Medical College of Georgia

Tuberculosis Clinic Streamlines Patient Care

by Toni Baker

The convenience and immediacy of telemedicine technology is giving Georgia’s public health providers a new way to treat an old disease.

Tuberculosis, an infectious disease that still runs rampant in parts of the world, no longer thrives in Georgia. But it does endure, infecting about 800 Georgians each year.

The cure — a combination of antibiotics taken over six months — is nearly a half-century old, but public health efforts continue to find the most cost-efficient and effective means of properly identifying patients and ensuring proper treatment.

The evolution began in earnest in the 1980s when the tuberculosis rate began to level off after years of steady decline, said Mary Rhoden, supervisor for tuberculosis care for the East Central Georgia Health District. The appearance of human immunodeficiency virus, which weakens the immune system making people more susceptible to other diseases, was partially blamed for the leveling off, Mrs. Rhoden said. But the declining emphasis by the public health sector on a disease whose numbers were dwindling likely also was a factor, she said.

The Georgia Department of Human Resources, in an effort to provide more cost-efficient care for tuberculosis patients, decentralized tuberculosis treatment in 1995 and closed the tuberculosis unit at Northwest Georgia Regional Hospital in Rome July 1, 1996. This fueled initiatives to find ways for each health district to locally manage tuberculosis.

About the same time, the Georgia Statewide Telemedicine Program became part of the solution by making it easy for public health providers who care for tuberculosis patients where they live to consult with pulmonologists at the Medical College of Georgia.

Public health nurses at telemedicine sites at Emanuel County Hospital in Swainsboro and Tri-County Health Systems, Inc., an outpatient facility in Warrenton, connect twice monthly with pulmonologists at MCG to review cases.

A third telemedicine tuberculosis clinic began in January with Wayne Memorial Hospital in Jesup. At that monthly clinic, Drs. Claire Hicks and Ellen Richardson, family medicine physicians, consult with MCG pulmonologists regarding the patients they service locally, said Sherri Ward, the hospital’s Telemedicine Coordinator.

"This is a perfect market (for telemedicine)," said Dr. W. Bruce Davis, MCG Chief of the Section of Pulmonology. He and Dr. John DuPre, another MCG pulmonologist, direct the Tuberculosis Clinic via telemedicine. A major role of telemedicine is to help provide care locally when possible and triage patients who need treatment elsewhere. Many people with tuberculosis never need to be hospitalized and, particularly during the first several weeks when the disease is infectious, going to a clinic can endanger other patients, Dr. Davis said.

Tests results and X-rays could be mailed, then discussed by telephone, but telemedicine enables health care providers at both ends to look at X-rays and pertinent test results together, discuss patients thoroughly and make a decision about care. "You resolve it then and there," Dr. Davis said.

Public health nurses also view the interaction as a continuing education course for themselves, Mrs. Rhoden said. "Especially in the rural areas of our state, telemedicine saves time and energy and gets patients evaluated quicker and on the correct treatment," she said.

Copyright © 1998
Medical College of Georgia Telemedicine Center