A Strategic Focus on Population Health Management and the Integration of Telehealth

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1 A Strategic Focus on Population Health Management and the Integration of Telehealth Expert Care is just a screen away UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CENTER FOR TELEHEALTH

2 Learning Objectives Define Population Health and outline challenges facing the poorest and least healthy population in the US Describe the impact strategic partnerships have on improving population health Discuss how Telehealth, an innovative model, is eliminating barriers to access and quality health care

3 Photo source: University of Mississippi Medical Center

4 Population Health Management A population health management program strives to address health needs at all points along the continuum of health and well-being through participation of, engagement with and targeted interventions for the population. GOAL: Maintain or improve the physical and psychosocial well-being of individuals through cost-effective and tailored health solutions. Source: Population Health Alliance

5 The Mississippi Delta The poorest corner of the poorest state in America

6 Background Information The Mississippi Delta Pervasive health problems Overweight and obesity levels 31% of adults overweight 39% of adults obese Diabetes Almost twice the national average Tobacco use 56% use

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10 UMMC has missions of education, research and health care. I like to boil those down to one overarching goal: A Healthier Mississippi. That doesn t just mean in the Jackson metro area or the state s larger cities. That means every corner of our state, including the Mississippi Delta Dr. LouAnn Woodward, Vice Chancellor UMMC Source: UMMC Campus , VC Notes for Friday, September 1, 2017

11 Community Outreach Strategy We ve gone where we ve been asked to go Kevin S. Cook, CEO UMMC Health UMMC Grenada Retreat, July 29, 2017

12 Common Denominator for Strategic Partnerships Relationships

13 Common Denominator for Strategic Partnerships Healthier Healthier individuals Healthier economy Healthier communities Healthier workforce

14 UMMC Community Care Clinic Humphreys County A Population Health Management Strategy

15 Urgent Care 30 months 90+ trips 14,720+ miles hours Outcome Photo source: EMILY POOLE ARCHITECTURE, PLLC

16 Photo source: University of Mississippi Medical Center As of March 31, the clinic has served nearly 300 patients in this rural community

17 Belzoni Payor Sources OTHER COMMERCIAL 5% AETNA UNITED HEALTHCARE CHIP 1% 2% SELF PAY MEDICARE 11% 12% MEDICAID MS 46% MAGNOLIA HEALTH PLAN 4% CIGNA 1% BCBS 18% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

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19 UMMC Community Care Clinic Staff All staff hired are from the Delta 75% reside in Humphreys County Expanding workforce opportunities by the creation of jobs. Photo source: Tonya Moore, PhD, RN Photo source: Tonya Moore, PhD, RN

20 Collaborative Care Photo source: University of Mississippi Medical Center Photo source: Tonya Moore, PhD, RN Photo source: University of Mississippi Medical Center

21 Photo source: Tonya Moore, PhD, RN Photo source: Tonya Moore, PhD, RN

22 Empowerment Care Photo source: Tonya Moore, PhD, RN Photo source: Tonya Moore, PhD, RN Photo source: Tonya Moore, PhD, RN

23 Finally, the local community can t sit on the sidelines; it has to be part of the solution. If the enthusiasm of the standing-room-only crowd last Tuesday is any indication, the people of Humphreys County are all in on their new after-hours clinic. Dr. LouAnn Woodward, Vice Chancellor UMMC UMMC Campus , VC Notes for Friday, September 1, 2017 Photo source: University of Mississippi Medical Center Photo source: University of Mississippi Medical Center

24 Telehealth Innovation

25 Trendwatch According to a study done by the American Hospital Association in 2013: 53% of hospitals utilized telehealth and 10% were beginning the process of implementation 74% of U.S. consumers would use telehealth 76% of patients prioritize access to care over the need for human interaction 70% of patients are comfortable communicating with HCP via text, , or video

26 What is Telehealth? Telehealth lets doctors examine and treat patients remotely, in real time, using online streaming video technology and interactive tools. PATIENT & LOCAL CLINICIAN USING UMMC S ONLINE TELEHEALTH TOOLS UMMC SPECIALISTS

27 Why is Telehealth important? Currently, 53 of Mississippi s 82 counties are more than a 40-minute drive from specialty care. UMMC CENTER FOR TELEHEALTH Provides specialty care that is convenient for patients Offers vital support for primary care physicians Helps decrease the cost of care and improve patient outcomes Supports population health in underserved areas Provides interactive distance education for providers to improve quality of care

28 UMMC Telehealth by the numbers 500,000+ patients helped since UMMC available specialists 35+ specialty services and growing 200+ Locations, with new locations weekly 28

29 UMMC Center for Telehealth in Mississippi Community Hospitals & Clinics Mental Health Clinics FQHC s Schools & Colleges Mobile Health Vans Corporations Prisons Patient s Homes

30 Clinical Quality Maintain same standard as in-person care If the technology can not replicate the exam you would do inperson then the visit is not appropriate for telehealth. Do not cut corners. Study clinical outcomes and compare to in-person outcomes

31 Technology Solutions Clinical need drives the solution Mobile versus fixed Examination needed (Psychiatry versus Child Development) Image sharing 31

32 Device and Data Collection Does the specialty need video? (Pathology, Radiology) Does the specialty need Far End Camera control? (TelEmergency, Child Development vs Adult Psych) Does the specialty need scopes? If so, can the information just be relayed? Do you need to share data? 32

33 TelEmergency Connects emergency departments in rural hospitals with UMMC s Level One Trauma Center Uses real- time video and audio connection Produces patient outcomes in rural hospital that are on par with those of the academic medical center Photo source: University of Mississippi Medical Center

34 TelEmergency 25% reduction in rural emergency room staffing costs 20% reduction in unnecessary transfers Produces patient outcomes in rural hospital that are on par with those of the academic medical center Connects 16 emergency departments in rural hospitals with UMMC s Level One Trauma Center Uses real-time video and audio connections 34

35 TelEmergency Sites in Mississippi 35 Covington County Hospital Field Memorial Community Hospital Franklin County Memorial Hospital H.C. Watkins Memorial Hospital Holmes County Hospitals & Clinics Lackey Memorial Hospital Lawrence County Hospital Magee General Hospital North Sunflower Medical Center Pearl River County Hospital and Nursing Home Perry County General Hospital Scott Regional Hospital Sharkey- Issaquena County Hospital Simpson General Hospital South Sunflower County Hospital Tallahatchie General Hospital

36 TelEmergency Outcomes Evaluation New Site-Satisfaction Survey Community Hospital (Q1 2014) 100% physician satisfaction Total patients seen with TelEmergency: 884 Total admission to that facility: 208 Total transfers from that facility: 68 Total discharges: 608 Total admissions to this facility increased by 101 patients in Q1 of program

37 Sustainable Models Base annual telehealth fee for all sites Monthly MD availability rate based on coverage and specialty Reimbursement- Prof fee, facility fee, CCM, RPM FFS contract (no insurance or individual billing) Networking fee Educational revenue Downstream revenue Penalty avoidance 37

38 Remote Patient Monitoring (RPM) Chronic disease management in the patient s home including: Daily Health Sessions Personalized Interventions Targeted Education Health Coach Behavior Modification Patient Empowerment 38

39 MS Diabetes Telehealth Network HbA1c 1.7% Retinopathy Found 9 cases Medication Compliance 96% Weight Loss 71 pounds Health Session Compliance 83% Miles Saved 9, No Hospitalizations or ER visits for DM Preliminary results on first 100 patients

40 SB 2009 (2013)- Parity SENATE BILL NO (As Sent to Governor) AN ACT TO REQUIRE HEALTH INSURANCE PLANS IN THIS STATE TO PROVIDE COVERAGE FOR TELEMEDICINE SERVICES TO THE SAME EXTENT THAT THE SERVICES WOULD BE COVERED IF THEY WERE PROVIDED THROUGH IN-PERSON CONSULTATION; TO DEFINE THE TERMS "HEALTH INSURANCE PLAN" AND "TELEMEDICINE"; TO AUTHORIZE HEALTH CARE PRACTITIONERS 5 LICENSED IN THIS STATE TO PROVIDE TREATMENT RECOMMENDATIONS TO A PATIENT AFTER HAVING PERFORMED AN APPROPRIATE EXAMINATION OF THE PATIENT THROUGH TELEMEDICINE; TO AMEND SECTION , MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISIONS; AND FOR RELATED PURPOSES. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 40

41 SB 2646 (2014)- SAF; RPM SENATE BILL NO (As Sent to Governor) AN ACT TO CREATE NEW SECTION , MISSISSIPPI CODE OF , TO REQUIRE HEALTH INSURANCE AND EMPLOYEE BENEFIT PLANS IN 2 THIS STATE TO PROVIDE COVERAGE AND REIMBURSEMENT FOR 3 "STORE- AND-FORWARD TELEMEDICINE SERVICES" AND "REMOTE PATIENT 4 MONITORING SERVICES" TO THE SAME EXTENT THAT THE SERVICES WOULD BE 5 COVERED AND REIMBURSED IF THEY WERE PROVIDED THROUGH IN- PERSON 6 CONSULTATION; TO DEFINE "STORE-AND-FORWARD TELEMEDICINE" AND 7 "REMOTE PATIENT MONITORING"; TO AMEND SECTION , 8 MISSISSIPPI CODE OF 1972, TO INCLUDE EMPLOYEE BENEFIT PLANS IN THE 9 REQUIREMENT FOR INSURANCE REIMBURSEMENT FOR TELEMEDICINE SERVICES; 10 AND FOR RELATED PURPOSES. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI 41

42 Opportunities No shows Travel Staffing Model Financial Responsibility

43 Take Home Points Population Health Management Identify your mission and align strategy Patient centered experience Spend time building key relationships Maximize existing resources Leverage technology -- Telehealth/TeleMedicine

44 Thank you? Tonya Moore, PhD, RN Administrator, Community Health Services Center for Telehealth University of Mississippi Medical Center Bridging the gaps in quality healthcare 44

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