabetes care and education!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

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