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Dissertation Information for Richard Nauert

NAME:
- Richard Nauert

DEGREE:
- Ph.D.

DISCIPLINE:
- Library and Information Science

SCHOOL:
- University of Texas, Austin (USA) (2002)

ADVISORS:
- E. Glynn Harmon

COMMITTEE MEMBERS:
- Ronald E. Wyllys
- Janet Rose Bezner
- Helen Cronenberger
- James Legler
- Jody Ray Rogers

MPACT Status: Fully Complete

Title: Telehealth consumer-provider interaction: A chronic disease intervention in an underserved population

Abstract: The purpose of this study is to evaluate the efficacy of home-based telehealth intervention for the management of diabetes mellitus. The research targets an underserved, predominantly Hispanic population in Laredo, Texas and surrounding counties. Telehealth allows diabetic care management to be delivered to individuals who are not receiving home-based follow-up. The daily transfer of clinical information and provision of health behavioral training to diabetics, within the home , serves as a catalyst for health improvement and long-term behavioral change. As a patient-centered sphere of influence develops, positive health behaviors increase, quality of life improves, and utilization of medical resources declines.

Test participants (n = 133) received a home device while controls (n = 71) did not. Data from participant records were retrospectively analyzed to assess the initial, 18-month usage impact of the telecommunication-augmented device on individual diabetic health status. Test and control participants' Hb1Ac levels and frequency of outpatient, inpatient, and emergency clinic utilization were compared to pre-study activity. The objective was to determine (a) if this new communication device intervention resulted in improved health, as measured by Hb1Ac diabetic test values, and (b) if it served to cut costs through decreased resource utilization.

Findings reveal a mean 21% reduction in Hb1Ac values and a 49% reduction of total charges. A 38% and 13% decline of inpatient and outpatient admissions, respectively, occurred. Total encounters, or episodes of care, were reduced by 31% for the test cohort. Inpatient encounters dropped by 46% and outpatient encounters declined by 25%.

Conclusion: A contribution of this study is the evaluation of a new health care delivery method and philosophy as applied to an underserved, predominantly Hispanic population (>99%) living with chronic disease. Although this new form of provider-patient relationship might never replace the traditional office visit, telehealth can be found to improve health and decrease outpatient and inpatient utilization. The benefits of this form of intervention are sufficiently promising to warrant further research trials. Virtual health care as a surrogate to traditional, face-to-face medical encounters continues to be a relatively new but potentially groundbreaking area of research.

MPACT Scores for Richard Nauert

A = 0
C = 0
A+C = 0
T = 0
G = 0
W = 0
TD = 0
TA = 0
calculated 2008-01-31 06:26:00

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Students under Richard Nauert

ADVISEES:
- None

COMMITTEESHIPS:
- None