America is in a vigorous national discussion of health care reform. The debate centers on many issues that result in health disparities and inequities for many people. For families living in rural or remote frontier areas, like many in West Texas communities, the most acute is in the significant challenges when seeking pediatric health care services.
Today with the use of telemedicine, the Texas Tech University Health Sciences Center F. Marie Hall Institute for Rural and Community Health began to help overcome those challenges. Through Project CHART, Children's Healthcare Access in Rural Texas, the delivery of the first live pediatric specialty consultation or a child was completed in Stratford, Texas. Stratford is a small rural community at the very top of Texas, more than an hour's drive from Amarillo.
Many rural and underserved West Texas communities continue to face a severe shortage of general pediatricians and pediatric specialists. More than half of the counties in Texas do not have a general pediatrician in many cases, gaining access to pediatric care involves lengthy travel to locations where health care specialists are available. Sometimes, that travel can be very expensive in money and lost work and school time -- expenses that many families simply cannot afford.
Project CHART is funded by the Texas Health and Human Services Commission and over the next 26 months will establish 29 additional sites to expand and study access to pediatric primary and specialty care for Medicaid enrolled children in rural communities throughout the 108 most western counties in Texas.
"This project will help us demonstrate the technological advantages of telemedicine and allows us to connect children with the best pediatric care available even though their physician may be hundreds o miles away," said TTUHSC President John C. Baldwin, M.D.
The technology consists of a television that is linked to a security encrypted network that allows the patient to be presented by another physician or nurse from a remote location to a pediatric specialist located at one of the campuses of TTUHSC. Richard Lampe, M.D., chairman of the Department of Pediatrics, likened it to a live clinic, "the difference is that you cannot shake hands at the end."
Billy Philips, Ph.D., vice president and director of the TTUHSC F. Marie Hall Institute for Rural and Community Health, said this project also will provide an outstanding platform to conduct complementary population-based research activities that further enhance quality of life in our region.
"Through our experiences, we can help educate about the role of telemedicine and on how this works in reducing access issues, improves efficiency and adds to the quality of health care delivery," Philips said. "These are critical issues in the national debate on health care reform that seek solutions to prevailing inequities in access to care, physician and provider shortages, inefficiencies, quality issues and coordination within complex systems of care. All of these are heightened by factors of geographic, socioeconomic and cultural diversity that are present among the people of West Texas."
David Lefforge, chief operating officer of the F. Marie Hall Institute and architect of Project CHART, said 30 West Texas communities along with training and support for its use. "We want to work those communities that recognize a need and that have a commitment to bringing these services to their children," he said.
Currently there is one clinic in Stratford (Stratford Family Medical Clinic), staffed by a solo nurse practitioner, Ward Palmer, N.P. "We are excited to partner with Texas Tech and explore how this tool will improve access to health care for our community," Palmer said. "This equipment will afford the patients in this area access to specialists without the need for them to travel."
