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A Clinical Event
Marilyn Dahler, RN Avera Telehealth & Great Plains TRACKarla Knobloch, RN
Avera Telehealth
Avera Telehealth
• Not for profit system
• Active in Telehealth since 1993
• 100 endpoints at >50 locations
• >900 education/meeting events
• >2300 consults this fiscal year
Specialties
• Mental Health
• ID
• Pulmonary (adult and peds)
• OB Ultrasounds
• Pediatric Cardiology (echoes)
• GI
Specialties Con’t• Dermatology
• Oncology
• Wound Care
• Endocrinology
• Nephrology
• Internal Medicine
Telehealth
Electronic transfer of medical information, either
synchronous or asynchronous for the
purpose of providing patient care
Telehealth Application• Education/meetings
• Telemedicine
• Store and forward
• e-ICU
• e-health
• Telehome care
Benefits
• Increased access
• Enhances quality of care
• Saves travel dollars
• Supports main street
• Promotes continuum of care
• Promotes family connectivity
Telemedicine
Use of interactive video conferencing for
patient care
Getting Started
• Site w/need and willing– Administrative support/telepresenter– Find a champion
• Equipment &required peripherals
• Network and connectivity
Getting Started Con’t
• Provider• Reimbursement –Medicare–Medicaid– Third Party– Contracts
….Remember
This is patient care, so applying the same standards will give you a starting point
Licensure & Credentialing
• Licensed in state where the patient is located
• Credentialed according to facility’s policy
Informed Consent
• Patient Rights
• Provider Rights
• Security measures
Privacy
• Visual and auditory
• Introduce those present at both locations and their role
• Disable multi point calling
• Mute upon answering
Security
• HIPPA Complicant–Network
–Patient information/Medical Record
–Clinic’s HIPAA form
Safety
• Safety –Staff competencies
–Biomedical
– Infection Control
Policies & Procedures
• Scheduling of room/equipment
• Specific provider needs
Medical Record
• Use existing records
• Documentation–Who is present in room
–Participation in exam–Written/verbal orders
–Discharge instructions
Continuum of Care
• Patient information transferred before and after appointment
• Discharge Planning
• Failure of the patient to show–Who is notified
Implementation
• Train staff
• Provide ongoing support
• Evaluate/problem solve
• Train again and again and again……
It’s not about the ball!
It’s about the delivery of healthcare
Summary
• Apply healthcare standards
• Build upon established practices
• Fill in the gaps
• Provide training and ongoing support and evaluation
Marilyn Dahler – 605-322-6028
Karla Knobloch – 605-322-6263
