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Health Journalism 2006 Field Trips: UTMB-Galveston

The bus for this tour will leave the conference hotel at 8 a.m.

A continental breakfast will be served when you arrive in Galveston. You also will be served lunch at the UTMB campus. The bus will return to the hotel by 4:30 p.m., in plenty of time to attend the 6:30 p.m. newcomer orientation and 7 p.m. opening reception.

Key sessions planned for the UTMB field trip:

Frontera de Salud

Dr. Kirk Smith

In the lower Rio Grande Valley colonia of Cameron Park - one of the poorest communities in one of the poorest regions of Texas - UTMB medical, nursing, and allied health students and local residents have joined forces to create a revolution in health care. It's called Frontera de Salud - a unique collaboration between UTMB students and medical residents living with area families and lay health workers recruited from the local community.

Frontera has established a clinic to provide primary health care services for medically underserved families, but with the help of its local "promotoras de salud" it also reaches out to offer services that go beyond the usual scope of clinical practice: a highly active home-visit and counseling program aimed promoting life changes that prevent chronic diseases such as diabetes and hypertension, health maintenance classes, depression screening and counseling, and men's and women's health discussion groups.

Frontera's co-founder - Kirk Smith, a medical doctor and member of UTMB's Institute of Medical Humanities - will discuss the creation of the program, its development over the last seven years, and what its success could mean for the future of health care.

Infectious Disease and Biodefense

Drs. C.J. Peters and Stanley M. Lemon

In the past 10 years, UTMB has become a global leader in the fight against new and emerging infectious diseases and bioterrorism, recruiting some of the world's best researchers, building a biosafety level 4 lab (the first such maximum-containment "spacesuit lab" on the campus of an American academic health center), and being chosen to build one of two NIH-funded national biocontainment labs, the $167 million Galveston National Laboratory.

UTMB professor C.J. Peters is the former director of the Centers for Disease Control Special Pathogens Branch and an internationally known expert on hemorrhagic fever viruses such as Ebola; world-renowned virologist Stanley M. Lemon is the director of UTMB's Institute of Human Infections and Immunity, principal investigator of the Galveston National Laboratory, and co-editor of the 2005 Institute of Medicine report, "The Threat of Pandemic Influenza: Are We Ready?"

Dr. Peters and Dr. Lemon will discuss UTMB's biodefense and infectious disease programs and the special problems posed by the possibility of an avian flu epidemic, looking at how we can assess the real risk of epidemic influenza, how that risk can best be communicated to the public, and the responsibilities of the press in the face of a possible bird flu outbreak or similar threat. Dr. Peters is also interested in talking about the possibility that the United States may limit research or communication of research findings out of fear that advances in biodefense could potentially give rise to new, more dangerous infectious threats.

Telemedicine: UTMB's Electronic Health Network and the Wired Health Care

Drs. Glenn Hammack, Oscar Boultinghouse, and Michael Davis

Today, UTMB has the largest and farthest-reaching telehealth program in the world, using advanced video and sensor systems and satellite and fiber optic networks that enable physicians in Galveston to examine and treat patients, read ultrasound scans, interpret X-rays, prescribe medications and even listen to a human heartbeat from any "wired" location on the planet.

Initially developed to support UTMB's work with the Texas Department of Criminal Justice (currently the largest user of telemedicine in the nation), the Electronic Health Network has expanded dramatically in both scope and capability in the last decade. Today, it provides everything from dedicated medical consultation for the Amundsen-Scott South Pole Station to telemedicine services for cruise lines to telemedicine-based corporate health-care programs for local companies (allowing employees to "see" their primary care physicians without leaving work) and physician services for UTMB's far-flung regional and maternal child health care clinics in rural East Texas.

Electronic Health Network director Hammack and Drs. Boultinghouse and Davis will discuss the unique capabilities of telemedicine and its likely future development, as well as demonstrating the operation of the UTMB system.

Healthy Aging and the Fight Against Frailty

Dr. Elena Volpi and Dr. Susan Tyler

Although age-related mental disorders like Alzheimer's disease get more publicity, the most important factor in enabling elderly people to stay independent and out of nursing homes is actually physical: the muscle loss that accompanies aging, which limits mobility, reduces ability to accomplish tasks younger people take for granted, and dramatically increases the risk of catastrophic injury from falls. And as the percentage of the population over age 65 increases, it's a problem faced by more and more Americans every year.

UTMB's federally funded Claude Pepper Older Americans Independence Center - one of only nine Pepper Centers in the nation - is focused on solving this problem by finding new, highly effective ways to fight frailty in the elderly.

The UTMB center has combined the expertise of specialists in molecular biology, exercise physiology, metabolism, endocrinology and diet to produce clinical breakthroughs that are working right now to keep older people stronger and healthier longer.

Access to Health Care - Making the Hard Choices

Drs. Karen Sexton and Barbara Breier

As the number of Americans without health insurance increases, institutions that care for those who can't afford to pay for treatment find themselves in a financial bind, trying to satisfy unlimited demand with increasingly limited funds. Almost all make decisions about whether to treat uninsured patients on an ad hoc basis, without ever directly facing the controversial issue of health care rationing.

By contrast, UTMB - which was running an $80 million budget deficit in 1997 largely because so many of its patients were uninsured - chose to confront the problem head-on, creating a system of "rational rationing" to determine how best to apply its limited resources. The result, eventually, was financial success (a small budget surplus) and national recognition for finding a consistent way to make the hard choices that much of the American health care system seems to be doing its best to avoid.

Dr. Karen Sexton, vice president and CEO for UTMB's hospitals and clinics, will tell the story of the program's development and application. Dr. Barbara Brier, director of the UTMB Center to Eliminate Health Disparities, will discuss the potential of a new concept in low-cost health insurance known as the "3-Share Program," under which low-income workers, their employers, and state and local governments combine to pay the cost of coverage; UTMB is working to establish such a program in Galveston.