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Release: Immediate

UI study examining use of telemedicine for pediatric genetic counseling

IOWA CITY, Iowa -- A researcher in the University of Iowa College of Medicine has been awarded a grant to evaluate the use of telemedicine in pediatric genetic counseling in Iowa.

Dr. Kim Keppler-Noreuil, assistant professor of clinical pediatrics, division of medical genetics, received $6,500 from the Children's Miracle Network for her pilot study.

Telemedicine is the use of telecommunications technology to provide medical care, such as patient exams or consultations. The UI study will track follow-up pediatric genetic consultations of patients and their families at Broadlawns Medical Center in Des Moines, one of 16 Regional Genetics Consultation Services (RGCS) in Iowa.

Families throughout Iowa are referred for a genetic evaluation by the RGCS when their children are diagnosed with one or more birth defects or when there is a known or suspected genetic disorder. Because many conditions can be inherited, a geneticist may need to evaluate the entire family. Other birth defects are caused by environmental factors. More than 1,200 children are born with birth defects in Iowa each year.

UI telemedicine services are provided through a live video program that uses an interactive communications device called the TeleDoc. Using the technology, the examining UI physician-geneticist can remain at the UI Hospitals and Clinics (UIHC) and visually evaluate a patient with a birth defect or inherited condition at a distant health care site. A UIHC genetic nurse counselor travels to the site to guide the patient and family through the teleconsultation and conduct any exams requiring the use of a stethoscope or otoscope. Personnel at the two sites provide technical support for the telemedicine network.

The TeleDoc provides such clear images that a physician can detect even minor anomalies of the skin, hair or bones, for example, which point to an underlying genetic disorder. "It's just like being there," said Keppler-Noreuil, who has used the technology.

Keppler-Noreuil said the UI study is evaluating patient and physician satisfaction with the teleconsultations, ease of use, timesaving factors and cost-effectiveness. She said patients are asked to compare the quality of care provided in a TeleDoc visit with meeting with a physician in person.

"The study results will show us how the UI can best use telemedicine to expand genetic and educational services for children and their families and primary care providers. Physicians should be able to devote more time to their work and less time to travel."

Currently, a physician may spend up to six hours traveling to a genetic counseling site, and some clinic visits require an overnight stay, Keppler-Noreuil said.

Keppler-Noreuil would like to publish her report in late 1999.

Teleconsultation in pediatric genetic counseling is one of several clinical telemedicine services offered by the UI.

Children's Miracle Network raises funds to benefit the Children's Hospital of Iowa at the UIHC and helps underwrite advanced medical technology, sophisticated facilities, pediatric research and diversionary items that improve the quality of life for hospitalized children and their families.