title: Primary-care delivery for sickle cell patients in rural Georgia using telemedicine.
abstract: BACKGROUND
  Advances in newborn screening and pediatric management of sickle cell disease have resulted in patients living well into adulthood. For adults, preventive care and medication monitoring are crucial for optimal health maintenance. The Medical College of Georgia (MCG) in Augusta provides consultative services and comprehensive medical care to about 1200 sickle cell patients residing in middle and southern Georgia. An increase in the demand for clinical services in this patient population has resulted in expansion of sickle cell outreach efforts throughout the state.
  
  
  OBJECTIVE
  A telemedicine clinic for adult sickle cell patients was established in order to meet the growing clinical demands.
  
  
  METHODS
  An on-site outreach clinic was introduced in the target area. After 10 months of operation, a monthly telemedicine clinic was offered to patients as an option for routine medical follow-up. A clinic model was used, with scheduled appointments and a public health nurse assisting at the remote site. Phlebotomy and laboratory services enhanced the telemedicine encounter.
  
  
  RESULTS
  Over a 12-month period, 52 encounters for 28 patients from 17 medically underserved counties were completed. All patients were African-American, and 89. 3% had Medicaid or Medicare insurance coverage or both. The clinic encounter time was 24 +/- 7.9 minutes (mean +/- SD), comparable to that for all telemedicine clinic encounters during the same period.
  
  
  CONCLUSIONS
  The adult sickle cell population in rural Georgia accepts innovative health care delivery using telemedicine. Thus, the telemedicine sickle cell clinic has increased access to care for rural patients in underserved areas. For providers, it has allowed greater clinical productivity and diminished travel time to outreach clinics.
authors.affiliation: Medical College of Georgia Sickle Cell Center, Augusta, Georgia 30912, USA.
authors.forename: K
authors.initials: K
authors.lastname: Woods
authors.forename: A
authors.initials: A
authors.lastname: Kutlar
authors.forename: R K
authors.initials: RK
authors.lastname: Grigsby
authors.forename: L
authors.initials: L
authors.lastname: Adams
authors.forename: M E
authors.initials: ME
authors.lastname: Stachura
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000188:drug therapy / Q000517:prevention & control*; D001071:Appointments and Schedules; D003159:Community-Institutional Relations; D005260:Female; D005500:Follow-Up Studies; D005845:Georgia; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics; D008507:Medically Underserved Area; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D011320:Primary Health Care; D011637:Public Health Nursing; D019114:Remote Consultation; D019035:Rural Health Services; D013997:Time Factors; D014481:United States