2004 - 2005 Grantee Directory - Texas

Cook Children’s Medical Center (CCMC)
801 Seventh Avenue
Fort Worth, Texas 76104
http://www.cookchildrens.org

Steven K. Whitson
Ph: 682-885-4329
Fax: 682-885-1646
Email: stevew@cookchildrens.org

Network Partners: Cook Children’s Subspecialty Clinic in Abilene, Texas, is the single spoke partner.

Project Purpose: To:

1. implement Rural Specialty Health Telemedicine as a pilot project utilizing genetics as the chosen pediatric specialty; and
2. implement a mechanism to provide Continuing Medical Education (CME) in CCMC’s rural service area. Major project activities include equipment selection, acquisition, and installation; training project participants in the use of the equipment; and project implementation, including the provision of genetic services and distance learning opportunities and the evaluation of those services and opportunities.

Outcomes Expected:

Telemedicine:

1. increased number of referrals by at least 20;
2. increased number of patient encounters by 60%;
3. decreased costs of care;
4. )increased time efficiency of service delivery;
5. patient families will choose to utilize telemedicine services, (all of which can be measured via data analysis); and
6. patient families will be satisfied with telemedicine services (as measured by satisfaction survey).

Distance Learning:

1. health care providers in outlying areas will have increased access to educational opportunities and Pediatric Grand Rounds (project implementation provides the opportunity);
2. health care providers will utilize distance learning (measured by numbers of CMEs applied for); and 3) health care providers will be satisfied with distance learning services (as measured by satisfaction survey).

Service Area:

Telemedicine: the primary service area is Abilene, Texas, in Taylor County, serving 1 HPSA and 2 MUAs.
Distance Learning: overall service area is 110 counties in Texas, serving a total of 210 HPSAs and 139 MUAs.

Services Provided:

Telemedicine: direct patient clinical assessment, counseling, follow-up within the scope of Genetics, video-conferencing for general medical consultation.
Distance Learning: video-conferencing for medical consultation and education and "anytime" access to pediatric-specific education. Overall project implementation is expected to begin in March 2004.

Equipment: Router, View Station FX - H.3232, Monitors & Cart, Medlink Cart for VC, Telemedicine Peripheral, 5 Megapixel Camera, MiniDV Video Camera, MGC25 VC Bridge.

Transmission: Fractional T1 up to 1.5 Mbps, ISDN up to 768kbps.

Division of Pediatric Endocrinology and Diabetes
7703 Floyd Curl Drive, MC 7806
San Antonio, TX 78229-3900
http://www.pediatrics.uthscsa.edu/pediendo

Peggy M. Visio, MS, RD, LD
Ph: 210-567-5283
Fax: 210-567-0492
Contact Person visio@uthscsa.edu

Network Partners: Rio Grande City Consolidated Independent School District (RGCCISD) Community Action Council of South Texas (CACST)
Starr Therapeutics (STARR).

Project Purpose: The objective of this program is to implement a comprehensive diabetes screening program in the school system and then enroll children at high risk for type II diabetes into a treatment program.
The children “at risk” are randomized into either a group that receives traditional treatment available in Rio Grande City or they are enrolled in a group receiving telemedicine consultations with a Pediatric Endocrinologist, Behavioral Therapist, and Pediatric Dietitian located at the University of Texas Health Science Center at San Antonio, 250 miles away.

Outcomes Expected: The goal of this project is to determine if access to specialized therapy via telemedicine will affect measurable parameters such as weight, blood pressure, blood glucose, insulin levels and hemoglobin A1C levels.

Service Area: The UTHSCSA/RGC Telehealth Network serves children in the Rio Grand City School District, which encompasses the communities of Rio Grande City, La Grulla and Graciasville, all located within Starr County. Starr County includes over 125 colonias; pockets of poverty with little access to adequate housing, employment, and health services.

Services Provided: The UTHSCSA/RGC Telehealth Network will provide clinical telemedicine services and distance learning. The Pediatric Endocrinologists, Behavioral Therapists and Pediatric Dietitian will provide consultations to patients and families via interactive video-conferencing. Distance learning will take place when the healthcare team has quarterly patient care conferences to discuss the patient care plans.

Equipment: The equipment at UTHSCSA is a VCON Monitor 1000 Desktop videoconferencing system with a Sony EV1-D31 tilt and zoom camera, a goose neck microphone, on a Dell PC with a wireless keyboard. Similar equipment is available at the CACST clinics.

Transmission: Transmission is across T1 capacity lines at 384 Kbs. using H.323 IP and H.320 ISDN connections.

Telehealth Center
301 University Blvd.
Galveston, TX 77555-1042
http://www.utmb.edu/telehealth/

Jeanette C. Hartshorn, RN, PhD, FAAN
Ph: 409-747-6290
Fax: 409-747-6249
Email: jhartsho@utmb.edu

Network Partners: Rural hospitals, state universities, distance education programs, telemedicine services through agreements with counties, corporations, foundations, community mental health centers, state prison system, and cruise lines.

Project Purpose: To continue the development of the Texas Telehealth Resource Center (TTRC) by providing guidance, technical assistance, training to others for the development of telehealth programs. To conduct a beta test of the TTRC through a partnership with the Veterans Health Administration
(VHA) to provide specialty care via telemedicine.

Outcomes Expected:

1. Increased use of TTRC/monitored by various measures of use (visits to web site, questions, information services for telemedicine providers, etc.
2. Patient satisfaction with telemedicine clinics/patient satisfaction survey.
3. Establish specialty clinic for VHA/decrease visits to Emergency department and travel to distant sites for care.

Service Area: Eastern and coastal Texas, world wide through various contracts. The Telehealth Center has contracts with Brazoria and Liberty counties to provide primary and specialty care. Brazoria County has 9 MUAs and no HPSAs. The entire county of Liberty County has been designated as
an MUA and HPSA.

Services Provided: Telehealth assistance: shared resources, expertise, information, distance education, telemedicine services.

Equipment: 177 telemedicine stations with Polycom videoconferencing equipment with appropriate medical peripherals.

Transmission: Connectivity: private IP network over dedicated T1 lines, which carry voice, data, and video.

Network Partners: The Methodist Hospital; community hospitals; cardiology, internal medicine, and family practice clinics.

Project Purpose: Examine a model for seamless transition between hospitalization, home care, and self-management for patients with Congestive Heart Failure (CHF) utilizing home monitoring technology; determine whether health care costs in a 60-day period are lowered among CHF patients who are home monitored; demonstrate improvement of clinical outcomes, patient quality of life and patient satisfaction through daily home monitoring of vital signs of CHF patients. Additional project activities: Development of CHF home telecare clinical pathway, determination of telephone CHF intervention decision tree; implementation of a telehealth continuing education program for clinicians involved with project.

Outcomes Expected: Decreased ER visits, hospitalizations, length of stays (measure) – Generalized Linear Mixed Models (GLMM) analysis. Telephone interventions successful (measure) - Trending data reports, descriptive analysis. Increased quality of life (measure) - SF-36 Standard Tool, repeated measures of Analysis of Variance (ANOVA). High patient satisfaction (measure) – Visiting Nurse Association (VNA) Patient Satisfaction Survey.

Service Area: Six southeastern Texas counties (Harris, Galveston, Liberty, Montgomery, Brazoria, Fort Bend) serving 1 Primary Medical HPSA, 1 Dental HPSA, 3 Mental Health HPSAs.

Services Provided: Since September 2001, home vital sign monitoring for CHF management: daily remote collection and evaluation of clinical data, telephone intervention protocol at first symptom recognition, telephone teaching program. Others services: diabetes, chronic disease management,
respiratory, infectious diseases, assisted living centers, and Left Ventricular Assistive Device (LVAD) patients.

Equipment: Seventy HomMed Sentry Observer System units, one Central Station Monitor with Intel Pentium 500 MHz processor.

Transmission: Java application of Windows 95/98 NT platform using Oracle 8 data base server; dual communication modes via wireless pager technology or standard phone lines.