ADVICE Program Description (2004-2006)

 Service Area: The “Arizona Diabetes Virtual Center of Excellence” (ADVICE) will initially serve three Health Professional Shortage and Medically Underserved Areas:

1. The service area of the Tuba City Regional Health Care Corporation (formerly Tuba City Indian Medical Center) is a 3,812 square mile area serving a total regional population of approximately 30,000 people with approximately 8,000 people living within the vicinity of the town of Tuba City (96.7% Native Americans)

2. Nogales covers 21 square miles and, has a local population of 21,110 (90.8% Hispanics), and

3. Amado, a very small town in Santa Cruz County covers 12 square miles with a population of 275. (63.5% Hispanics). 

Needs, Objectives, and Outcomes: Hispanics and Native Americans in this program’s service area are at the highest risk and are most vulnerable of all population groups for diabetes. This proposal integrates many assets of the Arizona Telemedicine Program (ATP) network and the Arizona Health Sciences Center, creating a “virtual center” of diabetes care. Through this innovative proposal, ATP will pilot a new model for telehealth by adding diabetes clinical and educational service layers onto an existing telehealth infrastructure in areas that have high incidences of pre-diabetes and diabetes.  The objectives are to: (1) Create the “Arizona Diabetes Virtual Center of Excellence” (ADVICE) network to establish a comprehensive telemedicine program for diabetes prevention, assessment, and management; (2) Create and evaluate innovative distance learning programs on diabetes for patients, families, children, community-based allied health professionals, and physicians in rural areas, thereby creating a community-based infrastructure for diabetes health education; (3) Provide access to specialty healthcare for people with diabetes and pre-diabetes in rural areas.  Outcomes studies will demonstrate participation, knowledge gained, and satisfaction with education and clinical activities with school children, community, patients, caregivers, health professionals and providers.

Telehealth Services: Services to be provided by this project are the clinical telemedicine services of tele-ophthalmology, tele-pediatric endocrinology, tele-surgery, and tele-podiatry; and distance learning programs for patients and families, healthcare providers, and to increase the number of rural Certified Diabetes Educators (CDE’s) for rural communities.

Additional Activities: This project will develop an innovative “virtual support group” concept utilizing “e-Promotoras” and “e-Community Health Representatives”.  This concept takes advantage of existing network and tele-home healthcare resources.

Network Development: Currently the ATP telecommunications infrastructure links 77 sites in Arizona and New Mexico.  This new application will utilize a rural regional medical center, four IHS clinical service units, a rural/border community health center and hospital, a mobile clinic, an eye-care foundation, a faith-based clinic, an academic medical center, a children’s rehabilitative clinic, and selected patient homes.

Sustainability: This project utilizes the existing award winning multi-service ATM network and some current staff thus reducing the burden of identifying new funds for these components when grant funding ends.  Also, for clinical telemedicine care, all Arizona third party payers, including the Arizona Health Care Cost Containment System (Arizona Medicaid) reimburse at the same level as traditional clinical services.

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Updated:  May 6, 2008