Improving Diabetes Outcomes in Rural Research Paper

Because patients have an active role in their care plan and are in
more frequent contact with their healthcare provider, they gain a better
understanding of their condition and become more compliant in their care."
(Moore, 1) This speaks directly to the challenges in healthcare relating
to diabetes, which is a condition that can best be controlled through
effective personal lifestyle habits and a sound treatment of one's body.
Being able to take proper routine measures to monitor, medicate and treat
one's self can be facilitated through telehealth consultation, reducing the
need for travel and doctor visits for those who might be less mobile due to
age and infirmity.
The importance of reducing hospital visits for both cost to
healthcare and strain on the patient can be especially appealed to where
diabetes is concerned. The chronic nature of the condition and the related
ability of the patient to control certain aspects of the condition through
proper behavior and lifestyle habits make this a prime context for
telehealth implementation. So is this suggested by a study from 2005
where, "in phase 1, over 1,650 patients with diabetes were randomized to
telehealth or normal care. Telehealth solutions as described above were
placed in patients' homes. Participants received Internet service, training
in equipment use, and maintenance support. Patients check their blood
sugar, blood pressure, and other factors that affect diabetes. Through
interaction with their clinical teams, the patients learn more about
diabetes and receive recommendations and instructions on how to manage
their disease." (Moore, 1) This bevy of methods would underscore the
suitable nature of diabetes to improvement of outreach through such
technologies.
Where the rural communities impacted by the condition are concerned,
this can be especially critical in lengthening and improving the lives of
diabetes patients. The difficulty or impossibility to traveling to proper
healthcare facilities for treatment can have a significant impact on
mortality rates in these areas. The correlation between conditions such as
obesity or advanced age and the presence of diabetes suggests that the
strain of excessive healthcare travel should be reduced as much as
possible. The above noted experiment and its results suggests telehealth
to be well-suited to addressing this matter.
This is further supported by Versweyveld's (2005) findings, which
would engage in an investigation of telehealth's prospects for the
improvement of clinical diabetes in the rural south. The south of the
United States is a particularly vulnerable area, emerging in much of the
research on both diabetes' spread and the value in bringing new telehealth
measures to rural regions. Accordingly, the Versweyveld study reports on a
pilot program conducted in 2004 both in Greenville and Jackson,
Mississippi. The article denotes that "the programme joined UTHSC's
telehealth programme with a pilot clinical diabetes management programme
from UMMC. Five hundred visits a month at UMMC and one hundred visits per
month at Greenville have improved all diabetic outcomes significantly. The
reach of the programme and high quality of care has far exceeded national
and Mississippi norms." (Versweyveld, 1)
These positive outcomes demonstrate the opportunity in producing
facilities as points of access but without the typical expenses and
distances which are a factor in making regular physician or hospital
visits. This manifests as both an improved opportunity for treatment for
the patient and in a reduced healthcare burden on state and municipality in
the face of rising diabetes prominence. The investment in the
technologies, facilities and educational campaigns which could promote and
realize such a program would produce considerable gains in the economically
strained area of American healthcare. Indeed, through the pilot program
upon which Versweyveld reports, the research conducted here is given
reinforcement to markedly and consistently positive outcomes.
The application of such suggested telehealth solutions, though rarely
suggested as a total replacement for necessary physician, specialist or
emergency room visits.However, for a chronic and treatable condition such
as diabetes, rural regions are particularly suited to what is offered by
telemedicine technologies. Indeed, this form of consultation far exceeds
in health outcome prospects the total absence of consultation often facing
elderly rural poor populations. Versweyveld reports, "'the addition of
telehealth connectivity has proven to be of great benefit to the outcomes
and sustainability of the programme results, significantly improving the
health status of diabetics and easing the burden of projecting university
medical centre teaching and expertise into a site 150 miles away from both
institutions', stated Karen Fox, Ph.D. assistant dean for University of
Tennessee Health Sciences Center. 'The results of the Greenville pilot
project have been a resounding success to date, duplicating or improving
upon all outcomes of the standard diabetic care model and far exceeding the
outcomes of local Delta care.'" (Versweyveld, 1)
This positive finding underscores a theme of fundamental importance
beyond the relative absence of good and qualified facilities. The
shortfall of qualified professionals and practitioners in rural areas means
that there is an unequal distribution of knowledge, ability and
qualification in the healthcare system. Teleconferencing through local
clinic facilities would offer direct access to some of the best
professionals in all aspects of diabetes treatment. In essence, this
allows physicians, therapists, nutritionists and pharmacists all to be in
many places at once, rather than demanding the impossible task of distant
transportation for many rural diabetes sufferers who may be poor, elderly
or both.
Telehealth solutions offer the prospect of an improved quality of
life and an improved life expectancy for diabetes sufferers in rural areas
otherwise typically isolated from quality care or any care at all. And
optimistically, we may also view these findings as a suggestion that the
improved distribution of information might change lifestyle habits as they
are passed from one generation to the next. Telehealth distribution in
rural areas could well serve as one way amongst the needed many to stem the
tide of the rising diabetes epidemic. At present, evidence already exists
to endorses the implementation of telehealth programs in rural areas, with
the opportunities self-apparent in diabetes treatment helping to open the
door to treatment solutions in all manner of rural healthcare needs.

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