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Closing the Distance on Care

By Aaron Bracamontes


New program eliminates long-distance travel for rural epilepsy patients


For Big Bend patients, the distance to El Paso is more than miles.


That was the case for Cheryl Pate-McCollister, who has a seizure disorder. Scheduling a routine electroencephalogram (EEG) exam was a multiday nightmare. With no EEG technician in the Big Bend area, she had to travel to El Paso for an exam.



Since Texas law prohibits anyone who has had a seizure from driving for three months, the visit required a round-trip bus ride of over 500 miles through the empty West Texas desert, sometimes leaving at 2 a.m. and returning late at night. Pate-McCollister also had to work with her doctor and insurance to schedule a Monday visit, so she could leave her grandson with a family member Sunday night to make sure he got to school. Even thinking about it drained her energy.


That meant stress, anxiety, fatigue and separation from loved ones … for a routine medical visit.


“They say, ‘mother birds don’t like to leave their nest.’ That’s me,” Pate-McCollister said while holding a day planner filled with appointments.


However, the launch of a new program from the Department of Neurology at Texas Tech Physicians of El Paso is bringing health care, including EEG exams, to Pate-McCollister and other Big Bend patients. The program sends EEG technician Maria de la Soledad Torres to Preventative Care Health Services clinics in Marfa, Alpine and Presidio once every three months.


“Patients would travel three to four hours each way or make multiple trips within a few days,” said Sushma Yerram, M.D., the TTP El Paso epilepsy specialist leading the program. “Now they can do it all in one visit and still be home for dinner.”



The EEG visits are funded by a Permian Basin Area Foundation grant. Additional funding from the U.S. Department of Agriculture’s Distance Learning and Telemedicine Grant Program will soon pay for computers with specialized instruments to check eyes, ears and hearts in the clinics. These tools will help TTP El Paso specialists expand their virtual visits with Big Bend patients.


Torres also serves as a medical assistant to help with virtual screenings. Along with the EEG exams, the screenings help determine if a patient needs to see a specialist in person or follow up with their local doctor.


“More sophisticated tests may still be needed because epilepsy is a chronic condition,” Dr. Yerram said. “But this helps us determine if those cases are severe and a trip to our offices is needed.”


Epilepsy patient Mikayla Morrow, an Alpine-area resident, dreaded her EEG exams. While each test brought clarity and understanding about her epilepsy, she couldn’t stand the journey.


“Once, I had to keep a mobile EEG device with me for a few days while it recorded my brain waves. So I had to drive from Alpine to El Paso and back. And then do it again a few days later,” said Morrow with a hint of annoyance. “It’s three hours each way, and with the time change, it felt like I lost days on the road. It’s a relief not to do that anymore.”


The program has more than 50 Big Bend patients, and it’s growing.


“We’re getting more new referrals now that we can do EEGs in their backyard. The providers are realizing they have a local option they can trust,” said Dr. Yerram, also an assistant professor of neurology at TTUHSC El Paso. “We don’t have as many no-shows. About 11% of our Big Bend patients used to miss their appointments. Now it’s rare for someone to skip an exam.”


The program makes Morrow feel “seen” by the medical community.


“It’s nice to have something in your city, especially for those of us in smaller towns where we don’t have as much,” Morrow said. “I get all the information I need, and it’s a pleasant experience now.”



Pate-McCollister said the program was “life-changing” and begs for it to continue in the Big Bend region. Because of it, she is getting more sleep and enjoying her visits with Torres.


“I can be here to see my grandson get on the bus in the morning, go to my exam and be back to welcome him home,” Pate-McCollister said as her face lit up with excitement. “I can live my everyday life without stress or worry. I feel like I have fewer seizures because I’m not anxious about the visit. I pray for the program’s success so it can stay in our area.”


The goal is to expand the programs’ reach and services. TTP El Paso epilepsy specialists Richard Brower, M.D., and Cecilia Olivas, D.N.P., APRN, NP-C, are joining Dr. Yerram using telemedicine to see patients. Soon, TTP El Paso ophthalmologist Claudia Maria Prospero Ponce, M.D., will begin conducting eye exams, which could detect early blindness in patients with diabetes. Dr. Ponce is an assistant professor at TTUHSC El Paso, while Dr. Brower is an associate professor and Dr. Olivas is a faculty nurse practitioner.


The program’s next milestone could be an expansion to other Big Bend-area clinics, while other towns, such as Dell City, have expressed interest.


“We want to make it a permanent program that grows with other departments,” Dr. Yerram said. “For small towns, this is a great opportunity. They want access to programs like this because they don’t have as many specialists to easily visit. Once you do the hard work, it’s easier for other towns and departments to follow.”


 
 

YOU CAN HELP


At TTUHSC El Paso, we are committed to growing our own health care heroes and changing the state of health care in our Borderplex. For more information about how you can help, please contact andrea.tawney@ttuhsc.edu or craig.holden@ttuhsc.edu or visit ttuhscep.edu/elpaso/ia/giving/.

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