Abstract 745 Poster Session IV, Tuesday, 5/4 (poster 31)

Children represent the fastest growing segment of the homeless population. These children present unique problems with limited opportunities to address their health issues. Unavailable transportation frequently hinders their ability to access health care. Metropolitan Ministries is a private, not for profit, community sponsored facility with a mission to serve the homeless population. A dedicated on-site clinic was established to provide health care to the pediatric population of this facility. The Metropolitan Ministries Clinic was electronically linked to the Pediatric Clinic of the University of South Florida. Telemedicine units(VTel TC1000), linked by ISDN lines, where placed at each site allowing 2 way tele-video(transmission rate 384 kbs). Peripheral devices at the Metropolitan Ministries Clinic include video-otoscope, video-dermascope and electronic stethoscope. A pediatric nurse practitioner evaluates patients and electronically consults with the USF faculty as needed. RESULTS: During 6 months 187 patients were seen. They were 36% white, 35% Black, 21% Hispanic and 5% Native American. Thirteen percent of the patients were less than 1 year of age, 46% 1-4 years, 36% 5-11 and 6% teenagers. Three quarters of the families had two adult caretakers although these might not both have been the parents. Families reported their homelessness lasted a mean of 16 days and relocation had occurred 3.9 times in 5 years. Health concerns range from well child visits (50%), 10% delayed immunizations, 12% upper respiratory illnesses, 12% a history of asthma and a wide variety of other problems. The telemedicine equipment was used at least 1 time per half day clinic(average of 7 patients per clinic). Review of uncertain physical findings and discussion of treatment plan most commonly necessitated its use. The patients rated the experience positively (4.75 out of 5). The children were not disturbed by the equipment. The most difficult issues for the providers were becoming comfortable with the equipment at either end. CONCLUSION: This project demonstrates that telemedicine can be used to support care to an urban homeless population.

Funded in part by a grant from GTE Foundation.