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Telemedicine Platform to Link Native American Docs to Pediatric Specialists

Children's Hospital of Philadelphia will provide pediatric specialist consults to the Indian Health Service in the first stage of what may be a system-wide telehealth implementation.

By Eric Wicklund

- A pilot telehealth program being launched in the Southwest aims to give doctors in remote Navajo communities access to pediatric specialists in Philadelphia.

If the tele-consult program succeeds, it could become a standard of care for remote, underserved Native American communities from Alaska to Arizona, improving clinical outcomes for hundreds of thousands of children.

In the initial phase, Children’s Hospital of Philadelphia is developing a pediatric specialty consult platform for Indian Health Service providers in Arizona Navajo’s Phoenix and Tucson regions and the neighboring Albuquerque, N.M., region, a broad swath of territory that includes portions of Nevada and Utah. Doctors at CHOP’s Department of Pediatrics will use the platform to help IHS doctors with difficult cases.

Mary L. Smith, principal deputy director for the HIS, said in a new release the partnership would “be able to design and develop a service specifically for pediatric care and consultation for our patients that live in very rural areas and may not be able to travel long distances to a facility to see a specialist."

“Access to pediatric specialty care is limited across much of the United States, with many communities experiencing delays in both consultation and service,” added Joseph W. St. Geme, MD, CHOP’s physician-in-chief and pediatrics department chairman. “As a result of this important initiative, children in rural communities will benefit from medical consultations provided directly, securely and effectively to their IHS health care providers by experts in the field of pediatric medicine.”

While highlighting the growing importance of telemedicine as a means of connecting healthcare providers with specialist for consults, the program also marks the latest effort by the IHS to improve healthcare access for all of its members.

Through a federal treaty, the IHS provides free healthcare for enrolled Native Americans in more than 560 tribes around the country.

Just last month, the IHS announced a partnership with South Dakota-based Avera Health to provider telehealth services to almost 20 IHS administrative regions in the Great Plains states, serving some 130,000 American Indians and Alaska Natives.

The one-year, $6.8 million contract, which could be extended out to five years for a total of $100 million, followed reports of federal investigations that uncovered substandard care and access issues at several rural health systems. IHS officials said they hoped this platform would improve access and outcomes for Native Americans living in rural communities.

“It is challenging to provide specialty healthcare in rural areas, and this is especially true in Indian Country,” Smith said in a statement announcing that contract. “IHS has long been a leader in information technology and electronic health records, and IHS experience shows that telemedicine is an effective way to increase access to quality healthcare services in remote, hard-to-reach areas.”

With the CHOIP program, Smith said the IHS hopes to develop a business plan for an expansion of telehealth services across more populations. This would include identifying potential new funding sources, improving the infrastructure needed to run and scale up such programs, and analyzing and improving clinical outcomes.

They’ve had success before.

In the mid-1970s, the agency worked with NASA to equip a telehealth van that travelled to reservations across parts of the Midwest and West, connecting via two-way microwave radio with nearby health systems. Federal grant programs helped expand the network in the 1990s, and by the turn of the century telemedicine specialty programs were emerging in various locations.

In 2001, the IHS launched a successful telehealth program to screen Native Americans across the country for diabetic retinopathy, the leading cause of blindness in those dealing with diabetes. And in 2009, the IHS created a TeleBehavioral Health Center of Excellence, in a partnership with the University of New Mexico Center for Rural and Community Behavioral Health, to tackle behavioral health and substance abuse issues in the Native American population.  

Dig Deeper:

Project ECHO Poised to Become a National Telehealth Model

Taking Telehealth to Rural America


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