Monday, November 09, 2009
Two Grants to Fund New Bioethics Research Center and Study on Telehome Care in Rural Maryland
The University of Maryland School of Medicine Office of Policy and Planning has received more than $4.9 million in federal stimulus funding from the National Institutes of Health (NIH) to explore new strategies to address health disparities throughout the U.S.
One grant, for more than $2.4 million, will create a national Bioethics Research Center funded by the National Center on Minority Health and Health Disparities (NCMHD), part of the NIH. The Bioethics Research Center will implement innovative strategies to address ethical issues in research and examine the implications of these issues on health disparities within Maryland and throughout the U.S. The grant will enable the Center to train physicians and researchers in bioethics. The Center, funded by the American Recovery and Reinvestment Act (ARRA) of 2009, will also work to foster public trust in clinical trials and medical research among minority and rural communities across the nation.
The formation of the Bioethics Research Center was announced by Claudia R. Baquet, M.D., M.P.H., professor and associate dean for the Office of Policy and Planning and director of the Center for Health Disparities at the University of Maryland School of Medicine. She made the announcement at a news conference on November 9 at the Bel Alton High School Alumni Association Community Development Center in Charles County, located in southern Maryland. Dr. Baquet also announced a second ARRA grant for $2.5 million to fund a telemedicine study in rural Maryland.
Joining Dr. Baquet at the news conference were officials John Ruffin, Ph.D., director of the NCMHD; U.S. Senator Benjamin L. Cardin; U.S. Representative Steny Hoyer, whose district includes southern Maryland; and state Senator Thomas M. “Mac” Middleton, who represents Charles County.
“I am committed to ensuring that all Marylanders – regardless of economic status, racial or ethnic origin or place of residence – have equal access to quality health care and wellness information,” says Senator Cardin. “These two Recovery Act grants will help make that possible by funding new, innovative approaches that will help improve the overall health of individuals.”
Congressman Steny Hoyer said he was “pleased to join so many partners dedicated to the cause of improving public health and reducing health disparities in rural communities. When it comes to improving health outcomes, we know preventive care works. Telehome care is an important part of increasing access to critically-needed services, especially for rural populations and the elderly," he told reporters. "The Recovery Act’s investment in the Maryland Telehome Care Network will directly benefit southern Maryland’s communities with improved access and delivery of services, while working to promote economic recovery by preserving 12 jobs and creating 14 more.”
“Previous studies have identified barriers to participation in clinical trials for certain groups, and there is a need to increase public trust in research among African American, rural and other underserved communities,” says Dr. Baquet. “The lack of diversity in clinical research participation is an impediment to advancing new ways to prevent, diagnose and treat diseases. This issue contributes to health disparities in underserved communities. We are grateful for this NIH stimulus funding, which provides critical support for expanding the research and education we at the Office of Policy and Planning have developed over the past 12 years, in Maryland and across the nation.”
The new Bioethics Research Center, which includes a partnership between the School of Medicine and the Maryland Center at Bowie State University, will address the issue of clinical trial participation throughout the U.S., connecting the School of Medicine with key partners to reach out to primary care physicians, researchers, nurses, African Americans and others from minority groups and rural communities.
The Maryland Center at Bowie State will help to create summer training programs and fellowships for historically black colleges, universities and academic health centers across the country for the study of bioethics and clinical trial design issues. The grant also supports partnerships with media entities such as the Times Community Services/Newspapers and the National Newspaper Publishers Association. These media partners will train journalists in how to develop coverage of clinical trial issues.
The partnership will also include the Eastern Shore and Western Maryland Area Health Education Centers (AHECs) and the Maryland Academy of Family Physicians, which will work on
public education and physician and nurse continuing education in Maryland and across the U.S.
The NCMHD promotes minority health and leads, coordinates, supports, and assesses the NIH effort to reduce and ultimately eliminate health disparities. “Health disparities remain a public health challenge for the nation because of issues such as trust deficiency in health care, which has been a historical problem for racial and ethnic minorities, and access to medical care for rural and other underserved populations,” says Dr. Ruffin, NCMHD director. “Recovery Act funds have afforded us the opportunity to bring key community partners together who are committed to building the necessary infrastructure to tackle these issues to ultimately improve community health and eliminate these systemic barriers to health equity. The diversity of partners involved in these two projects reminds us of the complex nature of health disparities and the importance of engaging all sectors and disciplines in efforts to eliminate health disparities.”
In addition to the Bioethics Research Center, a $2.5 million stimulus grant to the Office of Policy and Planning from the NCMHD examines social determinants of health. It will fund state-of-the-art “telehealth” technologies in rural western and southern Maryland counties. The “telehome care” study confronts the issue of health outcomes for chronically ill rural residents who receive home care far from their physicians’ offices. It will allow doctors to closely track the progress of chronically ill patients undergoing home care. This grant will allow Dr. Baquet and co-investigator Shiraz I. Mishra, M.B.B.S., Ph.D., associate professor of family and community medicine at the University of Maryland School of Medicine, to study whether home telehealth care can close rural gaps in health care.
“Multiple factors serve as barriers to health care delivery for rural patients,” says Dr. Mishra. “These factors include distance to health care facilities, transportation problems, lack of access to primary care and specialty services, loss of health coverage and lack of timely access to new technologies. Telehome care has the potential to provide a cost-effective alternative for the provision of timely and quality care to rural underserved populations.”
“We hope this study finds that telehome care can provide an innovative and potentially cost-effective solution to the disparities in both health status and outcomes and access to quality specialty care for rural residents,” says Senator Middleton. “We’re looking for solutions to provide southern Maryland residents with the same quality of care and the same chance at long, healthy lives that patients in the rest of Maryland enjoy. I am proud to be part of this national partnership and effort on behalf of rural Maryland.”
The telehealth project is a collaborative effort between the School of Medicine, the AHECs on the Eastern Shore and in western Maryland, and the Office of Policy and Planning’s rural health care delivery partners, Garrett County Health Department Home Health Agency in western Maryland, and the Chesapeake Potomac Home Health Agency in southern Maryland.
The study will be implemented in rural western and southern Maryland counties among 250 patients with chronic health conditions such as diabetes, heart failure and hypertension. All the patients are receiving home health care through their local health departments. Patients will be assessed periodically to gather information such as their medication history, number of emergency visits, hospitalizations and quality of life. They each will receive a blood pressure cuff and a glucometer and will electronically transmit their data. During the monitoring period, the home care nurse will work with local physician oversight to provide clinical care. The home care nurse will contact the patient via telephone or in-person regarding any abnormal data.
“Like all the federal stimulus funding earned by the University of Maryland School of Medicine’s world-class researchers, these awards will foster the development of new ideas and hopefully uncover solutions that will impact human health for the better,” says E. Albert Reece, M.D., Ph.D., M.B.A., dean and John Z. and Akiko K. Bowers Distinguished Professor at the School of Medicine, and vice president of medical affairs for the University of Maryland. “Both of these grants recognize our school’s dedication to improving the health of minority patients in Maryland and around the globe.”