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presented by:
         Telehealth Resource Centers
  Office for the Advancement of Telehealth
Health Resources and Services Administration

             February 22, 2008
…. clinical care was available anytime
           and anywhere
        …. clinicians could obtain consultations
           with medical centers of excellence
           anytime and anywhere
        …. home bound patients could be
           monitored remotely anytime and
           anywhere
        …. medical education programs were
           available anytime and anywhere


              This is the potential of telehealth

© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Clinical care provided from a distance

                 The use of electronic communication and information
                 technologies to provide or support clinical care

                         Primary Care

                        Medical Specialties

                        Intensive Care Services

                        Emergency Departments




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Telehealth encompasses telemedicine & other
uses for communications technologies
 Health professions education
 Administration
 Homeland Security
 Public Health
 Consumer Education
 Evaluation Research
 Regional Health Information Sharing
            - Dr. Dena Puskin
              Federal Office for the Advancement of Telehealth
Clinician shortages
                                                                  Misdistribution of providers
                                                                  Rural/Urban underserved
                                                                  Aging population
                                                                  Travel time, cost & hardship
                                                                  Delayed treatment
                                                                  Language barriers
                                                                  Clinical education programs
                                                                  Administrative meetings


© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Reduces barriers to access
            Increases efficiency for providers
            Reduces overall health care costs
            Improves quality of care
                 Consultant and primary provider communication
                 Education to providers
            Reduces delays in care
            Increases patient satisfaction
            Improves health outcomes
            Virtual accessibility


© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Clinical Services
  Primary & Specialty Care
  eICU
  Emergency Department
Educational Services
  Provider Education
  Patient Education
Administrative Meetings
Principal components
                                                             Camera
                                                             Viewing Screen
                                                             Codec
                                                             Scopes and peripherals
                                                             Transmission method

                         Tandberg
                     Telemedicine Unit




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Statewide Systems
Networks
University Based Systems
Regional Systems
Independent Health Care Organizations
Live Interactive
                 Store and Forward
                 Emergency Response
                 Patient Education Kiosks
                 Home Health Monitoring
                 Educational Services
                 Videoconferencing                                                            Polycom Telemedicine Unit




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.       February 2008
Patient visits using videoconferencing where
          patient & provider are communicating in real time.
          Allows provider to assess patient using medical
          scopes adapted for image transmittal
          Specialty services
                Dermatology
                Urology
                Psychiatry
                Orthopedics
                Neurology
                Pain Management
                Endocrinology
                ENT
                Rheumatology                                               Georgia Rural Healthcare Initiative




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Dental Services
                                                                      Connecting friends & family
                                                                        Family Counseling
                                                                        Support Groups
               Sacred Health Hospital                                   Patient education
                Telestroke Program
                 Pensacola Florida
                                                                        Administrative Meetings


© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Can be applied in many situations and locations

                                                                     •      Outpatient Clinics
                                                                     •      Mental Health Centers
                                                                     •      Intensive Care Units
                                                                     •      Correctional Facilities

                       In Touch Health


     • Emergency Departments
     • Emergency Transport Units
     • Surgery Suites
                                                                             Minnesota Telehealth Network Wadena



© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Oklahoma State University Center for Health Sciences
                                              Telemedicine Bus

               The Oklahoma State Mobile Telemedicine Clinic began operation in
               March 2007
               The mobile telemedicine unit also coordinates with emergency
               organizations on disaster response

© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
General Devices EMS System




                                                                                     Polycom Mobile Responder

                 The City of Tucson will soon initiate telemedicine in citywide
                 ambulance service


© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Children’s Hospital of Los Angeles



                          Children
                          School Sites



© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Loma Linda University
                                                                                             Mobile Telemedicine Vehicle




                  Telemedicine via Satellite




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.       February 2008
Improve Quality of Care – Avoid Medical
                                                               Errors
                                                               Multilingual
                                                               Culturally Competent
                                                               Trained in Medical Terminology
                                                               Meet legal/contract requirements

             Photo courtesy of
             Pine Tree Society, Maine

             Learn more www.pinetreesociety.org




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Diabetic Retinopathy Screening                                   Second Opinion Dermatology System
            Round Valley Indian Health Service

              Images are obtained at a local care center and transmitted
              for review by a clinician at a remote site
                   Picture and history adequate for diagnosis
                   Allows clinician to do work when convenient
                   Maximizes use of clinician time

© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Mee Memorial Hospital
                                                                                           Green field California




© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.     February 2008
Technology that supports monitoring
                                                     of chronic conditions
                                                         COPD – peak flow
                                                         Diabetes




                                                                                                                  Health Hero


    Visiting Nurse & Health Services
             of Connecticut

      Permission pending

© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.            February 2008
Allows clinical
                      staff to participate
                      in educational
                      programs without
                      leaving their
                      communities
                                                                             University of California Davis

                  Allows patients to receive health education and
                  health counseling services.

                                                        Permission pending


© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Administrators, providers and others in many locations
              can more efficiently hold administrative meetings.



© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
Medicare
Medicaid
Private Payors
• Blue Cross / Blue Shield
State Initiatives
Intellectual Property Rights
Risk Management
Credentialing and Privileging
Interstate Licensure
Telecommunications Law
Privacy
Fraud and Abuse
Some success factors
 Champion
 Coordinator
 Education and training
 Engagement of primary care providers
 Availability of services
 Technical and program support
 Stable technology
 Funding & reimbursement mechanisms
Reimbursement
Physician Champions
Institutional Buy-in
Convenience
Telecommunications Costs
Program Sustainability
Interstate Licensing
Put in all logos
Program Support & Assistance
               Assist health care organizations, networks and
               providers to implement cost-effective telehealth
               programs.
               Serve as a focal point for advancing the effective use
               of telehealth technologies.
                               Equipment Options
                               Practice Guides
                               Program Design
                               Reimbursement
                               Business Models



© California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission.   February 2008
National Telehealth Resource Center
       www.telehealthlawcenter.org
California Telemedicine & eHealth Center
        www.cteconline.org
Great Plains Telehealth Resource & Assistance Center
        www.gptrac.org
Midwest Alliance for Telehealth and Technology Resources
      www.midwesttrc.org
Northeast Telehealth Resource Center
       www.northeasttrc.org
Northwest Regional Telehealth Resource Center
      www.nrtrc.org
Telehealth

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Telehealth

  • 1. presented by: Telehealth Resource Centers Office for the Advancement of Telehealth Health Resources and Services Administration February 22, 2008
  • 2. …. clinical care was available anytime and anywhere …. clinicians could obtain consultations with medical centers of excellence anytime and anywhere …. home bound patients could be monitored remotely anytime and anywhere …. medical education programs were available anytime and anywhere This is the potential of telehealth © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 3.
  • 4. Clinical care provided from a distance The use of electronic communication and information technologies to provide or support clinical care Primary Care Medical Specialties Intensive Care Services Emergency Departments © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 5. Telehealth encompasses telemedicine & other uses for communications technologies Health professions education Administration Homeland Security Public Health Consumer Education Evaluation Research Regional Health Information Sharing - Dr. Dena Puskin Federal Office for the Advancement of Telehealth
  • 6. Clinician shortages Misdistribution of providers Rural/Urban underserved Aging population Travel time, cost & hardship Delayed treatment Language barriers Clinical education programs Administrative meetings © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 7. Reduces barriers to access Increases efficiency for providers Reduces overall health care costs Improves quality of care Consultant and primary provider communication Education to providers Reduces delays in care Increases patient satisfaction Improves health outcomes Virtual accessibility © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 8. Clinical Services Primary & Specialty Care eICU Emergency Department Educational Services Provider Education Patient Education Administrative Meetings
  • 9. Principal components Camera Viewing Screen Codec Scopes and peripherals Transmission method Tandberg Telemedicine Unit © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 10. Statewide Systems Networks University Based Systems Regional Systems Independent Health Care Organizations
  • 11. Live Interactive Store and Forward Emergency Response Patient Education Kiosks Home Health Monitoring Educational Services Videoconferencing Polycom Telemedicine Unit © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 12. Patient visits using videoconferencing where patient & provider are communicating in real time. Allows provider to assess patient using medical scopes adapted for image transmittal Specialty services Dermatology Urology Psychiatry Orthopedics Neurology Pain Management Endocrinology ENT Rheumatology Georgia Rural Healthcare Initiative © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 13. Dental Services Connecting friends & family Family Counseling Support Groups Sacred Health Hospital Patient education Telestroke Program Pensacola Florida Administrative Meetings © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 14. Can be applied in many situations and locations • Outpatient Clinics • Mental Health Centers • Intensive Care Units • Correctional Facilities In Touch Health • Emergency Departments • Emergency Transport Units • Surgery Suites Minnesota Telehealth Network Wadena © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 15. Oklahoma State University Center for Health Sciences Telemedicine Bus The Oklahoma State Mobile Telemedicine Clinic began operation in March 2007 The mobile telemedicine unit also coordinates with emergency organizations on disaster response © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 16. General Devices EMS System Polycom Mobile Responder The City of Tucson will soon initiate telemedicine in citywide ambulance service © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 17. Children’s Hospital of Los Angeles Children School Sites © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 18. Loma Linda University Mobile Telemedicine Vehicle Telemedicine via Satellite © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 19. Improve Quality of Care – Avoid Medical Errors Multilingual Culturally Competent Trained in Medical Terminology Meet legal/contract requirements Photo courtesy of Pine Tree Society, Maine Learn more www.pinetreesociety.org © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 20.
  • 21. Diabetic Retinopathy Screening Second Opinion Dermatology System Round Valley Indian Health Service Images are obtained at a local care center and transmitted for review by a clinician at a remote site Picture and history adequate for diagnosis Allows clinician to do work when convenient Maximizes use of clinician time © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 22. Mee Memorial Hospital Green field California © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 23. Technology that supports monitoring of chronic conditions COPD – peak flow Diabetes Health Hero Visiting Nurse & Health Services of Connecticut Permission pending © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 24. Allows clinical staff to participate in educational programs without leaving their communities University of California Davis Allows patients to receive health education and health counseling services. Permission pending © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 25. Administrators, providers and others in many locations can more efficiently hold administrative meetings. © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 26. Medicare Medicaid Private Payors • Blue Cross / Blue Shield State Initiatives
  • 27. Intellectual Property Rights Risk Management Credentialing and Privileging Interstate Licensure Telecommunications Law Privacy Fraud and Abuse
  • 28. Some success factors Champion Coordinator Education and training Engagement of primary care providers Availability of services Technical and program support Stable technology Funding & reimbursement mechanisms
  • 30. Put in all logos
  • 31. Program Support & Assistance Assist health care organizations, networks and providers to implement cost-effective telehealth programs. Serve as a focal point for advancing the effective use of telehealth technologies. Equipment Options Practice Guides Program Design Reimbursement Business Models © California Telemedicine & eHealth Center 2008. Please request permission to use. Photos used with permission. February 2008
  • 32.
  • 33. National Telehealth Resource Center www.telehealthlawcenter.org California Telemedicine & eHealth Center www.cteconline.org Great Plains Telehealth Resource & Assistance Center www.gptrac.org Midwest Alliance for Telehealth and Technology Resources www.midwesttrc.org Northeast Telehealth Resource Center www.northeasttrc.org Northwest Regional Telehealth Resource Center www.nrtrc.org