State awards grant to UF researchers for diabetes telemedicine project

Children with diabetes who live outside the Gainesville area now will have increased access to specialized treatment closer to home, thanks to University of Florida health practitioners who are using a dose of the Internet and telemedicine technology to improve their care.

The Florida Department of Health’s Children’s Medical Services has awarded a $400,000 grant renewal to UF researchers to expand the Florida Initiative in Telehealth and Education program.

Since November, dozens of Volusia County children who have diabetes and other endocrine problems have been treated by UF clinicians through the Daytona Beach Children’s Medical Services clinic, instead of coming all the way to Gainesville. Future use of the technology developed through the project will be applied to pediatric subspecialty clinics elsewhere in the state.

Every two weeks, a nurse stationed on-site assesses the patients, then presents case details to the medical team in Gainesville via a secure videoconferencing system. UF physicians personally examine patients at the Daytona Beach clinic once a year during a three-day intensive on-site visit, said Toree Malasanos, M.D., a clinical assistant professor of pediatrics at UF’s College of Medicine.

“Before we started this clinic, we used to go to see the patients quarterly, so if a patient missed a visit with us or if they needed health care more often that that—which a lot of our children with diabetes end up needing—they’d have to come to Gainesville or wait several months,” Malasanos said. “That meant these kids might miss a couple days of school every time they came to clinic. Telemedicine visits also save transportation costs for the families that would have had to come to Gainesville, or transportation costs for the whole medical team.”

The program also includes an educational Web site, http://fite.peds.ufl.edu, open to all children who attend UF diabetes clinics, their teachers and any secondary caregivers, including prospective counselors at the Florida Camp for Children and Youth with Diabetes.

The project’s third arm, a virtual hospital unit for children whose diabetes is especially difficult to manage, aims to help these patients learn about their disease through Web-based education and counseling via home videophones. Patients also can report blood-sugar levels through the Internet. Until last year, these children spent as many as four months in a special unit at Shands at UF medical center learning about diabetes, and receiving individual and family counseling. That inpatient unit closed last fall.

Some of the grant funds also will go toward tracking the initiative’s effectiveness.

Malasanos is collaborating with UF colleagues Andrew Muir, M.D., a clinical assistant professor of pathology, immunology and laboratory medicine; registered nurse Martha Halsey-Lyda; information technology specialist Bhavin Patel; and webmasters Manav Chiakurithi and Jay Klein.

“There are other telemedicine clinics that concentrate on general medicine or general pediatrics,” Malasanos said. “But in terms of complete pediatric subspecialist care, Web-based education and counseling interventions, we are fairly unique.”