April 20, 2001
Volume XXXIV, No. 16


Of Note


Telehealth helps diagnose, treat Zapata patient

A young man in the South Texas town of Zapata is benefiting from occupational therapy expertise hundreds of miles away, thanks to a telehealth project of the Health Science Center, an Arizona company and a Massachusetts company.

Sandy Hubbard, occupational therapy, worked with StarView VideoTelephones of Tucson, Ariz., and American Medical Development of Lowell, Mass., to assist the patient, his family and the family physician with remote consults. Hubbard worked with funding from UTHSC's South Texas/Border Initiative, a diverse set of programs supported by the Texas Legislature since the mid-1990s.

The patient is a 15-year-old boy who has had multiple problems since injuries from a car accident when he was 5. Hubbard's occupational therapy skills are primarily aimed at helping with his physical positioning, to ease his burden of care and improve the quality of his life.

"It has been so difficult for the patient to travel in a regular car that his parents purchased a mobile home just to take him to his medical appointments," Hubbard said. "Our first consult was using the Health Science Center's T-1 lines to Laredo Community College and Zapata High School, where his parents brought him for the appointment. Our second appointment allowed the patient to stay home and use the new 400 HP JetConnect POTS videotelephone from StarView.

"We realized that when he sits on a flat surface, he is not supported equally on both sides and he leans to one side to compensate. This causes curvature of his spine. He needs seats with different height cushions under him. When the physician, the family, the patient and the team in San Antonio were able to talk together, we were able to accomplish in an hour what might have taken a year of appointments and difficult travel for the patient," Hubbard said.

Another piece of equipment Hubbard and colleagues are testing is a stethoscope from American Medical Development that can be used at a remote site to amplify the patient's swallowing. The sounds are fed into the telephone so they can be interpreted by a computer to diagnose aspiration. Aspiration of food and liquid into the lungs is a result of a condition called dysphagia. Aspiration is common with the elderly and the disabled and can be fatal. "With proper diagnosis, caregivers can learn what to feed and what not to feed and can overcome many of these difficulties," she said.

"What we are doing with these consults is not only helping patients, but also testing new technology for usefulness in expanding treatment possibilities," Hubbard said.

She will be leaving San Antonio to pursue her Ph.D. in rehabilitation science at the University of Pittsburgh, but Hubbard hopes to help keep the door open to telehealth advances for patients in South Texas. "The needs are great, especially in certain fields such as orthopaedics, and places like Zapata may never have quick access to a lot of expensive medical equipment. Telehealth consults are a real opportunity to help such isolated populations."