NIH News Release
National Library of Medicine

Friday, December 1, 2000

Contact: Robert Mehnert
Kathy Cravedi
(301) 496-6308

Iowa Project Links Rural Areas Cross-State to Top-Notch Medical Advice
— Live Videoconference Scheduled —

(Bethesda, Md.) — When a child has a complicated problem like autism or cerebral palsy, it can take a village — medical professionals, therapists, teachers, family members, and home care aides — to provide proper care. For families in rural areas, it's hard to get to the specialists their children need to see. Another challenge is developing a plan to coordinate the diverse team of caregivers.

The University of Iowa's Child Interdisciplinary Disability Project (CIDP), based at the University Hospital School in Iowa City, fulfills this function, but with a high-tech twist. "Thanks to a fiber optic network and interactive audiovisual devices, experts at the University can perform clinical evaluations, and plot a course of care, for children hundreds of miles across the state," said National Library of Medicine Director, Donald A.B. Lindberg, M.D. "The patient is spared long car trips, parents don't have to miss work, and the family can tap into the best medical advice the state has to offer without leaving their hometown. Perhaps best of all, with the various experts all assembled, they can collaborate with ease."

The Iowa project, created with financial support from the National Library of Medicine, an arm of the National Institutes of Health, will be showcased Monday, December 4th, at 1:00 p.m. at the Health Information Infrastructure conference, sponsored by the non-profit Friends of the National Library of Medicine. The session will not only tell but will show how CIDP works, with a live hook-up to sites in Iowa and an interview with a patient's family in rural Iowa. U.S. Senator Tom Harkin (D-Iowa) will be on hand to discuss the project's potential for the Nation's disabled Americans. The event will take place at the Bethesda Marriott Hotel, 5151 Pooks Hill Road, Bethesda, Maryland.

Here's how it works. In the case of the Walker family, who will be appearing via remote from Ottumwa, Iowa, their eight-year-old son visited the University Hospital School outpatient clinic in Ottumwa for clinical evaluation in 1998. After Samuel was diagnosed with severe behavioral problems, his parents were eager to consult with experts about his care.

Using a two-way interactive system with video monitors at each end, a team of specialists at the University Hospital School (UHS) in Iowa City conducted consultations with the Walkers and their interdisciplinary team back in Ottumwa. On the consultation days, space in Ottumwa High School was reserved and special equipment put in. Noon was chosen so that Samuel wouldn't miss classes and so his teachers could attend the sessions, too. At the Ottumwa site, the Walkers' Behavioral consultant and in-home worker joined the discussions. With technology provided by the Iowa Communications Network, the groups in the two sites could see each other on monitors, observe the patient, talk about his behavior, and discuss the best strategies for care. Since 1998, Samuel, now 10 years old, has had 12 consultations.

"The main advantage to Samuel," reports Dr. Kent Walker, Samuel's father, "has been that we can coordinate all of his care with his teachers, his physician, and his psychiatrist all at one time. When Samuel was seen by Dr. [David] Wacker [a nationally respected expert on developmental disabilities] at the University, he had many aggressive problems and now he is improving."

"Access to specialty care is a major challenge in a rural state like Iowa," notes Michael G. Kienzle, MD, principal investigator. "This project, with the support of NLM, has shown that we can enhance access while maintaining or improving the quality of care by using telemedicine technology." NLM, the National Library of Medicine, provides funding for telemedicine projects around the nation.

Dennis Harper, PhD, Project Investigator of the CIDP, says, "We are going statewide with this effort, based on demand from rural communities. This project is now ongoing and it seeks to normalize the lives of children with disabilities."

"The Iowa model might be replicated in other states with good results," observes Senator Tom Harkin (D-IA). "Telemedicine puts technology to work to improve the delivery of health care," says Harkin. "It links patients and their doctors in rural or remote hospitals with highly trained medical specialists and state-of-the-art medical technology located hundreds or even thousands of miles away. At a time when health care costs continue to skyrocket, telemedicine has the potential to ensure that quality health care remains affordable and accessible for working families in all areas of the country."

University Hospital School is a hospital component of the University of Iowa Hospitals and Clinics in Iowa City. In 1996, UHS received a grant from the NLM as a means of providing services to children with development disabilities. That funding continued through March of 2000. Now, the project is supported by the University of Iowa.

To learn more about the Iowa telemedicine project:

To learn more about the National Library of Medicine:

Note to reporters: B-roll of project is available upon request.