a strategic focus on population health ... - mississippi hfma€¦ · –31% of adults overweight...
TRANSCRIPT
A Strategic Focus on Population Health Management
and the Integration of Telehealth
Expert Care is just a screen awayUNIVERSITY OF MISSISSIPPI MEDICAL CENTER
CENTER FOR TELEHEALTH
Learning Objectives
• Define Population Health and outline challenges facing
the poorest and least healthy population in the US
• Describe the impact strategic partnerships have on
improving population health
• Discuss how Telehealth, an innovative model, is
eliminating barriers to access and quality health care
Photo source: University of Mississippi Medical Center
Population Health Management
A population health management program strives to address
health needs at all points along the continuum of health and
well-being through participation of, engagement with and
targeted interventions for the population.
GOAL: Maintain or improve the physical and psychosocial
well-being of individuals through cost-effective and tailored
health solutions.Source: Population Health Alliance http://www.populationhealthalliance.org/research/understanding-population-health.html
The poorest corner of the poorest state in America
The Mississippi Delta
• The Mississippi Delta
– Pervasive health problems
• Overweight and obesity levels
– 31% of adults overweight
– 39% of adults obese
• Diabetes
– Almost twice the national average
• Tobacco use
– 56% use
Background Information
• “…UMMC has missions of education, research and health
care. I like to boil those down to one overarching goal: A
Healthier Mississippi. That doesn’t just mean in the
Jackson metro area or the state’s larger cities. That
means every corner of our state, including the Mississippi
Delta…”Dr. LouAnn Woodward, Vice Chancellor UMMC
Source: UMMC Campus Email, VC Notes for Friday, September 1, 2017
We’ve gone where we’ve been asked to goKevin S. Cook, CEO UMMC Health Systems @ UMMC Grenada Retreat, July 29, 2017
Community Outreach Strategy
Common Denominator for Strategic Partnerships –
Relationships
Common Denominator for Strategic Partnerships –
Healthier
Healthier individuals
Healthier communities
Healthier workforce
Healthier economy
UMMC Community Care Clinic Humphreys County
A Population Health Management Strategy
Photo source: EMILY POOLE ARCHITECTURE, PLLC
Urgent Care
• 30 months
• 90+ trips
• 14,720+ miles
• 671.5+ hours
• Outcome…
As of March 31, the
clinic has served
nearly 300 patients
in this rural
community
Photo source: University of Mississippi Medical Center
18%
1%
4%
46%
%12
%11
2%
1%
5%
BCBS
CIGNA
MAGNOLIA HEALTH PLAN
MEDICAID MS
MEDICARE
SELF PAY
UNITED HEALTHCARE CHIP
AETNA
OTHER COMMERCIAL
0% %5 10% 15% 20% 25% %30 35% 40% 45% 50%
Belzoni Payor Sources
UMMC Community Care Clinic Staff
Photo source: Tonya Moore, PhD, RN
• All staff hired are
from the Delta
• 75% reside in
Humphreys County
• Expanding workforce
opportunities by the
creation of jobs.
Photo source: Tonya Moore, PhD, RN
Collaborative Care
Photo source: University of Mississippi Medical CenterPhoto source: Tonya Moore, PhD, RN
Photo source: University of Mississippi Medical Center
Photo source: Tonya Moore, PhD, RN Photo source: Tonya Moore, PhD, RN
Empowerment Care
Photo source: Tonya Moore, PhD, RN
Photo source: Tonya Moore, PhD, RN
Photo source: Tonya Moore, PhD, RN
“Finally, the local community can’t sit on the sidelines; it has to be part
of the solution. If the enthusiasm of the standing-room-only crowd last
Tuesday is any indication, the people of Humphreys County are “all in”
on their new after-hours clinic.Dr. LouAnn Woodward, Vice Chancellor UMMC
UMMC Campus Email, VC Notes for Friday, September 1, 2017
Photo source: University of Mississippi Medical Center Photo source: University of Mississippi Medical Center
Telehealth Innovation
Trendwatch
• According to a study done by the American Hospital Association in 2013:– 53% of hospitals utilized telehealth and 10% were beginning the
process of implementation
– 74% of U.S. consumers would use telehealth
– 76% of patients prioritize access to care over the need for human interaction
– 70% of patients are comfortable communicating with HCP via text, email, or video
What is Telehealth?
Telehealth lets doctors examine and treat patients remotely, in real time, using online
streaming video technology and interactive tools.
PATIENT & LOCAL CLINICIAN
USING UMMC’S
ONLINE TELEHEALTH TOOLS UMMC SPECIALISTS
Why is Telehealth important?
Currently, 53 of Mississippi’s 82 counties are more than a 40-minute drive from specialty care.
Provides specialty
care that is
convenient for
patients
UMMC CENTER FOR TELEHEALTH
Offers vital
support for
primary care
physicians
Helps decrease
the cost of
care and
improve patient
outcomes
Supports
population
health in
underserved
areas
Provides
interactive
distance
education
for providers
to improve
quality
of care
UMMC Telehealth by the numbers
28
500,000+ patients helped since 2003
200+ UMMC available
specialists
35+ specialty
services and
growing
200+ Locations,
with new
locations weekly
UMMC Center for Telehealth in Mississippi
• Community Hospitals & Clinics
• Mental Health Clinics
• FQHC’s
• Schools & Colleges
• Mobile Health Vans
• Corporations
• Prisons
• Patient’s Homes
Clinical Quality
Maintain same standard as in-person care
If the technology can not replicate the exam you would do in-person then the visit is not appropriate for telehealth. Do not
cut corners.
Study clinical outcomes and compare to in-person outcomes
Technology Solutions
Clinical need drives the solution
• Mobile versus fixed
• Examination needed (Psychiatry
versus Child Development)
• Image sharing
31
Device and Data Collection
32
Does the specialty need video? (Pathology,
Radiology)
Does the specialty need Far End Camera control?
(TelEmergency, Child Development vs Adult
Psych)
Does the specialty need scopes? If so, can the information just be
relayed?
Do you need to share data?
TelEmergency
Connects emergency departments
in rural hospitals with UMMC’s Level
One Trauma Center
Uses real- time video and audio
connection
Produces patient outcomes in rural
hospital that are on par with those of
the academic medical center
Photo source: University of Mississippi Medical Center
TelEmergency
• Connects 16 emergency departments in rural hospitals with UMMC’s Level One Trauma Center
• Uses real-time video and audio connections
34
25% reduction in rural
emergency room staffing costs
20% reduction in unnecessary
transfers
Produces patient outcomes in rural
hospital that are on par with those of
the academic medical center
TelEmergency Sites in Mississippi
35
• Covington County Hospital
• Field Memorial Community Hospital
• Franklin County Memorial Hospital
• H.C. Watkins Memorial Hospital
• Holmes County Hospitals & Clinics
• Lackey Memorial Hospital
• Lawrence County Hospital
• Magee General Hospital
• North Sunflower Medical Center
• Pearl River County Hospital and Nursing
Home
• Perry County General Hospital
• Scott Regional Hospital
• Sharkey- Issaquena County Hospital
• Simpson General Hospital
• South Sunflower County Hospital
• Tallahatchie General Hospital
TelEmergency Outcomes Evaluation
New Site-Satisfaction Survey
Community Hospital (Q1 2014)
100% physician satisfaction
Total patients seen with TelEmergency: 884
Total admission to that facility: 208
Total transfers from that facility: 68
Total discharges: 608
Total admissions to this facility increased
by 101 patients in Q1 of program
Sustainable Models
• Base annual telehealth fee for all sites
• Monthly MD availability rate based on coverage and specialty
• Reimbursement- Prof fee, facility fee, CCM, RPM
• FFS contract (no insurance or individual billing)
• Networking fee
• Educational revenue
• Downstream revenue
• Penalty avoidance
37
Remote Patient Monitoring (RPM)
38
Chronic disease management in the patient’s home including:
Daily Health Sessions
Personalized Interventions
Targeted Education
Health Coach
Behavior Modification
Patient Empowerment
MS Diabetes Telehealth Network
39
HbA1c
1.7%
Medication
Compliance
96%
Health Session
Compliance
83%
Retinopathy
Found
9 cases
Weight Loss
71 pounds
Miles Saved
9,454.11
No Hospitalizations or ER visits for DMPreliminary results on first 100 patients
SB 2009 (2013)- Parity
SENATE BILL NO. 2209 (As Sent to Governor)
AN ACT TO REQUIRE HEALTH INSURANCE PLANS IN THIS STATE TO PROVIDE COVERAGE FOR TELEMEDICINE
SERVICES TO THE SAME EXTENT THAT THE SERVICES WOULD BE COVERED IF THEY WERE PROVIDED
THROUGH IN-PERSON CONSULTATION; TO DEFINE THE TERMS "HEALTH INSURANCE PLAN" AND
"TELEMEDICINE"; TO AUTHORIZE HEALTH CARE PRACTITIONERS 5 LICENSED IN THIS STATE TO PROVIDE
TREATMENT RECOMMENDATIONS TO A PATIENT AFTER HAVING PERFORMED AN APPROPRIATE EXAMINATION OF
THE PATIENT THROUGH TELEMEDICINE; TO AMEND SECTION 25-15-9, MISSISSIPPI CODE OF 1972, TO
CONFORM TO THE PRECEDING PROVISIONS; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
http://billstatus.ls.state.ms.us/documents/2013/pdf/SB/2200-2299/SB2209SG.pdf
40
SB 2646 (2014)- SAF; RPM
SENATE BILL NO. 2646 (As Sent to Governor)
AN ACT TO CREATE NEW SECTION 83-9-353, MISSISSIPPI CODE OF 1 1972, TO REQUIRE HEALTH INSURANCE AND EMPLOYEE BENEFIT PLANS IN 2 THIS STATE TO PROVIDE COVERAGE AND REIMBURSEMENT FOR 3 "STORE-AND-FORWARD TELEMEDICINE SERVICES" AND "REMOTE PATIENT 4 MONITORING SERVICES" TO THE SAME EXTENT THAT THE SERVICES WOULD BE 5 COVERED AND REIMBURSED IF THEY WERE PROVIDED THROUGH IN-PERSON 6 CONSULTATION; TO DEFINE "STORE-AND-FORWARD TELEMEDICINE" AND 7 "REMOTE PATIENT MONITORING"; TO AMEND SECTION 83-9-351, 8 MISSISSIPPI CODE OF 1972, TO INCLUDE EMPLOYEE BENEFIT PLANS IN THE 9 REQUIREMENT FOR INSURANCE REIMBURSEMENT FOR TELEMEDICINE SERVICES; 10 AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI
http://billstatus.ls.state.ms.us/documents/2014/pdf/SB/2600-2699/SB2646SG.pdf
41
Opportunities
No shows TravelStaffing Model
Financial Responsibility
Take Home Points
Population Health Management
• Identify your mission and align strategy
• Patient centered experience
• Spend time building key relationships
• Maximize existing resources
• Leverage technology -- Telehealth/TeleMedicine
Thank you
Tonya Moore, PhD, RN
Administrator, Community Health Services
Center for Telehealth
University of Mississippi Medical Center
601-984-4176
@ummctelehealth
44
?Bridging the gaps in quality healthcare