UNIVERSITY OF MISSISSIPPI MEDICAL CENTERCENTER FOR TELEHEALTH

SOUTH CENTRAL TELEHEALTH FORUM

OUR VISION

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The Center for Telehealth at the University of Mississippi Medical Center is dedicated to providing much needed access to underserved areas in our community, educating future health care leaders and discovering innovative ways to advance medicine.

OUR MISSION

Bringing quality health care to the underserved is one of UMMC’s most ambitious public health goals. Telehealth plays a key role by dramatically increasing access to health care in small towns. Using telehealth; clinics, schools, and businesses can offer much-needed medical care to communities with few or no medical specialists. We are committed to:

– Bringing care to those who need it most by delivering quality health care– Training the next generation of health professionals– Discovering ways to utilize technology to improve health outcomes

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GOALS AND OBJECTIVES

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The goals of the Center for Telehealth are to focus on Health Care, Education and Research.

Health Care

Provide specialty care that is convenient for patients.

Increase the number of Patients enrolled in RPM with a focus:• Internal Acceptance• Epic Utilization• Research Studies• Insurance Partnerships

Education

Integration of telehealth curriculum with the School of Medicine, School of Nursing.

Telehealth workforce training and development at local college(s).

Provide interactive distance education for providers to improve quality of care.

Research

Successful completion of work plans as part of HRSA’s Center of Excellence (COE)

TRADITIONAL TYPES OF TELEHEALTH

REAL-TIME CONSULTATION REMOTE MONITORING STORE AND FORWARD• Patients videoconference with providers in

real-time, from anywhere

• Providers connect and collaborate with each other regarding diagnoses/therapies

• Hospitals/Clinics augment capacity using Telehealth HCPs

• Chronically ill adult and pediatric patients connect with care teams through tablet computers and other specialized/IoT devices anytime, anywhere

• Providers can share patients’ medical information such as lab reports and images with physicians and patients, across time zones and locations

Dermatology

Cardiology

Radiology

Endocrinology (e.g., diabetes)

Congestive Heart Failure & Hypertension

Emergency Medicine

Corporate Health

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Specialty Care (e.g., BehavioralHealth, Child Development)

Pulmonary (e.g., Asthma, COPD)

BACKGROUND

•The “MS Diabetes Healthcare Network Initiative” is focused on one of Mississippi’s most burdensome health challenges: Diabetes.

•Mississippi continues to rank in the top two for highest prevalence of Diabetes in the nation.

•This pilot project on delivery of a coordinated approach to diabetes management where specialty Diabetes physician services, pharmacy Medication Therapy Management (MTM) services, and ophthalmology exams to screen for diabetic retinopathy via telemedicine to underserved areas.

•In 2012, diabetic medical expenses in Mississippi totaled $2.74 billion, according to the American Diabetes Association.

MISSISSIPPI DIABETES TELEHEALTH NETWORK

• Mississippi Diabetes Telehealth Network was formed to demonstrate how a new clinical care delivery model would affect outcomes of uncontrolled diabetics in the Mississippi. By way of a multidisciplinary team, health care resources were delivered to the participants in rural communities using interactive technology solutions.

STUDY SYNOPSIS

Purpose: To initiate a multidisciplinary team approach, using technology, to empower patients to better manage their diabetes

Design: Longitudinal (12 months), quasi-experimental•Inclusion Criteria

•HbA1c ≥ 7•Age ≥ 18

•Rolling enrollment resulted in > 2-year study period •Outcomes:

•Primary: HbA1c •Secondary: BP, cholesterol, LDL, HDL, triglycerides, # ER visits & # hospital admissions

•Measurements at baseline and quarterly

Goal: Reduce HbA1c by 1% or greater

METHODS

•ADA guidelines followed for all patients

•All patients received an electronic tablet, glucometers & blood glucose strips

•Patients were to complete daily health sessions that included diabetes self management education, biometric measurement and allowed for feedback.

•RN Care coordinators monitored data and communicated with patients as needed.

•RN Care coordinators communicated with primary care providers and coordinated specialty care as needed.

•Specialty care was provided via telehealth when appropriate.

REMOTE PATIENT MONITORING (RPM)

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The delivery of home health services using telecommunications to enhance the delivery of home health care including:

PRELIMINARY FINDINGS

HbA1cAverage Decrease

1.7

Medication Compliance

96%

Health Session Compliance

83%

RetinopathyFound

9 cases

Total Weight Loss

71 pounds

Total Miles Saved

9,454.11

No Hospitalizations or ER visits for DM

RESULTS

CONCLUSIONS

The study did support the preliminary findings. There was a significant decrease in HbA1c after 3 months on the program. HbA1c measurements after the 3 month measurement did not demonstrate significant change. They were consistent.

Future research should include a larger sample, random assignment of treatment, measurement of patient and provider satisfaction, and an analysis of cost effectiveness.

IMPACT

CURRENT WORK

• Adult and Pediatric Diabetes• HTN• HF• BMT• COPD• ASTHMA• Pediatric obesity

Thank you

Tearsanee Carlisle Davis, DNP, FNP, BCCenter for Telehealth

University of Mississippi Medical CenterTcdavis2@umc.edu@ummctelehealth

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?Bridging the gaps in quality healthcare