Reaching out to help

Candice and Noel Bardonnex
Noel Bardonnex encouraged her daughter Candice to take advantage of the UC Davis Healthy Eating-Active Living Telehealth Program aimed at helping adolescents fight obesity and adopt healthy lifestyles. The UC Davis program is part of the telehealth services that Tamea Weiss, medical director of the Toiyabe Health Project, brought to the Bishop, Calif., clinic.

Posted Feb. 24, 2010

Noel Bardonnex, a Bishop, Calif., resident and a member of the Lone Pine Paiute Shoshone Tribe, is well aware that obesity and diabetes are common diseases among Native Americans. Her husband has type 2 diabetes, and she worries that their young teenager Candice could be at risk.

When Bardonnex heard about a UC Davis Health System telehealth program designed to educate adolescents about healthy behaviors, she decided it would be a good opportunity for Candice to learn how she can avoid the obesity and diabetes that many in their community have.

“As a parent, you can tell your children the right things to do, but they are not always going to listen to you. This program is a way for her to learn from experts,” says Bardonnex.

Candice has met nearly all her goals in UC Davis’ Healthy Eating-Active Living Telehealth program (HEALTH).

New tools yield new understanding

UC Davis physician Joyce Leary is using cutting-edge information technology tools in her search to determine if drug regimens for patients with diabetes have been appropriately adjusted in response to elevated glucose levels in their blood.

“By identifying adjustments made to drug regimens when the diabetes control is poor, I am hoping to identify barriers to improving long-term diabetes control," Leary says. She is amassing the data to identify treatment trends using a sophisticated database called Cohort Discovery, developed by the UC Davis Clinical and Translational Science Center, and UC Davis Medical Center’s electronic medical records system that stores medical information of its patients.

Together, the data repositories enable these researchers to securely access clinical data from which patient identifying information has been removed and to analyze health trends, create comparison groups and better understand the genetic basis for complex diseases.

“Developing secure systems that allow sharing of health data advances research and improves all areas of health care, from reducing health disparities to ensuring new treatments reach the patients who need them,” says Kent Anderson, CTSC biomedical informatics co-director.

The system is being piloted at UC Davis and will eventually link together a consortium of academic medical institutions including University of Washington and UC San Francisco, significantly expanding the data that can be searched.

Telehealth technology connects larger health-care centers with community hospitals and clinics like the one operated by the Toiyabe Indian Health Project using high-speed data lines and video units.

UC Davis’ telemedicine program gives clinics and hospitals throughout the state access to more than 40 medical specialties not readily available in many smaller communities. The program reaches 100 sites throughout the state, but will expand even further in the next few years.

UC Davis Health System and the University of California are leading efforts to create a broadband network linking more than 860 sites across the state, 40 percent of them based in rural areas or on tribal lands. The Toiyabe Indian Health Project, a federally funded clinic, is one of nearly 80 Indian health clinics that will become part of the California Telehealth Network.

Dr. Nesbitt © UC Regents“Nationally, we’re looking at how to more efficiently use the resources we have, particularly expensive resources like specialists. Telemedicine provides a way to move that expertise to where it is needed.”
— Thomas Nesbitt

Initial $22.1 million funding for the California Telehealth Network comes from the Federal Communications Commission and is supplemented with $10.6 million from Emerging Technology Fund, United Health/Pacificare Foundations and the National Coalition for Health Integration.

In addition, requests for $55 million have been submitted under the American Recovery and Reinvestment Act that could expand the network to some 2,000 sites.

Thomas Nesbitt, UC Davis associate vice chancellor for Strategic Technologies and Alliances and co-director of the California Telehealth Network, says the push to expand telemedicine is consistent with the ongoing effort at the national level to reform the country’s health-care system.

“Nationally, we’re looking at how to more efficiently use the resources we have, particularly expensive resources like specialists. Telemedicine provides a way to move that expertise to where it is needed.”

Dr. Shaikh using telemedicine © UC Regents
Ulfat Shaikh, a professor in the Department of Pediatrics and a clinician at UC Davis Children's Hospital, recently received a three-year $430,000 grant to support her research into the use of telemedicine to treat obesity in children in disadvantaged rural communities.

Bardonnex says UC Davis’ telehealth program has helped her daughter choose smaller portions of food, healthier snacks and more exercise.

The telehealth sessions conducted every other month by UC Davis pediatrician Ulfat Shaikh augment the support Candice receives from her own physician at the Toiyabe clinic, Ann Gasior; from her nutritionist, Katrina Otten; and from Toiyabe telehealth nurse John Clark.

“The support Candice gets from the entire team has been very beneficial,” Bardonnex says.