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IHS Leadership Symposium April 17, 2012 Understanding the Interest and Utility of Telehealth

Understanding the Interest and Utility of Telehealth

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Understanding the Interest and Utility of Telehealth. IHS Leadership Symposium April 17, 2012. What is telehealth? . The practice of transcending geography by using electronic communication devices to enable face-to-face clinical services and education. . Why telehealth? . - PowerPoint PPT Presentation

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Page 1: Understanding the Interest and Utility of Telehealth

IHS Leadership SymposiumApril 17, 2012

Understanding the Interest and Utility of Telehealth

Page 2: 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.

Page 3: Understanding the Interest and Utility of Telehealth

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

Page 4: Understanding the Interest and Utility of Telehealth

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

Page 5: Understanding the Interest and Utility of Telehealth

BTOP Grant Partners Rural Iowa Telehealth Initiative

Iowa HealthDes Moines

Clarke County Hospital

Greene County Medical Center

Guthrie County Hospital

Grundy CountyMemorial Hospital

Page 6: Understanding the Interest and Utility of Telehealth

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

Page 7: Understanding the Interest and Utility of Telehealth

Clinical Telehealth Applications

Page 8: Understanding the Interest and Utility of Telehealth

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

Page 9: Understanding the Interest and Utility of Telehealth

Local Access to Quality Health Care

Specialty physicians (outpatient, inpatient, emergency)

Professional and community education

Quality improvement through case review

Enhance patient experience

Page 10: Understanding the Interest and Utility of Telehealth

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

Page 12: Understanding the Interest and Utility of Telehealth

Community Based Telehealth Applications

Page 13: Understanding the Interest and Utility of Telehealth

Unique Telemedicine Applications Women’s Health NICU and PICU Pediatrics

Page 14: Understanding the Interest and Utility of Telehealth

Telemedicine/Telehealth

Telemedicine associated with direct patient clinical services.

Telehealth associated with a broader definition of remote healthcare services.

Page 15: Understanding the Interest and Utility of Telehealth

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

Page 16: Understanding the Interest and Utility of Telehealth

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

Page 17: Understanding the Interest and Utility of Telehealth

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

Page 18: Understanding the Interest and Utility of Telehealth

Education Based Telehealth Applications

Page 19: Understanding the Interest and Utility of Telehealth

GCMH School & EMS Locations

Page 20: Understanding the Interest and Utility of Telehealth

School Education Current Programs

CNA course assistance Career exploration Infection

control/prevention Telehealth 101 Fire Safety

13 courses conducted 6 schools 19 staff hours

Page 21: Understanding the Interest and Utility of Telehealth

School EducationFuture 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

Page 22: Understanding the Interest and Utility of Telehealth

EMS Education Quarterly CEH/CEU

offerings Connection to IHS-

sponsored events Connection to

other video-based education

Future plans: Remote ECG transmission

Page 23: Understanding the Interest and Utility of Telehealth

Additional Telehealth Applications

Page 24: Understanding the Interest and Utility of Telehealth

Guthrie County Hospital

Page 25: Understanding the Interest and Utility of Telehealth

Access - Internal 4 Family Medicine Clinic sites Employ

Internal Medicine Family Practice Family Practice ARNP Pediatrician (July 2012)

Page 26: Understanding the Interest and Utility of Telehealth

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

Page 27: Understanding the Interest and Utility of Telehealth

Specialists – In place Employed – IM, Pediatrics, ED General Surgery Plastic/Reconstructive Surgery Vascular Surgery and Wound Care Neurology

Page 28: Understanding the Interest and Utility of Telehealth

Other Connections - Dreams Cardiology Psychiatry Oncology Area Nursing Homes Home Monitoring

Page 29: Understanding the Interest and Utility of Telehealth

Knowledge Access Collection Distribution Relationships

Page 30: Understanding the Interest and Utility of Telehealth

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

Page 31: Understanding the Interest and Utility of Telehealth

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

Page 32: Understanding the Interest and Utility of Telehealth

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

Page 33: Understanding the Interest and Utility of Telehealth

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]

Page 34: Understanding the Interest and Utility of Telehealth

Resources American Telemedicine Association

www.americantelemed.org Great Plains Telehealth Resource &

Assistance Center http://www.gptrac.org/

BroadbandUSA http://www2.ntia.doc.gov/iowa