LAUSR

Since December 2019, a novel coronavirus disease (COVID19) caused by severe acute respiratory syndrome coronavirus 2 was found in Wuhan, and rapidly spread throughout China and extended globally.1 By the end of August 2020, the positive momentum in COVID19 control has been locked in, and nationwide virus control is now being conducted on an ongoing basis in China. In order to improve the regular epidemic response mechanisms to prevent a resurgence of the outbreak, Beijing Municipal Health Commission recently issued a notice that appointment is required for all nonemergency outpatients in general hospitals. Although outpatient appointment has emerged for several years, queuing registration onsite is still the traditional and predominant way in China, which is different from the consistent outpatient reservation system in western countries. Whether this rapid shift in the approach of outpatient registration would heighten the difficulties in accessing medical services during the coronavirus crisis? In addition, although the situation of the COVID19 epidemic is improved, China is still under pressure of preventing sporadic or asymptomatic cases. All these challenges are worthy of attention, and new ways of getting medical services are urgently needed. With the popularisation of smartphones and wireless networks, mobile health technology was applied to the selfmanagement of chronic diseases, such as diabetes. Since 2016, mobilebased diabetes prevention and selfmanagement have been highlighted and recommended by American Diabetes Association and Chinese Diabetes Society.2,3 However, most of these mobile applications were focused on diabetes selfmanagement and lacked the involvement of professional medical personnel, which results in limited effect. Beijing Municipal Medical Insurance Bureau recently released a notice saying expenses from Internet medical services could be covered by Chinese Medical Insurance Funds, which was a forceful policy support for patients to get individualised medical services in this regular epidemic containment stage. The latest research demonstrated that diabetes was a representative indicator of multiorgan injury and an earlier predictor for poor outcomes and death in COVID19 patients.46 Assisting diabetes patients in managing diet and blood glucose during the COVID19 epidemic has been a hot issue concerned by diabetologists. In order to explore the diabetes management model based on physiciannurse collaboratively online consultation during the coronavirus crisis, ‘306 Diabetes Club’, a mobilebased public WeChat account established by the Department of Endocrinology in our hospital, was provided to outpatients with diabetes.7 There were 1443 individuals who followed this account, including 491 new followers from 14 Feb to 31 Mar 2020. In this period, a total of 362 consulting questions were raised by followers, which mainly focused on diabetes diagnosis (27.1%) and medications (42.8%).7 All of these consultations were timely replied by professional endocrinologists and senior nurses, with high user satisfaction. By outpatient appointments combined with physiciannurse collaborative online consultation, the risk of coronavirus infection might be decreased by preventing crowding. Meanwhile, the basic medical needs could be timely met, which won outpatients’ high praise.7 In addition, flexible working pattern and reduced workload were also well received by health professionals, which may ease strained doctor– patient relationships in China. Considering practical feasibility and clear benefits, we expect outpatient appointments combined with mobilebased physiciannurse collaborative medical consultation could become routine in China with the regular containment of COVID19.