Telemedicine is a favorable mode of treatment for the rural population as it gives them a chance to access physical consultation as well as specialty health services without having to travel long distances. Telemedicine is the ideal equalizer for the people living in the rural areas who usually have to make do with inadequate services and less than ideal health outcomes in comparison to the urban populations that have large medical centers at its disposal.

Diabetes control is one of the most affected areas in Rural Arizona. Patients suffering from the illness have to take frequent trips to visit their specific healthcare providers and may spend between 1 to 2 hours one way on the road. Overall, doctors prefer to see diabetes patients regularly for not less than four times in a year. Diabetes patients must also have a regular appointment with a nutritionist, get tests done on their eye and feet every year, get their blood sugar regularly screened as well and get their medication supplies refilled. As much as the trips are necessary and may mean the difference between life and death, they can drain the patients’ resources due to the transport costs and time spent.

We will be launching a new project dubbed Tuba City Regional Healthcare Corporation or simply (TCRHCC) in the fall of 2015 in Tuba City to facilitate the expansion of telehealth services for diabetes care which will include screening and telenutrition services. The project will avail these crucial services to communities in the remote areas of Navajo Nation. It will involve using a telehealth vehicle to bring healthcare such as telenutrition visits, screenings and routine blood pressure tests closer to the people. This project was financed in 2014 by a lump sum grant from the charitable Special Diabetes program set aside for the Indians. It will enable people to get quality diabetes care through telemedicine while making fewer trips to the clinic. However, they will still have to visit the doctor occasionally for personalized care, but they can now go to the Chapter Houses for general check-ups like screening, eyes and foot tests and nutrition advice.

Limitations for the Rural Telehealth
Despite the fact that telehealth is an excellent way of easing health problems for rural patients, it is not without its share of challenges. The main challenge is the inadequate infrastructure in the rural Arizona in terms of internet reach, and impassable roads. The scattered population further compounds the problem, and the poor WIFI signals make video conferencing difficult.

Future prospects
TCRHCC plans to increase its telemedicine services in future with the help of the grant that has enabled the acquisition of better facilities. We are in the process of setting up a telestroke program in collaboration with the Arizona-based Mayo Clinic. We are also hoping to duplicate the ECHO project of the University of New Mexico in Northern Arizona that will offer specialized treatment like rheumatology, and pulmonology.