Telemedicine in the Amish and Mennonite communities of Wisconsin.

The Plain Community (PC) is a medically underserved group found predominantly in the northeastern and midwestern USA. Due to the community's founder population with few converts and infrequent outside marriage, metabolic and genetic disorders are more prevalent. Individuals in the PC experience geographic, financial, and cultural barriers when accessing healthcare. In Wisconsin, a collaboration between clinicians at a rural community health clinic and the academic medical clinic established an outreach clinic for medical genetics located in a rural location closer to a Wisconsin PC which consists of both Amish and Mennonite communities. However, patients with acute medical concerns requiring more urgent genetics care must travel to the academic center. Telemedicine (TM) is a technology that increases access to healthcare, often reducing financial and travel barriers. Using survey tools, we explored whether TM could be used to provide genetic services to individuals in the Wisconsin PC at an outreach clinic. Results indicated that 36% of survey participants responded favorably to receiving services by TM at a clinic designed for the PC. Members of the Mennonite community are significantly more likely to consider receiving services via TM than those of the Amish community. The results of the surveys indicate potential utility of TM at the outreach clinic as alternative way to improve access to genetic and other subspecialty services for the PC.