Tennessee Continues Push to Improve Medical Care

Thursday, February 12, 2015 | 06:01am

Tools developed by top DIDD doctor and universities reach worldwide audience in first year

NASHVILLE—Under the best circumstances, a trip to the doctor can be an ordeal.  For patients with intellectual or developmental disabilities, even the ‘best circumstances’ don’t produce the best diagnosis.  But a set of tools for physicians and nurses adapted in Tennessee is trying to change that.

Patients with intellectual disabilities may have difficulty communicating with their primary care practitioner.  That can lead a doctor to focus on the outward signs of the disability and not the cause of the medical issue that has prompted the office visit.  Misdiagnosis of challenging behavior is one cause of a much broader trend of overmedication among people with intellectual disabilities says Department of Intellectual and Developmental Disabilities (DIDD) Deputy Commissioner of Health Services Tom Cheetham, MD.

“Primary care physicians don’t get enough training and don’t have enough experience dealing with people with intellectual disabilities,” said Dr. Cheetham.  “That’s not a personal indictment.  It’s just the way our medical education system is set up.”

That’s where the IDD Toolkit comes in.  Using Dr. Cheetham’s work in Canada as a starting point, he and the Vanderbilt Kennedy Center and the University of Tennessee Boling Center used a grant from the Special Hope Foundation to translate the tools to match U.S. practice and laws on disability.  Following their release in January 2014, elements of the IDD Toolkit have been downloaded more than 135,000 times worldwide.

“The toolkit’s strength is in its utility,” Dr. Cheetham said.  It’s a simple set of guides that doctors can easily implement in the short time they have to see a patient.”

The IDD Toolkit’s top downloads are tools that help physicians look past a patient’s challenging behavior to focus on the deeper causes including physical health issues, environmental triggers and psychological factors that are at the root of the behavior.  This helps a doctor see through behavior such as self-talk that could be a sign of psychosis in a patient without an intellectual disability.

“It empowers the patient, the family and the direct support professional to get the best diagnosis, and as a result, the best care possible,” said Dr. Cheetham.

What’s the next step for the IDD toolkit? Dr. Cheetham said he is seeking funding to translate the tools into apps for physicians to use in their offices.

To read more about the toolkit: www.iddtoolkit.org

To download HD video of Dr. Cheetham and Janet Shouse talking about the toolkit: http://youtu.be/T11NdZXVO0w


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