University Health System, Inc.
1520 Cherokee Trail, Suite 110
Knoxville, TN 37920
www.utmedicalcenter.org

John J. Sheridan
Ph: 865-544-6611
Fax: 865-544-6619
Email: jsherida@mc.utmck.edu

Network Partners: None listed at this time.

Project Purpose: The University of Tennessee Medical Center provides perinatal care including professional education, consultation, transportation and follow-up with high-risk newborns and provides the highest level of
diagnosis and treatment for those life-threatening conditions of mothers and infants. The project will allow for the renovation of existing facilities, expand the opportunities for existing services and purchase state-of-the-art equipment.

Outcomes Expected: The upgrade of equipment and renovation of the perinatal care system at UT Medical Center will provide improved access and availability and the highest level of care for expectant mothers and critically ill newborns. Upon the commencement of services in a facility with improved physical
attributes and upgraded equipment, new benchmarks can be established allowing for the continuing measurement of outcomes.

Service Area: A 21-county region in East Tennessee, along with Appalachian areas of Southeast Kentucky, Southwest Virginia and Western North Carolina.

Services Provided: The University of Tennessee Medical Center provides special care services for critically ill and premature infants and those women experiencing high-risk pregnancies.

Equipment: Giraffe Omnibeds (10).

Transmission: Not listed at this time.

University of Tennessee Health Science Center
920 Madison Avenue, Suite 434
Memphis, TN 38163
www.utmem.edu/telemedicine

Karen C. Fox, PhD
Toy Strickland
Ph: 901-448-8844
Fax: 901-448-4344
Email: twstrickland@utmem.edu

Network Partners: University of Mississippi Medical Center

Project Purpose: To demonstrate the value of a health information technology (HIT) intervention that delivers best practices care to an underserved population. This HIT intervention will consist of telehealth coupled with an electronic health record (EHR) system. This project will demonstrate that a telehealth-based diabetes disease management (THDDM) program can lower overall costs of care and access barriers by reducing care delays, and improving patient self-care practices, self-care efficacy and satisfaction with
care. This program will improve access to care for rural patients with diabetes and, as a result of this improved access, patients in the program will enjoy higher quality care and better health outcomes.

Outcomes Expected: Diabetes self-management education; Medical Nutrition Therapy (MNT)—Modification of diet to attain and maintain normal blood glucose, lipid, and pressure levels; Glycemic control—average
HgbA1C of ~7%; Blood pressure control—lower blood pressure to <140mmHg systolic and <80mmHg diastolic; Lipid control—Use of nutritional assessment and intervention, increased physical activity and statins as needed to maintain target lipid levels; Monitoring—Patient self-monitoring of blood glucose levels; Care Teams—Care from a physician-coordinated, collaborative and integrated
team that includes (but is not limited to) physicians, nurses, dietitians, and mental health professionals with expertise in diabetes; Individual management plans—Plans should consider patient age, school or work schedule, physical activity, eating patterns, social situation and personality, cultural factors, and
the presence of complications or comorbid conditions. Goals and treatment plans must be reasonable. Effective implementation requires that each aspect of the plan be understood and agreed upon by the patient and the care team.

Service Area: Jackson, Mississippi (inner city is a Primary Care HPSA); Greenville, Mississippi (Primary Care HPSA); Clarksdale, Mississippi (Primary Care HPSA); Lexington, Mississippi (Primary Care HPSA).

Services Provided: The UTHSC Telehealth Network has been operational since 2001. Specialty services include: allergy, dermatology, endocrinology, ENT, infectious disease, mental health, nutrition, pediatrics, surgery, and
neurology; Bioterrorism/disaster preparedness training for healthcare professionals; Patient and provider-centered education.

Equipment: At remote sites: 5 Polycom videoconferencing systems, which include stethoscopes, otoscopes, dermascopes, and document cameras. In Memphis: Polycom, ACCORD bridge, satellite, server, and network.

Transmission: Full T1 lines between Mississippi clinics and hub in Jackson, MS; Full T1 to Memphis from Jackson hub with an ISDN option; Internet and Internet 2.

University of Tennessee Health Science Center
920 Madison Avenue, Suite 434
Memphis, TN 38163
www.utmem.edu/telemedicine

Karen C. Fox, PhD
Toy Strickland
Ph: 901-448-8844
Fax: 901-448-4344
Email: twstrickland@.utmem.edu

Network Partners: Rural Education and Community Health Services (FQHC), Jacksboro, TN; Morgan County Medical Center (FQHC), Wartburg, TN; Mountain People’s Health Councils (FQHC), Huntsville, TN Ridgeview Psychiatric Hospital and Center, Oak Ridge, TN (provider)

Project Purpose: Develop telehealth services in three underserved counties in the traditionally coal mining Appalachian region of Tennessee. Provide disease management services from county clinic nurses to asthmatic and diabetic patients. Asthmatic children in schools in each county will use peak flow meters daily and record data. County clinic nurses will have videoconferences with
each student at least weekly. Clinic nurses will receive data transmitted by Type 2 diabetic patients in each county. Counseling will be provided to patients having black lung disease.

Outcomes Expected: Pediatric asthmatic disease management – increase appropriate treatment with anti-inflammatory medication from typical level <70%, to target level of >95%, and reduce lost school days per 6 weeks
from typical 2 to <1. Diabetes disease management – reduce average HbA1C readings from typical >9% to <7% and increase patients having dilated eye exams from typical <30% to target of >70%. Black lung clinics – increase access of coal miners to black lung benefits and education.

Service Area: Counties served are contiguous in Tennessee: Campbell (Jacksboro), low income HPSA, dental HPSA and a full county MUA; Morgan (Wartburg), full county HPSA, dental HPSA, and full county MUA; and Scott (Huntsville), low income HPSA, dental HPSA, and low income MUA.
Ridgeview provides mental health services for all counties with huge waiting lists for services.

Services Provided: UT Telehealth Network has been operational since September 1995 and is providing services in dermatology, rehabilitation medicine, pre-anesthesia evaluation, emergency mental health, home agency care, disease management in diabetes, congestive heart failure, and pediatric asthma; black lung benefits consultations; practitioner and patient education; and bioterrorism/disaster preparedness training for healthcare professionals. As of 2004, specialty services have expanded to include: allergy, dermatology, endocrinology, ENT, infectious disease, mental health, nutrition, pediatrics, and neurology.

Equipment: At remote sites: 5 Polycom videoconferencing systems; 9 component POTS videoconferencing systems; 90 Roche Accu-Chek glucometers with modems; and 3 PCs. Knoxville campus: Polycom
and POTS CODEC, Polycom bridge, and server and network for data collection.

Transmission: Full T1 lines between clinics and UTTN office (distance independent UT contract), POTS to homes and schools, ISDN to mental health provider and hospital, Internet and Internet2 for medical staff and patient education.

University of Tennessee Health Science Center
920 Madison Ave, Suite 434
Memphis, TN 38163
www.utmem.edu/telemedicine

Karen Fox, PhD
Toy Strickland
Ph: 901.448.8844
Fax: 901.448.4344
Email: twstrickland@utmem.edu

Network Partners: University of Tennessee Medical Group, The Regional Medical Center, LeBonheur Children’s Medical Center, Dyersburg Regional Medical Center, UTMG Jackson Family Clinic, Alliance HealthCare System, East Arkansas Children’s Clinic, University of Tennessee at Martin Health Clinic.

Project Purpose: Bridge the gap between the resource-rich metropolitan center of Shelby County with surrounding medically under-served counties. Through a network of telemedicine connections, rural health care providers will have access to a wide range of specialty services available from UTHSC. In addition to clinical services, patient seminars and continuing medical education programs are made available to all participants to supplement their educational needs.

Outcomes Expected: Improvement in the quality of healthcare through increased access, more timely interventions, coordinated preventative measures, a broader range of medical services, reduction in time and expense
for patients, and an increase in medical expertise. Expected outcomes include improved health status for targeted communities, decreased number of unnecessary transports, improved access to patient educational materials, and increased collaboration between rural and urban healthcare professionals.

Service Area: Martin, Tennessee (Primary Care HPSA); Dyersburg, Tennessee; Jackson, Tennessee; Holly Springs, Mississippi (Primary Care HPSA); Forrest City, Arkansas (Primary Care HPSA).

Services Provided: The UTHSC Telehealth Network has been operational since 2001. Specialty services include: allergy, dermatology, endocrinology, ENT, infectious disease, mental health, nutrition, pediatrics, surgery and neurology; Bioterrorism/disaster preparedness training for healthcare professionals; Patient and provider-centered education.

Equipment: At remote sites: 5 Polycoms videoconferencing systems, which include stethoscopes, otoscopes, dermascopes, and document cameras. In Memphis: Polycom, ACCORD bridge, satellite, server, and network.

Transmission: Full T1 lines between clinics and Memphis (hub) with an ISDN option; Internet and Internet2.

University of Tennessee Health Science Center
90 Madison Avenue, Suite 434
Memphis, TN 38163
www.utmem.edu/telemedicine

Karen C. Fox, PhD
Toy Strickland
Ph: 901-448-8844
Fax: 901-448-4344
twstrickland@.utmem.edu

Network Partners: Putnam County Health Department (PCHD), Cookeville, TN, Monroe County Health Department (MCHD), Madisonville, TN.

Project Purpose: Demonstrate the value of using telehealth in providing care for vulnerable populations, specifically rural and Hispanic communities in East Tennessee. Diabetes control management and education, including the fortification of self-management skills for diabetics in two underserved mountainous counties—Putnam and Monroe.

Outcomes Expected: Diabetes disease management: Increase number of patients who control HbA1C readings per year from <25% to national Healthy People target level of >90%, reduce average HbA1C reading from typical
level of >9.0% to <7.0%. Diabetes education through audio-conferencing: hold 12 monthly telesupport group meetings, and do pre- and post-tests to determine knowledge gained through attendance at support group meetings.

Service Area: Putnam County (Cookeville), Non-NSA; p-MUA (low income); HPSA (low income), Dental HPSA; Monroe County (Madisonville) Non-NSA; NUA; HPSA (low income); Dental HPSA.

Services Provided: This Telehealth Network has been operational since September 1995. It provides specialty clinical consultation; psychiatric crisis services; home telehealth care; disease management for adult diabetics
and child asthmatics; bioterrorism/disaster preparedness training for healthcare professionals. As of 2004, specialty services have expanded to include: allergy, dermatology, endocrinology, ENT, infectious disease, mental health, nutrition, pediatrics and neurology.

Equipment: At remote sites: 2 Polycom videoconferencing systems, 2 component POTS videoconferencing systems, 15 Roche Accu-Chek glucometers with modems, 5 conference phones, and a PC. At UT office: Polycom and POTS CODECs, Polycom bridge, data server and network.

Transmission: Full T-1 lines between clinics and the Knoxville campus, POTS to homes, Internet and Internet 2 for medical staff and patient education.