UF Health brings telemedicine program for diabetic children to underserved area of Collier County

For children with diabetes or other endocrine system disorders who come from less affluent families, access to care can be difficult and time-consuming. University of Florida Health experts will provide services for children in underserved communities in Collier County through a new grant from the Naples Children & Education Foundation that will allow them to start a pediatric endocrinology telemedicine clinic in the Southwest Florida county.

“We are pleased to participate in this strategic initiative to help establish a pediatric endocrinology clinic in the Immokalee area and ensure that at-risk and underprivileged children get the care they need to thrive,” said Maria Jimenez-Lara, chief executive officer of NCEF, which founded the Naples Winter Wine Festival. “This partnership will expand access to specialty care which is not readily available at this time for children in this underserved community.”

The three-year, $689,000 grant will allow a team of UF Health physicians, diabetes educators, clinical psychologists and other health care workers to establish weekly telemedicine clinics in Immokalee, with in-person clinics to follow as COVID-19 rates decline. The community will gain access to world-class care from experts in the diabetes and endocrinology program, which was ranked No. 22 in the country in the U.S. News & World Report’s 2020-21 Best Hospitals survey.

Michael J. Haller, M.D., a professor and chief of endocrinology in the UF College of Medicine’s department of pediatrics, explains how the telemedicine clinic will meet an urgent need.

Q: Many children with diabetes in Florida do not have access to pediatric endocrinologists. How is their care managed?

A: Primary care providers are busy treating the tremendous number of patients with complex general pediatric issues who typically fill their clinics. As such, there is no way they can stay up-to-date on standards of contemporary diabetes care. Programs like the Extension for Community Health Outcomes – Diabetes, or ECHO, have allowed us to train pediatricians who are managing the care of children with diabetes. Through a combination of programs like ECHO and telemedicine, we can have the largest potential impact on improving the health of children with diabetes in Florida.

Q: UF Health has launched telemedicine endocrinology care programs for children in other underserved areas of Florida. How have those patients benefited?

A: We have seen tremendous value in providing telemedicine services to children in rural and underserved areas. Many of these children would otherwise be unable to attend clinic visits every three months as recommended by the American Diabetes Association. Telemedicine has resulted in marked improvement in clinic attendance, reduced travel time and cost for families, cut down on lost school time, and improved access to teaching about continuous glucose monitoring technologies. It has also reduced emergency room visits and hospitalizations and, of course, eliminated the risk for potential COVID-19 exposure.

Q: Why was Collier County chosen for the next phase of pediatric diabetes telemedicine?

A: Collier County is unique in that there are a limited number of pediatric endocrinologists combined with a mix of affluent and indigent communities. As a result, many children in the county have very limited access to subspecialty care. Also, we have a long-term relationship with the Help A Diabetic Child Foundation, founded by Joe and Tami Balavage. They live in Collier County and work tirelessly to provide access to insulin and other supplies to children across Florida and beyond. Thanks to the incredible generosity of the Naples Children & Education Foundation, we have funding that will allow us to provide much-needed diabetes telemedicine services directly to the children of Collier County without the usual constraints of a fee-for-service system. Additional support is being provided by the Richard M. Schulze Family Foundation (continuous glucose monitors), revenue from clinic operations and The Leona M. and Harry B. Helmsley Charitable Trust.

Q: How will the program work and how many children will it serve?

A: Our program will expand our connections with local primary care providers, social services and philanthropic groups to identify children in need of diabetes and endocrine care. We will then work to establish contact with these families and schedule telemedicine appointments. In collaboration with funds received from the Federal Communications Commission, families who lack adequate access to internet-connected devices will get telemedicine kits including iPads with WiFi access and continuous glucose monitors. We plan to target families who are underinsured or uninsured and who are part of the large migrant worker population in Collier County. Overall, we expect to serve more than 100 children in Collier County and hope to be able to expand our services further with subsequent philanthropic gifts.

Q: What are the benefits to patients?

A: Children and young adults who have access to subspecialty care benefit by seeing providers who are knowledgeable about the latest treatment practices. These patients are far more likely to receive access to continuous glucose monitors, insulin pumps, research opportunities and support groups. Together, these tools result in improved quality of life and better blood sugar control.

Q: How will you measure the results of this program?

A: We will track the number of children and families we are able to serve along with average reductions in hemoglobin A1c, rates of continuous glucose monitor use, reductions in body mass index, improvements in frequency of screening for complications, and reduction in emergency room visits and hospitalizations.