Home Telehealth for Chronic Disease Diabetes Management in Rural Community Research Paper

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Improving Diabetes Outcomes in Rural America Through Telehealth Solutions

The United States is a nation characterized by deep socioeconomic

divisions which are prompted by racial, ethnic and geographical patterns.

In spite of the nation's relative affluence, indications persist in its

public health outlook to suggest both the increasing permeation of epidemic

health conditions precipitated by lifestyle tendencies and the lopsided

distribution of healthcare access. The latter concern is of particular

relevance to us as countless Americans suffering from a treatable condition

are nonetheless incapable of accessing the healthcare facilities and

professionals that can help them. With the condition of diabetes, which is

fast proliferating today in the United States due to poor nutritional

habits, negative lifestyle tendencies and cultural patterns encouraging

both, its appearance in rural America has become especially problematic.

This is because in America's rural regions, healthcare access tends to be

lesser, conditions such as obesity and heart disease are more common and

the education which is necessary to help people either prevent or treat

diabetes is likely to be lacking or insufficient. It is thus that we

undertake the study here, which is engaged to determine the value of newly

evolving healthcare technologies in addressing this identified publicDownload full Download Microsoft Word File
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health problem. The emergence of telehealth technologies through the

online computer medium is opening these regions up to new treatment and

educational opportunities. These could have a substantial impact on the

length and quality of life for diabetes sufferers in rural America. This

invokes the discussion here, both on the presence and problematic nature of

diabetes in America's rural region and on how telehealth technologies are

improving healthcare access both in a general sense and where diabetes is


TOPIC: Research Paper on Home Telehealth for Chronic Disease Diabetes Management in Rural Community Assignment

This is important because diabetes has become a definite epidemic in

the United States. According to a study by Dabney & Gosschalk (2008), "the

number of diagnosed cases has increased nearly 10-fold over the past 40

years and has nearly doubled in the past 10 years. Approximately 17

million Americans-6 percent of the population-are diabetic, with perhaps

one-third of the cases being undiagnosed. Furthermore, a newly recognized

condition called 'pre-diabetes' affects another estimated 16 million

Americans." (Dabney & Gosschalk, 57) This denotes that diabetes is a

significant public health problem which levies considerable costs on the

public healthcare system. Given that diabetes-and especially its

inexorable rise in prominence-is connected to lifestyle decisions and

negative lifestyle habits, intervention on a wide based level is justified.

This discussion focuses this imperative on those rural communities where

for various geographical reasons often are at a significant disadvantage in

terms of received proper healthcare.

Access and education being the dual obstacles to treatment, the

consideration of telehealth technologies as a way of focusing on diabetes

issues specifically in the rural context is fielded here. The study by

Dabney & Gosschalk provides a useful jumping off point in this discussion,

indicating that "in this nationwide survey of state and local rural health

leaders, diabetes was ranked third among the most frequently nominated

rural health priorities after access and heart disease and stroke. There

was substantial agreement on the rural priority status of diabetes relative

to all other . . . functional areas." (Dabney & Gosschalk, 58) This

illustrates that there is a clear need to take measures that can alter the

current outlook for those in rural areas. To the point, we will therefore

initiate a discussion on the apparent value and benefits of telehealth

technologies and methods in a general sense. With the integration of

internet technologies into everyday business functions, it seems an

intuitive leap to consider the ways in which advancing communication and

information tools might help to improve the quality and accessibility of

healthcare which cutting down on the costs to the company and the laborer.

The potential represented by telemedicine, still modestly unexplored,

bears a great deal of undiscovered opportunity for rural residents in need

of access to medical attention that is quick, affordable and reliable. By

placing live medical care and pertinent medical information at the computer

user's fingertips, the process of telecommunication removes many of the

fundamental obstacles to receiving healthcare. Among these, telemedicine

eliminates the need for and cost of transportation, significantly

diminishes the amount of time required by employees to obtain medical care,

compensates for a decided shortage of healthcare professionals and,

ultimately, reduces many of the inherent costs in an office visit.

As a result of the relative cheapness of the basic required equipment

for access to online healthcare, this has been widely touted as a sensible

avenue for exploration as a means to advancing opportunities for healthcare

to many venues and geographic locations where such had previously been

unavailable. For our considerations here, the traditional medical or home

facility will serve as a hypothetical venue where, though, it has not been

traditionally present, medical access may through online strategies become

a reality. "The adoption of PC-based desktop medical teleconferencing is

tracking closely after the more widespread use of desktop videoconferencing

(DVC) for business" (B2B Media, 1) As this relates to telemedicine, it

seems apparent that very little physical adaptation needs to be made in

order to participate in a growing network of online healthcare users and


The abilities which it gives patients and doctors to connect from

remote locations by way of any modestly equipped PC terminal makes

telemedicine a route to the expansion or supplement of our abilities to

contend with radiological, pathological and even cardiological challenges.

In fact, "depending on how it is defined, telemedicine can involve the use

of imaging and diagnostic equipment to gather data from a patient, computer

hardware and software to record data, communication lines or satellites to

send the data from one location to another, and computer equipment at the

receiving end for a physician or specialist to interpret the data."

(Weldon, 4) This suggests a range of potential uses for telemedicine that

is broad and still subject to continued exploration and experimentation.

Therefore, in attempting to intervene with the above-noted pattern of

rural diabetes spread, researchers have found that telemedicine approaches

are far more manageable and affordable than the construction of new

hospital facilities or the expansion of existing ones. Indeed, for those

who are truly immobilized by the nagging health concerns either relevant to

or consequent of diabetes at an advanced age, such facilities which still

provoke unwanted strain on the system. By contrast, "without leaving the

office or clinic, doctors and nurses can make personal "visits" to patients

at home, using state-of-the-art technology that simultaneously transmits

voice and video combined with clinical data streams from medical

peripherals such as blood pressure monitors, stethoscopes, and glucose

meters - all over standard telephone lines." (Moore, 1)

Telehealth has also come to serve as a blanket term for the delivery

of information and information services. Again, the recurrent issue of

poor nutritional and lifestyle habits in the spread of diabetes implicates

the need for just such a delivery. The increased presence of terminals for

access of such information in the homes of diabetes sufferers can

contribute to improved lifestyle habits and lowered mortality due to

insufficient self-treatment. According to the article by Templeton (2007),

this can be a path to overcoming some of the key informational problems

which make rural areas most vulnerable to conditions like diabetes.

Templeton indicates that such "problems include poverty, lack of healthy

food and, worst of all, lack of doctors, pharmacists, dietitians,

psychologists and diabetes educators." (Templeton, 1)

These are problems which are directly associated with the conditions

often inherent to rural life in the United States, where economic

inequality pervades and carries with it a wide scope of social symptoms.

Chronic health conditions are among the most prominent of these symptoms,

owing to the negative cycle of persistent poverty and its related lifestyle

tendencies. For those living with diabetes in rural areas, chances of

mortality are made considerably higher by this reality and a lack of

concrete resources denotes the need for far-reaching healthcare solutions

that are simultaneously cost-effective. This is underscored by Bull's

(1993) prescient observation of the persistent patterns facing rural

America. Bull reports that "according to W.R. Lassey, a contributing

author to The Elderly In Rural Society, "Poor rural older people suffer

from what might be referred to as the 'poverty-illness syndrome'--that is,

they are poor, which ... limits their access to medical services while

subjecting them to many of the risk factors associated with the higher

incidence of chronic disease. Because of their chronic diseases, they are

often unable to improve their incomes. Geographic and social isolation

limit their ability to escape from either poverty or (ill) health.'" (Bull,


This suggests a condition in which the problems of poverty produce

healthcare obstacles which can become self-perpetuating. The prospects of

telehealth to resolve this are immense according to currently applied

research, which has put into practice the prospect both for the

distribution of information and of health services through

telecommunication means. Reporting on these efforts, Moore (2005)

indicates that "one of the most interesting and promising… [END OF PREVIEW] . . . READ MORE

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