design your own virtual visit february 29, 2016...slow emr integration with telehealth one-off...
TRANSCRIPT
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Design YOUR Own Virtual Visit February 29, 2016
Kathy H. Wibberly, PhD, Director
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Conflict of Interest
Kathy Hsu Wibberly, PhD
Has no real or apparent conflicts of interest to report.
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Agenda
1. Learning Objectives
2. Looking Back: How We Got Here
3. Looking Forward: Opportunities and Challenges
4. Intentional Design: Back to the Future?!
5. Questions
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Learning Objectives
•Review the current landscape of telehealth with a focus on enabling digital encounters
•Assess the approach to using technology to provide care in a virtual setting
•Recognize the components of creating a successful telehealth program leveraging virtual visits
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Looking Back: How We Got Here
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Health Care - Past
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Health Care - Present
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Progress??? CARE PAST PRESENT
Location Home Clinic/Hospital
Provider Generalists Specialists
Interaction Frequent Episodic/Periodic
Relationship Personal Impersonal
Unit Family/Community Individual
Focus Health Disease
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A mechanism for enhancing health care, public health, health administration and health education delivery and support, using electronic communication and
information technology.
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Necessity Breeds Invention Telehealth - Past
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It’s A Good Fit for Rural Health
It Started with Rural
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It Looked Like This
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Videoconferencing
It Started with Synchronous
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Telestroke – Time is Brain
• Administration of tPA
at stroke centers =
10% - 20% of ischemic
stroke patients
• Administration of tPA
outside of stroke
centers = 1% - 2%
(without telestroke)
and 10% - 20% (with
telestroke)
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Parkinson’s Care
This program has saved patients
roughly 20,000 miles of travel
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It’s Not Just For Rural Specialty
Care
Telehealth + Rural?
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PCMH + Telehealth? It’s A Good Fit for the
PCMH
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It Looks Like This
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Remote Patient Monitoring
Was Added
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Types of School Based Telemedicine
Care Provided – 2011 Survey of 46
Organizations
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Remote Patient Monitoring: Real Patients/Real
Outcomes – Large Academic Medical Center
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Remote Patient Monitoring: Real Patients/Real Outcomes –
Medium Sized Rural Health System
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Remote Patient Monitoring: Real Patients/Real Outcomes –
Small Rural FQHC Look-Alike
Replication Underway
http://cotnexperience.blogspot.com/p/blog-page.html
• 72% decrease in
costs
• 50% decrease in
hospital bed days
• 81% decrease in ER
visits
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Paradigm Shift
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Telehealth Future Is Here…
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House calls trump virtual care because the provider:
a. Has patient's medical history
b. Can touch the patient
c. Can use medical devices
d. Virtual care is equivalent
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Looking Forward: Opportunities
and Challenges
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Integration of telehealth into
mainstream care delivery
https://www.accen
ture.com/us-
en/insight-virtual-
health.aspx
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Assess
Reasons for Adoption Abound
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Assess
Reasons for Adoption Abound
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Assess
Reasons for Adoption Abound
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Assess
But The Struggle Is Real
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What % of outpatient care can be effectively done virtually?
a. 15% or less
b. 50% or less
c. 70% or less
d. more than 70%
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Assess
Challenges
Organizational
Clinical
Financial
Technology
• Current IT infrastructure
• Broadband connectivity
• Network integrity
(security, utilization,
firewalls, hardware, QoS)
• Existing equipment
• Staffing
Needs
• Providers
• Patients
• Data/
Information
Coding and Billing
Administration
• Buy-In
• Staffing
• Scheduling
• Training
• Policies, Procedures and
Protocols
Purchasing
Contracting
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Assess
Current State
What the patient wants What the provider wants
What the clinician wants to do What the clinician is trained to do
Slow EMR Integration with Telehealth
One-Off Solutions and Pilots
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What About Asynchronous?
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What About mHealth
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Continuity of Care
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What is the greatest barrier to virtual care? a. Technology
b. Reimbursement
c. Patient and Provider Buy-In
d. Other
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Intentional Design:
Back to the Future?
CARE PAST PRESENT FUTURE
Location Home Clinic/Hospital Anytime/Anywhere
Provider Generalists Specialists Team
Interaction Frequent Episodic/Periodic Continuous
Relationship Personal Impersonal Personal
Unit Family/Community Individual Population
Focus Health Disease Prevention
What Do You Want YOUR Health
Care to Be Like?
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Opportunities
What Do You Want YOUR Health
Care to Be Like?
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The Champ!
What Do You Want YOUR Health
Care to Be Like?
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http://www.himss.org/ValueSuite
http://www.the-
alliance.org/Blog/8_Ke
y_Questions_to_Consi
der_When_Adding_Tel
emedicine_to_Your_Be
nefit_Plan/
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What is the greatest benefit to virtual care?
a. Reduce Health Care Costs
b. Improve Access to Care
c. More Productive Workforce
d. Better Patient Experience
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Questions
www.facebook.com/MATRC
www.MATRC.org