One of the missions of the Georgia Council on Lupus Education and Awareness (GCLEA) is to develop resources for communities that lack access to specialized lupus healthcare providers. Because most rheumatologists practice in
metropolitan Atlanta, there is an overarching need to evaluate and treat
persons living with lupus in under-served areas of Georgia.
To enhance the lives of people living with lupus, the GCLEA partnered with various stakeholders to understand, educate, and implement a telemedicine pilot program in southwest Georgia. The GCLEA and stakeholders conducted a site visit of the Dougherty County Health Department and Clinic to survey the telemedicine equipment already in use at that facility to examine prenatal mothers and sickle cell patients. We also assessed the attitudes, behaviors and beliefs of various medical professionals and lupus patients throughout the state about the use of telemedicine to diagnose and treat patients.
The Georgia Council on Lupus
Education and Awareness (GCLEA) received a grant from the American College of Rheumatology with funding from
the Centers for Disease Control and Prevention to plan and implement a telemedicine pilot
study for persons living with lupus in rural southwest Georgia. The study linked primary care
practitioners in rural southwest Georgia with rheumatology specialists at Emory
University Hospital and Emory University School of Medicine. The Dougherty
County Health Clinic and
its county seat, Albany, Georgia were chosen as the pilot site because
Dougherty County and the surrounding 39 counties that make up southwest Georgia
are some of the poorest counties in Georgia. At the time of this study, there were
only three rheumatologists in 39 counties surrounding Albany, Georgia.
Telemedicine equipment is used throughout Georgia. The Georgia Partnership for Telehealth (GPT), a statewide non-profit telehealth network, reports that it has provided 130,000 patient encounters using 40 different specialties, as recently as 2013, and has the capacity to provide the same service to 106 of Georgia’s 159 counties. The Georgia Department of Community Health uses telemedicine equipment to provide services in some clinics throughout the state for patients on Medicaid. The Dougherty County Health Clinic uses telemedicine equipment to educate pregnant mothers about prenatal health and the birthing process. The clinic also uses equipment to diagnose and treat kids living with sickle cell anemia. The clinic has two units, one of which is mobile, and works with specialists in metropolitan Atlanta, Georgia. There are no set criteria for women and children to be treated or use the telemedicine services provided by the clinic. Current specialists are compensated using a patient’s private insurance carrier, Medicaid, PeachCare for Kids, or on a sliding scale.
Since the Georgia Department of Public Health (DPH) has a system of sites throughout Georgia that cooperate with telemedicine consultations for a variety of health conditions, GCLEA’s study assessed the frequency with which primary care practitioners in southwest Georgia saw lupus patients and their perception of the value of telemedicine in their practice. The GCLEA also conducted an assessment of attitudes, behaviors and beliefs of various rheumatologists throughout the state before the pilot consultation experience. The clinic which currently specializes in obstetrics and gynecology telemedicine consults, agreed to expand consultations to include people with lupus.
A team of rheumatologists, neurologists, nurses, government liaisons, academics and members of the GCLEA visited with the state representative in the district and the clinic staff to learn as much as possible about the system. The clinic trained rheumatologists from Emory on the ways in which telemedicine can be used to diagnose and treat lupus, the logistics of examinations, and funding mechanisms for the clinic and rheumatologists as a part of the study. Next, five women from southwest Georgia, who were previously diagnosed with lupus, agreed to be examined by the rheumatologists at the clinic using the telemedicine equipment. These women were previously instructed by the GCLEA about the process and given the opportunity to volunteer.
Data collected on these patients before and after the study included their perception of telemedicine both before and after the consultation, age, race/ethnicity, insurance status, current treatment plan and current travel time to see a rheumatologist. Each patient was examined by two doctors from Emory with the assistance of a nurse practitioner who followed the instructions of the examining physicians. The practicing rheumatologists who participated in the study also completed pre and post assessments. The results of this study are set forth in the following Feasibility Report.
Since this pilot, the GCLEA plans to expand this project and use state funds to establish a blueprint to conduct a larger telemedicine study, carryout suggestions set forth in the Feasibility Report, gather epidemiological information in southwest Georgia, and make recommendations to implement a comprehensive program for uninsured and under-insured lupus patients in the state.
The GCLEA is the only state sponsored mandated entity created to better the lives of Georgia residents who live with lupus by improving public education and awareness, improving access to resources for patients and family members, and developing information that will inform current and future public health efforts. It is housed in the Georgia Department of Community Health and frequently partners with the DPH.
The project described was supported by Grant number 6 NU58DP006138-01-02; CFDA number 93.068, Developing and Disseminating Programs to Build Sustainable Lupus Awareness, Knowledge, Skills and Partnerships.
Analysis and Evaluation of the GCLEA Pilot Study was conducted by Sinead Young, Ph.D. of Younge Consulting, LLC.
This project was supported by Grant Number 6 NU58DP006138-01-01; CFDA number 93.068, Developing and Disseminating Programs to Build Sustainable Lupus Awareness, Knowledge, Skills, and Partnerships through a grant from the National Association of Chronic Disease Directors and the Lupus Initiative, with funding from the Centers for Disease Control and Prevention.