Overview

The Minority Organ and Tissue Transplant Education Program (MOTTEP) has been actively working to solve the number one problem in transplantation, the shortage of organ and tissue donors. With more than 106,000 persons on the national transplant waiting list, nearly 50% represent minorities. Due to the shortage of organ and tissue donors, sixteen (16) persons die per day waiting for a life saving transplant.

The Problem

MOTTEP of Richmond was developed in response to three serious health problems for minorities in the State of Virginia. First, the inability of many minorities to access health care professionals in many of our rural communities is disproportionately elevated in Virginia. In a recent report from the Office of Health Policy and Planning (OHPP), many of the counties in the areas served by the Williamsburg Community Health Foundation are identified as Virginia Medically Underserved Areas (VMUAs). Vital Statistics from the recent 2003 Report for leading causes of death by ethnicity indicate that Blacks and Hispanics in the counties of Matthews, New Kent and Middlesex have suffered hypertension and diabetic related deaths at a rate of 14%. Some socio-economic factors play a role in some of these deaths and some social injustices play a role in the lack of healthcare delivery in some of these areas. This lack of medical care only precipitates the dilemma of chronic diseases that lead to end stage organ failure. Second, minorities in Virginia have disproportionately higher rates of heart disease, diabetes, and hypertension; which increases the need for organ transplantation. Third, almost half of the individuals on the statewide waiting list for organ transplants are minorities, yet less than 25% of the donor pool is composed of minorities.

Thus, the most recently addressed concern of MOTTEP of Richmond is for more minorities to have greater access to healthcare delivery, develop a healthier way of living, and for more minorities to become an active participant in their own health maintenance. This form of healthcare delivery system can be afforded by Telehealth technology. The action of adopting a healthier lifestyle could aid in eliminating some of the end stage organ failure.

The Project

MOTTEP of Richmond has collaborated with Dr. Joann Richardson, Ph.D., of Virginia Commonwealth University, Professor of Community Health & Health Performance, Dr. Joseph Boykins, MD. of the Diabetic Wound Healing Center of Retreat Hospital in Richmond, VA, Dr. Mark Jones, MD of West End Orthopedics in Richmond, VA., and Dr Maurine Harris, MD, Family Medicine in private practice, to develop a program to increase delivery of health care. The focus of this healthcare delivery will be in the area of hypertension and diabetes. The medical services will be delivered from remote locations to counties serviced by the Williamsburg Community Health Foundation. This Telehealth technology would enable patients with no insurance or under-insured in rural communities who would otherwise not receive much needed health care attention to be evaluated as well as to develop individual maintenance treatment plans. This Telehealth project would focus on the hypertension and diabetes among African American and Hispanics in counties surrounding Williamsburg, VA that have been designated as “Primary Care Health Professional Shortage Areas” (HPSA), see graph. This project will be conducted with the following expected outcomes:

* Increased access to qualified health professionals
* Increased patient education resources
* Increased patient managed care
* Increased patient compliance
* Decreased incidence of amputations
* Decreased incidence of diabetic retinopathies
* Decreased incidence of chronic ulcers
* Decreased need for dialysis
* Decrease incidence of cardiovascular disease
* Decreased incidence of End Stage Organ Failure

Evaluation

The Department of Health And Health Performance in The School of Education at Virginia Commonwealth University will utilize their current academic curriculum to access the success or failures of accomplishing the expected outcomes of the project. The diabetes education program of Retreat Hospital will maintain and report the impact of dietary life changes, physical activities and clinical successes by way of patient status as the project progresses. An annual comparison of the vital statistics relevant to the expected outcomes will be reported and published via an e-library resource which will be an integral part of the Telehealth technology itself.