Pre-Diabetes Education on Davenport's Doorstep
The story of Education over NW TeleHealth

Inland Northwest Health Services (INHS) Community Wellness serves the broad geographic area of eastern Washington and northern Idaho. The region is dotted by small rural communities often with many miles between each. Thanks to innovative use of INHS’ Northwest TeleHealth system, rural residents now have access to diabetes and pre-diabetes education.  

In partnership with Lincoln Hospital in Davenport, WA, INHS Community Wellness Diabetes Center offers a $30, three-hour pre-diabetes education class monthly via NW Telehealth, providing convenient, affordable access to the information and expertise patients need to prevent or delay diabetes.  

The class is taught in two sessions one week apart, with online registration. It’s open to anyone, though many participants come on the recommendation of their doctor.  

At Lincoln Hospital, Jennifer Larmer, RN, BSN, facilitates the class, which takes place through real-time, two-way video conference. Participants in the class can see, hear and interact with a certified diabetes educator in Spokane, asking questions and getting the answers they need without ever leaving their community. 

“We designed this course for people who have pre-diabetes, who need that education to delay or prevent Type 2 diabetes,” said Debbie Belknap, a registered nurse and certified diabetes educator with INHS Community Wellness. 

The class, she said, covers what pre-diabetes is and what people can do to improve and manage their blood sugar levels. While learning a range of lifestyle changes they can make with nutrition and exercise, participants learn how to test their blood sugar and what those numbers mean. 

After the first session, participants have a week to start implementing what they’ve learned, then return with specific questions and concerns. 

According to INHS Community Wellness office coordinator Michelle Ensminger, an hour-long one-on-one session with a diabetes educator typically costs around $100. At only $10 per hour, plus a free glucose meter, the pre-diabetes class is a great deal for patients who want to take charge of their health and avoid the significant health consequences of diabetes. 

“We’ve kept the cost low because we want people to get that education,” said Ensminger, adding that most insurance plans don’t cover pre-diabetes. 

Additionally, participants are encouraged to bring a support partner, such as a spouse, at no extra charge. 

“Maybe the husband has pre-diabetes and the wife does all the food and they tell me I just eat what she serves,” explained Belknap. “It’s important to get that spouse there. When you have a support person there that knows what you need to do, what’s going on, they won’t inadvertently sabotage you.” 

The video conference technology, said Belknap, is very interactive. She encourages participants to ask questions during class and get her expert insight into their unique health situations. “It’s a two-way street. I have the video feed here. They have the video feed there. They can ask questions. I like to be interactive. I hate to be the one that does all the talking. It’s like I’m in the room with them,” she said.  

According to Larmer at Lincoln Hospital, the class has been well-received in the Davenport community. “It’s an eye opener for patients to start looking at the symptoms and nutrition that they may not have been exposed to before. It gives them a different understanding of what impacts diabetes.” 

“We still have someone on-site to show how to use the glucometer,” Larmer continued, noting that offering the class via telehealth eliminates travel expenses and issues, especially in poor weather conditions.  

“We try, in our community, to provide quality services and this is one we’re able to provide without the distance and travel expense,” she said. “It’s a good opportunity for participants to learn about their own health and how to self-manage without a great expense. It’s great preventative care…It’s been an excellent class for us to have. I appreciate the knowledge the certified educators offer.” 

As a result of the education, the pre-diabetes class is changing lives. Many participants have lost weight and improved their blood sugar numbers, said Belknap. “One went from an A1C of 6.4 to 5.6% and lost 20 lbs,” she added. “That’s a big deal.”  

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