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Army Using Telemedicine For Healthcare Delivery

Wounded soldiers, pregnant women, and diabetes patients are receiving medical and appointment reminders to support their rehabilitation and treatment.
The Army has embarked on other initiatives using telehealth technology, the committee learned. For example, Text4Baby (T4B) is a free mobile health information service that provides timely health information to women from early pregnancy through their babies' first year.

Women who sign up for the T4B service receive three free text messages each week timed to their due date or baby's date of birth. The messages focus on topics critical to the health of mothers and babies, including nutrition, seasonal flu prevention and treatment, mental health issues, risks of tobacco use, oral health, and immunization schedules.

"The Army Medical Department plans to introduce T4B to military mothers at Madigan Army Medical Center at Joint Base Lewis McChord in Washington, as part of a demonstration to formally evaluate the acceptability and utility of using text messaging to deliver information and encourage healthy behaviors as part of its overall maternal health outreach initiatives," Poropatich told the committee.

The third wireless application that the U.S. Army is investigating is the impact of a reminder system on glycemic control in patients with diabetes. "The reasons why more patients do not reach appropriate goals for glycemic control are multiple and complex, among them poor compliance with self monitoring of blood glucose and medication non-adherence," Poropatich said during the hearing.

The Army is conducting a study at the Walter Reed Army Medical Center that examines whether a cell phone video reminder system will improve self-care and glycemic control in patients with diabetes when compared to those who don't use the system. Preliminary results show that blood glucose levels improved more in those patients provided with video reminders compared with those who did not receive them. Overall, the viewership was about 50%, which exceeds that of most other e-Health studies.

"Among subjects who watched at least two-thirds of the daily cell phone-based video tips [and] reminders, the decline in [blood glucose] was greater than it was for subjects who used the technology less," Poropatich said.

Looking ahead, Poropatich told the committee that the U.S. Army Research, Development, and Engineering Command (RDECOM) is evaluating commercial handheld solutions such as iPad, iPhone, iPod, and other platforms and their applicability in a tactical setting. RDECOM has developed numerous handheld command and control solutions and is supporting the development and transition of MilSpace, a combined planning and social networking environment. The Telemedicine and Advanced Technology Research Center is working with RDECOM to leverage U.S. Army investments in mobile technology and apply them to healthcare in the United States and in deployed settings overseas.