Wednesday, December 15, 2010

Border Communities Use Telehealth

The communities along the U.S. Mexico border are referred to as the Texas “colonias” which means communities in Spanish. Colonias are not only in Texas but also in New Mexico, Arizona, and California but Texas has the largest number of colonias.

These communities are unincorporated isolated subdivisions along the border and are characterized by substandard housing, inadequate plumbing and sewage disposal systems, and inadequate access to clean water. These conditions provide immediate health threats.

The Texas Department of Health’s data shows that hepatitis A, cholera, tuberculosis and other diseases occur at much higher rates in colonias than in Texas as a whole. For example, tuberculosis occurs almost twice as frequently along the border than in the rest of the state.

The lack of medical services compound health problems and with a shortage of primary care providers, residents have to travel long distances to healthcare facilities. If they go to distance facilities, they fear losing wages for time spent away from work, find healthcare facility hours inconvenient, find a lack of healthcare programs, and many residents do not have health insurance. As a result, many healthcare problems go unreported and untreated.

Since many border area colonias and communities do not have sufficient population to support a physician, these areas can easily be networked using health technologies. Texas Tech is successfully using telemedicine to link clinics in several rural communities and colonias to the Texas Tech University Health Science Center at the El Paso campus. Also, the university is able to provide diabetes education by electronically communicating to the high-risk areas.

In addition, the Colonias telehealth program is helping to improve access to health and dental services by providing health and dental education via mobile medical units. The University of Texas Health Science Center at Houston (UTHSC-H) has been operating a mobile medical clinic for the last 16 years in Hidalgo County. Physicians from the Department of Pediatrics and the Department of Internal Medicine provide colonias patient teleconsultations.

Today, the Texas Department of Health staffed with personnel from UTHSC-H, UTHSC-San Antonio, and the Texas A&M Health Science Center use mobile medical vans to conduct telehealth operations in the valley. The vans are equipped with an exam room, laboratory, blood collection station, health education room, and patient intake area.

Each mobile medical van provides these services:

• Primary healthcare
• Diabetic screening
• Immunizations
• Dental exams and panarex x-rays
• General health screening
• Eye exams
• Health and dental education

The Texas State Energy Conservation Office (SECO) provides funds to operate the vehicles and also to provide a telecommunications link via a satellite connection for telehealth and distance learning. The satellite communications increases the area in which the van is able to communicate and conduct telemedicine activities.

Also, the Rio Grande Valley’s first school-based telemedicine clinic was established at the colonia school, Cantu Elementary with funding from the Cullen Foundation. In addition through more foundation funding, more telemedicine equipment was installed in three additional colonia schools in Hidalgo and Cameron counties. Using telemedicine, healthcare personnel and patients are able to communicate directly to UTHSC-H.

In addition the University of Texas has developed low literacy health promotion brochures in Spanish and English on the topics of anemia and menopause. These brochures are being distributed to the clinics and hospitals throughout the Texas Mexico Border region to provide patient education in areas that previously had a major chasm in health promotional materials in Spanish.