Record Banner
Vol.25, No. 18 Mar. 31, 2000

The New "House Call": Project to Treat Diabetics Via Telemedicine Receives $28M

Columbia University College of Physicians & Surgeons (P&S) at Columbia Presbyterian Medical Center (CPMC) and SUNY Upstate Medical University have received a $28 million grant from the Health Care Financing Administration (HCFA) to bring health care into the homes of underserved rural and inner-city residents with diabetes—the largest telemedicine effort ever funded by the federal government's Department of Health and Human Services.

Columbia and SUNY Upstate join five other sites in the effort, called Informatics for Diabetes Education and Telemedicine (IDEATel), which will serve as a test bed for the national use of Internet technology to increase access to health care for all Americans. The demonstration project will be a model to develop more effective treatments for other diseases such as depression, obesity, asthma and heart failure.

Traditionally, Americans living in rural and impoverished inner-city areas have low levels of primary care and high levels of isolation from consistent specialized high-quality medical care. Led by Steven Shea, M.D., Hamilton Southworth Professor of Medicine in Public Health at P&S and director of the division of general medicine at Columbia Presbyterian Medical Center of New York-Presbyterian Hospital, the diabetes telemedicine program is a collaborative effort among the Joslin Diabetes Center of SUNY Upstate Medical University, the American Diabetes Association, Harlem Hospital Center, the Harlem Renaissance Network, Arnot Ogden Hospital in Elmira, Olean General Hospital in Olean, Good Samaritan Hospital in Watertown, the Hebrew Home for the Aged at Riverdale and HCFA.

"While much has been made of the digital divide between rich and poor, rural and urban, I believe this technology will bring better, faster health care to all," said U.S. Representative Charles B. Rangel (D-N.Y.) of Manhattan.

U.S. Representative Amory Houghton (R-N.Y.) of upstate New York added, "Telemedicine can reach beyond the limits to health care in rural New York to ensure quality care in any environment."

The IDEATel project will establish Web-based computing and telecommunications networks in both urban and rural economically disadvantaged areas within New York State.

"The promise of telemedicine is that it will improve health and access to care for all Americans. This study, pathbreaking in its use of medical informatics, will provide the data to understand the impact of telemedicine on the cost and quality of care," said President George Rupp. " Columbia is proud to lead this effort, the largest telemedicine grant ever funded by the federal government's Department of Health and Human Services."

Russell W. Bessette, executive director of the New York State Office of Science, Technology and Academic Research, said, "Governor Pataki has made a strong commitment to ensuring that New York State fosters innovative and high-tech industries such as telemedicine, and we are pleased that Columbia University's Center for Advanced Technology, one of our Centers for Advanced Technology, played a role in this project. Telemedicine is an exciting, new field that can create unlimited opportunity for patients and physicians and will reinvent the 'housecall'."

In New York State approximately 1.6 million people suffer from diabetes. Complications from diabetes cost the U.S. economy $45 billion each year, with an additional $47 billion attributed to indirect costs from diabetes-related disabilities. It is estimated that the federal government can save $247 million per year through early intervention in diabetes treatment, which could rise to $457 million if telemedicine can expand the reach of that treatment.

The four-year grant will enable researchers to study the efficacy of telemedicine in improving patient quality-of-life and reducing overall health care cost. Columbia's Department of Medical Informatics pioneered the use of the Web in providing clinical care. Two million patient records are computerized at CPMC and are available for secure access online by more than 4,000 clinicians. SUNY Upstate's Joslin Center is preeminent in providing state-of-the-art diabetes care in urban and rural settings, and Columbia's Naomi Berrie Diabetes Center is one of New York City's leading centers for diabetes care and research.

Initially, 1,500 patients from northern Manhattan ( Washington Heights, Inwood, and north and central Harlem) and rural areas of central and upstate New York will be enrolled in the project.

"We will use the power of the Web to treat people with diabetes with more success than ever before," says David Liss, executive director of Columbia's Center for Advanced Technology (CAT).

"Congratulations to Columbia and its partners for an excellent proposal to help our state's low-income residents with diabetes with the latest in high technology health care," said Rangel. "I am pleased that Columbia 's work has been recognized. It will provide lessons to the entire nation on how to better treat patients."