Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Computer Can Deliver Medical Care to Rural Poor Unemployment, Diabetes Plague Underserved Areas

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Computer Can Deliver Medical Care to Rural Poor Unemployment, Diabetes Plague Underserved Areas

Article excerpt

The empty storefronts in Brownsville and neighboring towns hint at more than economic distress.

They're also, researchers said, a sign of a runaway diabetes rate.

Fayette County, burdened by one of the highest unemployment rates in the state, also has one of the highest rates of diabetes-related deaths.

Researchers who specialize in treating rural and underserved populations are hoping a "telemedicine" study, offering feedback by computer, will help patients manage the insidious disease. They described telemedicine, with its emphasis on education and self- monitoring, as a potentially powerful tool in an area where unemployment, isolated communities and lack of transportation may boost the risk of diabetes but keep residents from health care.

"I ran into a lot of people who didn't have money for their medications," said Bonnie Pepon, a study leader. She said some are supposed to take two pills a day, "but they cut back to only one because they don't have money to do that."

The study is a project of Uniontown Hospital and the Center of Excellence for Remote and Medically Underserved Areas at St. Francis University in Loretto, Cambria County. Funding was provided by the Naval Health Research Center in San Diego, which sees telemedicine's potential to treat sailors remotely.

Informed Care Management, a private company working on a telemedicine program with Allegheny General Hospital, has reported success in trials in Georgia and Wyoming. The company found 100 percent of study participants learned to better manage diabetes.

Telemedicine may be the closest patients get to a house call these days. It's a help, not a panacea.

"It's not a replacement for our office visits," said Dr. Peter Grondziowski, who practices at Canonsburg General Hospital and directs Allegheny General's Center for Diabetes and Endocrine Health.

Diabetes is the body's inability to produce or efficiently use insulin. Complications include heart and vascular disease, high blood pressure, stroke, kidney failure, blindness, delayed wound healing and amputations.

Fayette County's Community Health Improvement Partnership, a consortium of government, health care, education and business leaders, made diabetes management a top priority after a re- evaluation of the population's health needs. The partnership between the hospital and CERMUSA followed.

The consortium was alarmed by figures showing the county had the state's sixth-highest diabetes death rate from 1998 to 2000 -- 37.3 deaths per 100,000 people, according to a report the state Health Department issued in 2002. The state and national averages for the period were 24.9 deaths per 100,000 people, according to the Health Department.

Since the report was issued, Fayette County's diabetes death rate has worsened; the county now may have the fourth-highest rate in the state, said Camille Wendekier, CERMUSA telehealth development specialist.

The study will involve as many as 100 people; a handful of slots remain to be filled, said Pepon, a registered nurse, certified diabetes educator and CERMUSA diabetes research analyst.

All participants will receive free equipment for testing their blood sugar, including glucometers they may keep when the six-month study ends.

Participants will be divided into a control group, whose members will continue to manage their diabetes as they always have, and a research group, whose members will transmit blood-sugar readings to CERMUSA via telephone modems provided to them.

Some of those in the second group have home computers while others do not, a distinction that could help refine study results.

Diabetes educators will monitor the second group's readings and contact a patient, by telephone or computer, if they observe something alarming. If a patient's blood-sugar level spikes at a particular time each day, educators may contact the patient to see what he or she has been eating at that time. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.