The 65-year-old woman's car is broken down, and she has to rely on family members to take her to doctor's appointments.
"If I have a way to go, I'll go. If I don't, I won't," she said.
Health officials say the poor and uninsured who live in rural areas have an especially difficult time receiving medical care for complex conditions because there are few specialists in those areas. Often this population goes without treatment, their health worsens and they end up in the emergency room.
Access to treatment is expected to improve by the year's end, however, with the installation of telemedicine equipment at 43 federally funded community health centers around the state.
Telemedicine involves the use of video conferencing, via a broadband connection, that makes it possible for specialists to examine patients in the offices of doctors elsewhere. They can see one another on computer monitors and communicate orally in real time, but the doctor loses the ability to touch the patient.
Vanderbilt University Medical Center, the University of Tennessee and St. Jude Children's Research Hospital in Memphis are providing specialists. Program officials say they are in the process of lining up more specialists, who could provide treatment for everything from heart disease to mental health issues.
Link will save time, cash
"Our patients are going to get better care because they are going to be able to see a specialist more conveniently," said Mary Heinzen, executive director of the Hardeman County Community Health Center clinics in Bolivar and Stanton. "It's going to save time, money and worry on the patient's end."
"As it is now, we have to send our patients 45 miles away to Jackson or 75 miles away to Memphis. A lot of them are poor or have limited resources. They don't have vehicles. They have to pay people to take them or their relatives have to take time off from work to take them."
In Tennessee, there are 23 federally funded community health clinics with more than 100 locations. These clinics serve roughly 250,000 patients who otherwise might go without prenatal care, cancer screenings, diabetes treatment and a long list of other services. However, the centers typically don't offer surgery or specialty care for heart disease, cancer or other serious problems.
Keith Williams, the chief executive officer of the Community Health Network, the group that applied for the telemedicine grant, estimates that roughly 10 percent of the 250,000 patients have greater needs than primary care.
"This will go a long way in making sure those services are available," Williams said.
Grant funds technology
The technology is being funded primarily by a $1.6 million grant from the eHealth Council, a state-funded group created last year by Gov. Phil Bredesento improve health care through the implementation of electronic technology. The Hardeman clinics were the first to be outfitted with the equipment last week.Heinzen said the program should be up and running soon.
Fitzhugh had never heard of telemedicine, but she said she is willing to try it.
"It would be better than going to Memphis," she said. "Last time, I had to pay my first cousin to carry me down there. We got lost. It took almost two hours to find the place. I just got upset."
Jeff McKissack, chief executive officer of Nashville's Matthew Walker Comprehensive Health Center, says getting specialty care is not just a problem for the poor and uninsured in rural areas.
"There are a lot of specialists in town, but not a lot specialists who treat the population we see," he said.
Community health centers are required to treat everyone, regardless of their ability to pay or immigration status. People without health insurance are billed on a sliding scale, based on income. Program officials say payment for telemedicine services probably will work the same way, but details are being worked out.
Kidney experts are vital
Matthew Walker has eye, foot and skin specialists and offers some general surgery. However, McKissack said there's a real need for patients to be linked with heart and kidney doctors.
When a patient needs specialized care the center typically turns to Bridges to Care Plus, an organization that works to link uninsured Nashville residents with specialists. If that organization can't help the only resource left for patients may be the emergency room, he said.
McKissack said he expects the situation to improve once the center is outfitted with the telemedicine technology in August.
"This will provide us with a larger specialty network," he said. "We'll be able to pull from specialists across the state."
Antoine Agassi, the eHealth council's director and chairman, said this initiative might just be the beginning. He said the state applied for a $7.7 million federal grant that would bring broadband connections to 400 nonprofit health centers, hospitals and mental health clinicsacross the state.
"It's all about providing access and improving patient satisfaction," Agassi said.
Autor(en)/Author(s): Claudia Pinto
Quelle/Source: The Fairview Observer, 27.07.2007
