The area of the Pine Ridge Reservation is mostly rural and health care is given by the Indian Health Service (IHS). This area has 2 hospitals (with less than 20 beds) and 4 rural clinics mostly staffed by primary care providers. Patients most days have to travel at least 30-60 miles to see their providers. Most providers see an average of 20-30 patients a day with very diverse health problems. Most clinics are staffed with registered nurses that accomplished several and varied tasks including patient education (IHS). Within this population, the rate of diabetes is recorded as 8 times higher than the national average. (www.ihs.gov)
A potential solution to help improve diabetes outcomes would be to develop a pilot telehealth nursing program. The nurse would receive daily blood glucose readings from the patients and with input from the interdisciplinary team, make appropriate changes in the medication management. The Veterans Health Administration is one of the leaders in telehealth in the nation. A similar program would be developed for this particular population taking into consideration their particular culture and the constraint for the use of technology in the area.
Change Model Overview
For this project, we will use the ...
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Within the local clinic, the findings would be communicated via staff meeting. Publication of the study would allow for national dissemination of the results. Within the IHS, presentation of the results would be made via email to stakeholders and other staff.
American Indians have a disproportioned rate of diabetes and the associated complications. Lakota Sioux living in Pine Ridge not only face even higher rates of diabetes as well as severe poverty and poor access to care.
Telehealth programs have been used successfully to provide better care for the diabetic patient improving outcomes and decreasing costs related to diabetes complications. It is clear that developing a telehealth program that includes a multidisciplinary care team, would give this population access to a more holistic care, and improve diabetes outcomes.
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