Diabetes Management and Insulin Adjustment via Clinical Pharmacy Telehealth Visit

Clinical Domains

Primary Care, Tele-Health/Tele-Medicine

Clinical Role(s)

Pharmacist, Registered Nurse

Patient Condition(s)

Diabetes, High A1C

Scenario Type


Strength of Evidence

Strength of Evidence Rating 5 out of 5

Date Last Reviewed



Human Factors Engineering (HFE), Office of Health Informatics, Veterans Health Administration

USER Goal:

Complete a telehealth consult visit.

Scenario Description

Clinical Pharmacy Specialist Carlos is serving as a Telemedicine Provider from his Medical Center, for the surrounding rural health community CBOCs. Carlos is performing a follow-up appointment, as a Telehealth consult, with the patient Judy who has diabetes and is not meeting the recommended A1C levels. While Carlos is reviewing the patient’s lab results, the Telehealth Nurse at the CBOC brings Judy into the video room. Using the clinical video telehealth (CVT) connection, Carlos reviews Judy’s medications and insulin injection data with her and adjusts them appropriately to be more effective. He then discusses the changes with Judy, provides her education on her new insulin injection routine and discusses her diet, exercise and weight loss. Carlos enters a progress note for Judy, which completes the consult. The information that is recorded includes the assessment and plan for Judy, as well as information related to tracking and managing interventions for the diabetes disease state.


• At some CBOCs, the CPS and RNs work together to provide diabetes education and the overall review.
• At some CBOCs, the CPS enters a nutrition consult in the system so the patient will be counseled on diet.
• A Patient’s glucose information can include data sent to the VA by a Care Coordination Home Telehealth (CCHT) device and pulled from that system by a nurse.
• This same appointment could occur in

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