The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69311

Thomas S. Nesbitt, MD, MPH¹, Javeed Siddiqui, MD, MPH², Richard E. Brunader, MD³, Donald M. Hilty, MD⁴, James P. Marcin, MD, MPH⁵, Dena S. Puskin, ScD⁶, Stacey L. Cole¹, and Martha M. Daschbach¹. (1) Center for Health and Technology, University of California Davis Health System, 2315 Stockton Boulevard, Sherman Building, Sacramento, CA 95817, (916) 734-5675, thomas.nesbitt@ucdmc.ucdavis.edu, (2) Department of Infectious and Immunologic Disease, University of California Davis Health System, 2315 Stockton Boulevard, Sacramento, CA 95817, (3) Department of Family and Community Medicine, University of California Davis Health System, 2315 Stockton Boulevard, Sacramento, CA 95817, (4) Department of Psychiatry, University of California Davis Health System, 2315 Stockton Boulevard, Sacramento, CA 95817, (5) Department of Pediatrics, Section of Critical Care, University of California Davis Health System, 2315 Stockton Boulevard, Sacramento, CA 95817, (6) Health Resources and Services Administration, United States Department of Health and Human Services, 5600 Fishers Lane, Room 7C-22, Rockville, MD 20857

Introduction: The prevalence of HIV/AIDS continues to increase within rural, medically underserved communities across the U.S. while local access to healthcare remains inadequate. Rural patients may therefore forgo effective medical treatments, receive suboptimal treatment regimens, or be forced to travel long distances to obtain state of the art therapies within urban specialty clinics. Hypothesis: Telemedicine programs offer specialized care to rural patients with HIV/AIDS and telemedicine providers believe it to be an effective means to support these underserved residents. Methods: HIV/AIDS telemedicine programs were prospectively identified within the U.S. and a standardized survey was completed defining the effectiveness of telemedicine, clinical challenges and patient demographics. Results: From a national sample of telemedicine providers, 33 were identified as possibly having HIV/AIDS programs and 25 (76%) responded to the survey. Only 11 (44%) utilize telemedicine for HIV/AIDS clinical care and 3 (12%) for educational video conferencing. Routine medical care (43%) and management of medication side effects (29%) were the most common reasons for using telemedicine. All participants reported telemedicine as an effective clinical modality that is accepted by their HIV/AIDS patients. Conclusion: In a comprehensive national survey, only 11 telemedicine programs were identified that provide HIV/AIDS care. This number likely does not adequately meet existing rural healthcare needs. Telemedicine can offer a means to improve the care of HIV/AIDS patients, and create an opportunity to educate the rural heath care system. Expanding telehealth outreach within the U.S. and to international arenas may significantly impact health care service delivery to these patient populations.

Learning Objectives:

• Identify the current prevalence of HIV/AIDS in rural communities.
• Describe the limitations of healthcare access within isolated rural communities.
• Define telemedicine technology and describe its ability to effectively address and support the health care needs of underserved rural patient populations.
• Understand the current uses of telehealth technology within the United States in the diagnosis, treatment and management of HIV/AIDS.
• Recognize key barriers to telehealth technology for the treatment of HIV/AIDS.
• Recognize the successes and challenges of telehealth programs treating HIV/AIDS patient populations.
• Describe ways that telemedicine can provide rural health practitioners with continuing medical education opportunities thereby improving their clinical knowledge and technical skills for the care of future patients.
• Recognize the educational benefits of telehealth outreach to rural HIV/AIDS patients.
• Identify key uses of telehealth technology that can improve the diagnosis, treatment, and management of HIV/AIDS in rural underserved populations.

Keywords: Telemedicine, Rural Health Care Delivery System

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: University of California Davis Health System Center for Health and Technology
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.