ihs leadership symposium april 17, 2012 understanding the interest and utility of telehealth
TRANSCRIPT
IHS Leadership SymposiumApril 17, 2012
Understanding the Interest and Utility of Telehealth
What is telehealth?
The practice of transcending geography by using electronic communication
devices to enable face-to-face clinical services and education.
Why telehealth?
The opportunity to improve quality, access, equity and affordability of health
care. The U.S. Veterans Administration reports reductions in utilization of
between 20-56% when care coordination and home monitoring are employed. -- Dept. of Veterans Affairs, June 2009
Mortality rates dropped from 13.6% to 11.8% after tele-ICU was implemented, and LOS in the ICU fell from 13.3 days to 9.8. -- JAMA, 2011
California prison officials provided roughly 9000 telehealth consultations in 2004, saving taxpayers more than $4 million in transportation and escort costs. -- CA Healthcare Foundation, 2008
Telemonitoring reduced hospitalizations by 75% and ER visits by 83%. -- PA Homecare Assn.
In 2007, Sutter estimated that 425 sepsis-related deaths were prevented and the eIUC resulted in $2.6 million in savings. -- Sutter Health EIUC, Computer World 2007
Broadband Technology Opportunities Program (BTOP) Funded by the American Recovery and
Reinvestment Act (ARRA) Nationwide provides $4.7 billion in
grant funding for deploying broadband infrastructure, enhancing broadband capacity at public computing centers, and promoting sustainable broadband adoption projects.
Advances the objectives of the Recovery Act to spur job creation and stimulate economic growth and opportunity
BTOP Grant Partners
Rural Iowa Telehealth Initiative
Iowa HealthDes Moines
Clarke County Hospital
Greene County Medical Center
Guthrie County Hospital
Grundy CountyMemorial Hospital
Rural Iowa Telehealth Initiative The Rural Iowa Telehealth Initiative proposes
to bring broadband capabilities to medical facilities across rural and underserved parts of Iowa. This project aims to improve health care and delivery, provide education and training for rural health care practitioners, facilitate telehealth, support disaster readiness, and promote health education and awareness for residents.
$8.3 million grant for 3 years through 8/31/2013, matched by $6.2 million in partner funds = $14.5 million
Clinical Telehealth Applications
Model Design Objectives Increase access to quality care locally Physician friendly & efficient “Anywhere” patient access within CCH Ease of use for all staff 24/7 availability Network reliability, security Flexible Available for inpatient visits from family friends that are
geographically separated Technology allows for system growth Partnership opportunities Community access throughout Clarke County Opportunity for new/increased revenue Potential for growth and expansion Compliant with industry standards to connect with other systems Fiscally responsible
Local Access to Quality Health Care
Specialty physicians (outpatient, inpatient, emergency)
Professional and community education
Quality improvement through case review
Enhance patient experience
Telemedicine Specialty Locations
Live
• Cardiology• Neurology• Nephrology• Pulmonology• General Surgery• Psychiatry• Plastics• Employee
Assistance Program
In Progress • Pharmacy• Urology• Podiatry• Endocrinology• Bariatric• Ambulance• Emergency Department
Future
• Internal Medicine• Orthopedics• Trauma Surgeons• Infectious Disease• Pathology• Oncology• Dermatology• Vascular• Wound Center• Pain Management
Patient Exam Devices Camera/Lightsource/Otoscope
Stethoscopes (Bluetooth technology)
Exam Cameras
Community Based Telehealth Applications
Unique Telemedicine Applications
Women’s Health NICU and PICU Pediatrics
Telemedicine/Telehealth
Telemedicine associated with direct patient clinical services.
Telehealth associated with a broader
definition of remote healthcare services.
Telehealth Applications & Benefits
Virtual Incident Command Center Strengthens partnerships for law
enforcement, schools, fire, rescue, city/county/state government, and public health with hospital
Inmate Health Assessments Reduced budget for sheriff's department Safety of hospital staff
Telehealth Applications & Benefits
Virtual Recreation Center Wellness education and fitness classes offered in smaller communities in
the county Health Improvement Plan intervention for
obesity and cardiovascular disease
Home Care Access to physicians, dieticians, wound care nurses, and other expertise for homebound patients
Telehealth Applications & Benefits
School health nursing services School nursing services in all buildings Health occupations education
Community and health care professional education Wellness education, support groups Health care professional education and CEUs EMS volunteers train in their own communities
Education Based Telehealth Applications
GCMH School & EMS Locations
School Education
Current Programs CNA course assistance Career exploration Infection
control/prevention Telehealth 101 Fire Safety
13 courses conducted 6 schools 19 staff hours
School Education
Future Plans Healthy cooking, healthy eating Basic functions of body systems Medicine/drug identification Heart health How germs work Process for trauma/heart attack
situations Sports injury prevention Death & Dying Getting enough sleep Preparing for Surgery Seat Belt Safety MRSA-Playing It Safe Diagnostic
Imaging Risk Watch – suffocation, chocking
strangulation Basics of health insurance
History (utilizing knowledge of LTC residents)
Community Service (Long Term Care - school e-buddy program)
Partnership with Hawkeye Community College for CNA course
EMS Education
Quarterly CEH/CEU offerings
Connection to IHS-sponsored events
Connection to other video-based education
Future plans: Remote ECG transmission
Additional Telehealth Applications
Guthrie County Hospital
Access - Internal
4 Family Medicine Clinic sites Employ
Internal Medicine Family Practice Family Practice ARNP Pediatrician (July 2012)
Access - Schools
Pediatrician – first ever Over 8,000 kids 0-14 School Based Health Clinics
6 schools systems with 13 different buildings
Behavioral Health Impact
Specialists – In place Employed – IM, Pediatrics, ED General Surgery Plastic/Reconstructive Surgery Vascular Surgery and Wound Care Neurology
Other Connections - Dreams
Cardiology Psychiatry Oncology Area Nursing Homes Home Monitoring
Knowledge Access Collection Distribution Relationships
Telehealth BenefitsSenior Affiliates Connectivity between campuses
Increased efficiency for staff and physicians Opportunity for business development
Expanded service to secondary markets (neurology, nephrology, cardiology)
Impact referral patterns (cardiology story) Expanded partnership with rural hospital network
Relationship expands to the patient care level Lead Iowa in implementation of telehealth technology
Approximately $6 million in video conferencing equipment funded by grant
Rural Hospitals Supports rural hospital ability to capture outpatient ancillary
services and procedures Support of affiliated specialty physicians and nurses Staff education and CEUs available in local communities
Telehealth Benefits cont. Patient
Health care close to home Decreased travel risks, travel time and cost Homebound patients, inmates and students can be
seen by physicians and nurses Physician
Decreased travel time and cost Decreased risk of driving in inclement weather Increased efficiency & ability to see more patients
Community Strengthens partnerships with schools, colleges, cities
and state govt. Patients stay in local community for care Wellness education & professional education can be
offered in local communities Increases IH-DM exposure in outlying communities
Key Points Planning
Market analysis Technology research
Telemedicine Team Development Internal team of IT, clinical, administrative, fiscal External team
Communication and Relationships Financial Impact/Sustainability Technology Considerations
Expertise IHS compatibility and growth
Resources We are committed to the success of the IHS telehealth
program. Clarke County Hospital Brian Evans, CEO [email protected] County Medical Center Cindy Kail, CNO/Public Health Director
[email protected] County Memorial Hospital Lynn Blythe, Ambulatory Services Manager [email protected] County Hospital Jerry Neal, CEO [email protected] Health-Des Moines Tracy Warner, Director, Rural Health Resources
[email protected] Connie Karloff, Hospital/Telehealth Liaison [email protected]
Resources
American Telemedicine Association www.americantelemed.org
Great Plains Telehealth Resource & Assistance Center http://www.gptrac.org/
BroadbandUSA http://www2.ntia.doc.gov/iowa