News &ViewsMARCH 2013

MY 2¢ worth

By Bob Wolverton, NRTRC Program Director

owdy!The big excitement around the Northwest Regional Telehealth Resource Center (NRTRC) these days is our

annual Telemedicine Conference, to be held in Billings this year March 18-20. Our schedule is set, speakers arranged and exhibitors are signing up for the trade show. Now all we need is you. Why should you attend? Well there are several reasons, here are a few:

PLENARy SPEAKERSPlenary speakers: we’ve got a lot and we’ve got great ones!

Stewart Ferguson, ATA president and NRTRC founding member will open the conference with a presentation on his view of Telemedicine and a challenge to you to get the word out about Telemedicine.Nirav Desai of Hands On Telehealth will present strategies and methods for getting the word out about Telehealth and expanding your program.James Bush, MD, NRTRC Board Member and Wyoming’s Medicaid Medical Officer will talk about working with payers.

ePatient Dave, a nationally-recognized speaker will challenge you to increase patient involvement with their care.Daniel Weaver, MD will send you off with an inspirational discussion about his experience as a Telehealth Provider.

SESSioN SPEAKERS There are two educational tracks this year, Technical and Administrative/Clinical. We’ve got a lineup of speakers to accent different approaches to the challenges of Telehealth and you’ll learn a lot from participating in their interactive discussions. See more at http://www.nrtrcconference/speakers

tECHNoLogy SEMiNARNRTRC’s Technical Committee is

hosting an informal discussion on the future of Telehealth technology. The session is open and all are welcome.

EXHibit HALLVendors are signing up for the exhibit hall and you’ll be able to spend quality time with representatives of several Telehealth equipment and service suppliers. This smaller venue gives attendees and vendors a great opportunity to have meaningful discussions and we are excited to present this opportunity

Our early-bird savings offer has expired, but the registration price is still a bargain. And, if you register a group from your facility at the same time, we have a significant saving for each registration. And, the site that registers the most people for this conference will receive two free passes to next year’s conference, so gather your ‘troops’ and sign them up today. Click on http://www.nrtrcconference.com/registration and log them all in at a discount!

But that’s not all! We’ve chosen a venue for the 2014 conference and we’ll announce that at the Billings event so you can start planning for next year. n

NRTRC’S VISION: Better health care for everyone

News &ViewsMARCH 2013

NRTRC

BoaRD

WelComes

Cynthia Roleff

ynthia Roleff was nominated to become the newest NRTRC board member. Here nomination will be ratified by the board in March when they meet in Billings. Cynthia was

nominated to replace outgoing board member from Alaska, Mandi Constantine.

Cynthia is a Lead Telehealth Coordinator for AFHCAN in Anchorage, Alaska. She has been with AFHCAN for 2½ years and manages the telehealth education program. She also consults with organizations as they implement/develop telemedicine programs throughout the state of Alaska and in various other US locations. AFHCAN usage and programs continue to grow exponentially. Cynthia helped to develop an online series of three (10 week and longer) university based telemedicine courses currently offered through the University of Alaska. During this past year, she chaired the development of a brand new professional society for telemedicine (the Alaska Coalition for Telemedicine & Telehealth). This new society has membership that crosses all aspects of telehealth in the state.

Cynthia has 26 years of ICU and medical/surgical nursing experience working both in small rural facilities and in large inner city teaching hospitals. During 9 of those years, her primary focus was in professional education. She taught at the University of Alaska, School of Nursing in Anchorage, managed the Alaska Native Medical Center’s (ANMC) Nursing Internship and Preceptor Development programs and worked as the Supervisor of Hospital Education for ANMC. Her Master’s degree is in Business Organizational Management and is board certified in Nursing Professional Development. Cynthia chairs the Alaska Coalition of Educators – Health Care group where she facilitated the development of a statewide competency system and collaborated in the development of an online multi-disciplinary clinical coaching course. She does a great deal of distance education in her current job and as a consultant for the University of Alaska and the University of Idaho.

Cynthia is also an Air Force retiree, a musician and enjoys hiking, camping, skiing, travel and spending time with her husband and three husky-mix dogs. n

University of Washington Helps Rural Clinicians ManageChronic Pain

SpOTlIghTBy Catherine Britain

Staff Writer

News &ViewsMARCH 2013

ural providers can be uncomfortable when treating patients with chronic pain. The University of Washington (UW) Division

of Pain Medicine wants to help change that. They offer weekly TelePain services using a panel of interprofessional specialists who

The UNIVeRSITy Of WaShINgTON DIVISION Of paIN MeDICINe OffeRS Weekly TelepaIN SeRVICeS USINg a paNel Of INTeRpROfeSSIONal SpeCIalISTS WhO aRe expeRTS IN The MaNageMeNT Of ChalleNgINg ChRONIC paIN pRObleMS.

for Pain Relief, serves as the clinical lead for UW TelePain. He states that limited training and expertise of community providers in pain medicine has led to poor patient outcomes and limited access to specialists, a problem detailed by the 2011 US Institute of Medicine report on pain care in America (more

PAIN l continued next page

for high dose and high risk patients.

UW Medicine’s telehealth program has been providing UW TelePain video-conferencing to support community providers (both primary care and specialty) in the management of complex and challenging chronic pain problems since 2006 as part of a telehealth project funded by HRSA’s Office for the Advancement of Telehealth. The project was designed to serve American Indian and Alaska Native communities. With funding from the National Institutes of Health, the program was expanded to include rural hospitals and clinics. In 2011, the program merged with a new collaboration between the UW Division of Pain Medicine and Project

are experts in the management of challenging chronic pain problems. Dr. David Tauben, Chief of the Division of Pain Medicine (interim) and Medical Director of UW Center

than 33,000 people with chronic pain for every specialist), and highlighted by Washington State’s 2012 opioid prescribing rules that require pain specialty consultations

PAIN l continued

ECHO (Extension for Community Health Outcomes) at the University of New Mexico, sharing the mission “to develop the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas, and to monitor outcomes of this treatment.”

In addition to the need for expert support with chronic pain management in rural and underserved urban areas, the TelePain program helps meet the need for access to pain management specialist consultations that are now required by the Washington State Department of Health regulations for opioid prescribing.

wEEKLy SESSioNS The TelePain sessions are conducted once a week on Wednesdays. Clinicians do not have to present a case in order to join the conference. Usually there are 35-40 clinicians gathered at 12-15 sites for the conference. Not all connect by videoconference. Some connect by phone and others by Adobe Connect. All of the cases presented have been de-identified in order to meet HIPAA compliance standards. The weekly videoconferences consist of:

1 Didactic presentations (15-20 minutes) from the UW Pain Medicine Core Curriculum, and other useful chronic pain topics for primary care providers;

2 Two or three case presentations from community providers;

3 Interactive consultations for providers with an interprofessional panel of specialists (This panel includes a pain management specialist, and specialists in internal medicine, anesthesiology, psychiatry, rehab medicine, addictions medicine, and a nurse care coordinator.); and

4 The use of measurement based clinical instruments to assess treatment effectiveness and outcomes for individuals and larger populations.

StUdy CoNStRUCtioN A new NIH grant is funding a study designed to look at both provider and patient outcomes of a telehealth-enhanced symptom management intervention. It is constructed as follows:

• Healthcareprovidersmustbe from the participating sites and work with patients diagnosed with pain

• Patientsmusthavebeendiagnosed with pain, be over 18 years of age, have been seen within the past two months, must have functional fluency in English, and none or mild cognitive impairment

• Allofthepatientsandhealthcareproviders participating in the study participate in a web-based survey to collect demographics and a baseline assessment during the first week of the study.

• Forthestudydesign,healthcareproviders and their patients are randomly assigned to either the telehealth-enhanced symptom management intervention group or the standard care group. Each patient is in the study approximately 3 months.

• Healthcareprovidersintheintervention group attend UW TelePain sessions, including the case conference and didactic presentation. Each provider participant gives a case presentation during a UW TelePain session for each

patient they have in the study and a follow-up presentation approximately 4-8 weeks after the initial presentation. Health care providers in the standard care group do not attend the UW TelePain.

• Healthcareprovidersreceive$100 for each patient that agrees to be in the study to compensate them for the cost of their time. Additionally, health care providers that are assigned to the intervention group receive 12 CME or CNE credits. Patient participants also receive $50 for their time in the study.

PAIN l continued next page

WaShINgTON ’S 2012 OpIOID pReSCRIbINg RUleS ReqUIRe paIN SpeCIalTy CONSUlTaTIONS fOR hIgh DOSe aND hIgh RISk paTIeNTS.

CHANgiNg tHE dyNAMiCS oF PAiN ANd SyMPtoM MANAgEMENt

Ardith Doorenbos, PhD RN, FAAN, Associate Professor at the UW School of Nursing, is the Principle Investigator for both NIH grants, and is focused on changing the dynamics of pain and symptom management from both the patient and the provider perspectives. From the patient perspective, the consultations between the clinicians and the pain management team have the potential to reduce pain intensity, its interference with sleep, reduce anxiety and depression and may allow them to return to work more quickly. It can also reduce the patient’s out-of-pocket costs for travel time and transportation.

From the provider perspective the UW TelePain approach is empowering, increasing their knowledge about pain management, and gives them a network of peers to call on when additional expertise is needed. Providers indicate that they are more likely to remain in rural practice when these resources are available to them.

UW TelePain is helping to close the gap between urban specialists and rural health care providers and their patients, reaching over 400 unique practitioners in over 100 locations, offering over 3,000 hours of pain consultation and education. In addition to serving practitioners and patients in Washington (70% of the cases are submitted from Washington), participation in TelePain has included health care providers in Alaska, Wyoming, Oregon, New York, Idaho, Colorado, Indiana, Arizona and Florida. Community providers have provided many unsolicited testimonials to the success of this teleconferencing model.

Cara Towle, Director of Telehealth Services at the University of Washington School of Medicine, hopes that the study will show the effectiveness of this approach. Positive outcomes will increase the likelihood of reimbursement particularly by workplace insurers. n

PAIN l continued

For more information about the TelePain program, contact Cara at ctowle@u.washington.edu.

discussion and collaboration among technical staff from around the region. Our technical committee members offer a deep well of knowledge and experience that will provide great insights in these discussions and will be an excellent opportunity for technicians, both novice and experienced, to learn from each other.

CoNFERENCE HigHLigHtS Along with these two great additions to the conference, Stewart Ferguson, (ATA President and founding NRTRC member) joins us via video, to open the conference Monday evening. Following Stewart’s presentation we will have the Networking Reception, the perfect opportunity to connect with other telehealth professionals from around the region as well as talk with our great group of vendors. Tuesday will be a day filled with some dynamic general and track sessions. For more information on the conference sessions and schedule go to http://www.nrtrcconference.com/conference-info/conference-schedules/

Mark your calendars “out of the office” March 18-20, register for the conference and book your flight for Billings, Montana today. You will be an important part of this amazing conference!

to REgiStERhttp://www.nrtrcconference.com/registration/

News &ViewsMARCH 2013

TELEMEDICINECONFERENCE

2013Crowne Plaza

Billings, MontanaMarch 18-20

Getting the Word Out:The Telehealth Solution

It’s hard to believe but the NRTRC Telemedicine Conference is just a few days away! If you haven’t registered yet, now is the time! This year’s conference is filled with great topics and engaging speakers. There have been some new things added this year to help better meet the needs of our attendees.

tELEMEdiCiNE 101 There will be a 4-hour pre-conference workshop on Telemedicine 101. Brad Wegrzyn, Media Services Engineer at Utah Telehealth Network; Nancy Vorhees, COO of Inland Northwest Health Services and Patricia Carroll, Outreach Coordinator at Utah Telehealth Network will co-lead this workshop, which will cover the basics of telemedicine for the clinician, administrator and technician. Our speakers will approach these topics from the viewpoint of, “If I knew then what I know now.” The workshop is included in the cost of registration or you can register for just the workshop.

tECHNoLogy SUMMit Another new session this year is the Technology Summit. The summit will take the place of the Technical Track on Wednesday morning and is hosted by our Technical Committee. During the summit there will be introductions of advanced technical themes in telemedicine with times of open forum to encourage

2013TelemedicineConference

SpOTlIghTBy Sara Rivera,

Social Media Specialist

Upcoming EventsBy Martha Nikides

MaRCh – apRIl 2013

................. MARCH ...............Second Annual NRTRC

Telemedicine ConferenceMarch 18–20, 2013Billings, Montana

The Road AheadOpen Mic Webinar

A Technical Roadmap presentedby Ron Emerson of Polycom

March 28, 2013

................. APRiL ...............Working with Payers

Open Mic Webinar presented by Cathy Britain and Doug Romer

April 25, 2013

For more information on upcoming events, please go to www.nrtrc.org.

EVENt SUbMiSSioNSPlease forward event information to martha@nrtrc.org

ARtiCLE ANd PHoto SUbMiSSioNS If you would like to write an article or provide photographs for this publication, please contact Cathy Britain (csbritain@gmail.com or 541-910-7366)

News &ViewsMARCH 2013

About UsThe Northwest Regional Telehealth Resource Center leverages the collective expertise of 33 telehealth networks in Alaska, Idaho, Montana, Oregon, Utah, Washington and Wyoming to share information and resources and develop new telehealth programs.

NRTRC Services•Providetechnicalassistancefornew programs and applications• Increaseexposuretotelehealthasahealth care delivery tool• Improveaccesstospecialtycarethrough regional collaboration•Developinformationonbestpractices and telehealth toolkits•Providecurrentinformationandfacilitate discussion of regional regulatory, policy and reimbursement issues

Northwest Regional Telehealth Resource Center1233 North 30th StreetBillings, Montana 59101888-662-5601 or 406-237-8665

NRTRC StaffBobWolverton ProgramDirectorSara Rivera Social Media SpecialistMartha Nikides Administrative AssistantDorisBarta PrincipleInvestigatorHeather Fink Grants Manager

NRTRC Board MembersAlaska: Cynthia Roleff, Javid KamaliHawaii: JoeHumphryExofficioIdaho: Tom Hauer, Neill Piland Montana: DorisBarta, Thelma McClosky-Armstrong Oregon: CathyBritain,DougRomerUtah: Patricia CarrollWashington: Cara Towle, Nancy VorheesWyoming: Jim Bush, Tom Richards

Spring 2013 Primary Care Conference

May 18–21 Anchorage, AlaskaAnchorage Marriott Downtown820 West 7th Avenue

Reservation informationSubmit an abstractExhibitor/Sponsor Prospectus

Our friends and members in Anchorage Alaska would like to invite us to their Spring Primary Care Conference. For more information, use the links below.