UPMC Telemedicine: World-Class Health Care Delivered Worldwide

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1 Contact Us Contact us for information about how UPMC can provide you and your patients with access to expert telemedicine services. UPMC Telemedicine: World-Class Health Care Delivered Worldwide UPMC Telemedicine 200 Lothrop St. Forbes Tower, Suite Pittsburgh, PA Natasa Sokolovich, JD, MSHCPM Executive Director, UPMC Telemedicine Phone: Fax: Lawrence R. Wechsler, MD Professor and Chair, Department of Neurology Vice President, UPMC Telemedicine Phone: Fax: Andrew R. Watson, MD Medical Director, UPMC Telemedicine Phone: Fax: Mariel Garcia Director, International and Telemedicine Services Children s Hospital of Pittsburgh of UPMC Phone: Fax: international@chp.edu UPMC.com/Telemedicine UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations. SYS TS/AS 11/ UPMC

2 UPMC Telemedicine: Redefining Health Care I had been working successfully with my physician for years to manage my diabetes condition. In a rough period several months ago, she recommended I see a specialist in Pittsburgh to get my blood glucose level under control. I was dreading having to make the five-hour round trip to Pittsburgh, but she said we could make it happen through UPMC s Telemedicine Program. I was able to schedule an appointment to be seen quickly at UPMC Bedford near my home. There was a nurse in the telemedicine examination room who set up the equipment and explained how it worked. I met with the specialist through a computer video and audio hook-up, and I was able to talk to her on the screen just the same as I would if we were meeting in person. We did four visits through telemedicine, and the treatment plan has worked well. I think it is a valuable, time-saving service and provides easy access to the medical experts I need. Robin Pittman, patient of Lisa Snyder Duvall, DO, of Pennwood Family Medicine Group in Everett, Pa., and Michelle Griffith, MD, of UPMC s Center for Diabetes and Endocrinology, Pittsburgh More than eight years ago, UPMC launched its Telemedicine Program through psychiatric care and stroke services, which provided patients with access to their specialist without burdensome travel. Cameras, monitors, and audio were coordinated to allow patient and physician to meet face-to-face, as if sitting in the same room. Since then, the UPMC Telemedicine Program has grown exponentially, with some 60 clinical specialty areas now linked across multiple locations, including clinics, health centers, and hospitals most of them in rural areas. With every new patient who opts to sign up for a virtual physician visit, with every new provider in an outlying area that joins the network and takes advantage of the cutting-edge technology, telemedicine is extending UPMC s world-class clinical services and access to hospitals, clinics, specialists, and primary care providers throughout our community. Beyond the western Pennsylvania region and selected sites in the United States, the Program s Global Care Division shares UPMC specialists expertise with the world, using an innovative service module to provide consultation to patients in settings as diverse as Mexico and Kazakhstan. Physicians can conduct a physical examination of a patient, whether 10 miles or 10,000 miles away, through secure video and audio conferencing that is assisted by health care professionals who are on-site and well-trained with virtual visits. Essential information, such as vital signs, medical history, images, and other test results, can be displayed. Physicians communicate in real time with providers and patients to better understand the condition, render a diagnosis, and prescribe a treatment plan. The Telemedicine Program helps to control health care costs while providing high-quality patient care. Telemedicine facilitates better management of chronic conditions and greatly reduces travel expenses. Rural hospitals and community health centers struggling in the midst of a national shortage of available specialists now have immediate access to UPMC specialists. In emergency situations, specialists can quickly assess patients in their remote locations without losing valuable time that may lead to complications that adversely impact outcomes and increase treatment costs.

3 Delivering patient and physician satisfaction The main focus of my practice is child and adolescent psychiatry, and I have found that I am able to provide care across the range of diagnoses. I believe telepsychiatry services are as good, or nearly as good, as in-person services in meeting patient needs. Teens seem more at ease and more relaxed with the medium, and patients with a history of trauma seem to feel more of a sense of safety with the distance. Telepsychiatry has allowed me to serve people from a variety of socioeconomic and cultural backgrounds, and that has been particularly rewarding. Joe Pierri, MD, medical director, Telepsychiatry, Western Psychiatric Institute and Clinic of UPMC Users of UPMC Telemedicine are clear that the major benefit of the program is the greatly increased convenience with no diminishment in the doctor-patient relationship. Surveys consistently show that patients and doctors are delighted with the ease of access, and they report no difference in quality between an appointment by telemedicine and an in-person visit. Among UPMC patients using telemedicine services, 40 percent reported that they would have foregone needed care if the program had not been offered in their community. *Survey of 1,000 patients from 6/28/12 to 9/29/14 Expanding services; extending expertise Physicians and other clinicians at UPMC Northwest see the addition of telemedicine as an essential tool in the diagnosis and treatment of a wide range of illnesses and injuries. There are many examples of positive outcomes as a result of using telemedicine technology, and they are growing by the day. My years on staff at a rural hospital were made much easier by the telemedicine technology provided by UPMC. David P. Gibbons, president, UPMC Northwest, and executive vice president and chief operating officer, UPMC Hamot UPMC Telemedicine, through its network partnership of physicians, hospitals, and medical facilities, has experienced an impressive double-digit growth rate over the past several years. Our Telemedicine Program expansion is a direct result of UPMC s commitment and investment in technology and the development of new models of care delivery. In Fiscal Year 2013, the program grew 48 percent an expansion from 6,530 telemedicine visits to 9,690. In FY14, there was additional growth, with more than 12,000 telemedicine visits completed. This success is directly attributable to careful management. The program is run by a team of executives, managers, and physician leaders with years of experience in telemedicine development and deployment. Also, there is special attention given to the most popular outlets for the service. One of the leaders of this effort is UPMC s own insurance plan (UPMC Health Plan), where telemedicine is viewed as a true innovation in improving access to those who need services most, as well as a service that optimizes treatment for those in need of acute care. The Health Plan has updated its benefits package to encourage virtual physician visits (known as evisits) that also includes UPMC AnywhereCare, which allows patients across Pennsylvania online access to clinical care 24 hours a day and every day of the year. Continued on next page >

4 The Health Plan is an integral member of UPMC s Telemedicine Program, collaborating on new uses of telemedicine to improve care and reduce member costs. Among the initiatives are an increase in remote monitoring capability, mobile wound care, and employer on-site clinics. The Health Plan effort is one facet of general telemedicine management in which leaders have developed comprehensive operational, information technology (IT), and business procedures. In addition, UPMC s Telemedicine Program encompasses ongoing patient and provider satisfaction monitoring and clinical quality monitoring oversight. The UPMC Telemedicine leadership team also provides these administrative assistance and ongoing support services to organizations interested in partnering with UPMC s telemedicine network. Increasing access to world-class expertise Time is of the essence when treating patients who are experiencing a stroke. For patients located outside of Pittsburgh, UPMC s Telestroke Program brings world-class stroke specialists to their local hospitals. Telestroke uses videoconferencing technology to link emergency department (ED) physicians and experts at the UPMC Stroke Institute. Featuring a computer monitor and remote-controlled camera that allows for two-way audio and video communication, UPMC stroke experts in Pittsburgh can: See and assess the patient in real time Ask questions of the patient, family members, and local ED staff View CT scans Help ED physicians determine whether the patient is a candidate for acute stroke therapy, including intravenous tpa In addition to IV tpa, acute neurological intervention treatment is available that can also improve outcomes and decrease patient disability. FY : 22 Telestroke Locations UPMC Locations UPMC Bedford UPMC Cranberry UPMC East UPMC Horizon Shenango UPMC Horizon Greenville UPMC Magee-Womens Hospital UPMC McKeesport UPMC Mercy UPMC Northwest UPMC Passavant UPMC St. Margaret Community Hospital Locations Armstrong County Memorial Hospital Excela Health Frick Excela Health Latrobe Excela Health Westmoreland Heritage Valley Beaver Jameson Jefferson Meritus Hagerstown, Maryland Mon Valley Uniontown Washington Hospital Creating new models of care One of the experiences that has given me assurance that telemedicine allows for the same bonding with patients and families as an office visit has come from my treatment of a 10-year-old girl for irritable bowel syndrome. She has some psychological dysfunction and lives several hours from Pittsburgh. Mom works full-time and has other children, so it s challenging for the family to make appointments in Pittsburgh. The girl already had missed a lot of school because of her condition, and taking time for a trip to Pittsburgh meant another day out of school. This case is complex and requires follow-up visits and adjustments in the child s routine. It was perfect for telemedicine, but I was concerned about maintaining the bond with the mom and her daughter to ensure treatment is followed. But I was in awe at how well everyone adapted. Mom understood the convenience, but she also was very involved as a parent. I knew that we had more than just a wired connection when the mom got a little emotional and asked me, Please help me work with the school on this. I couldn t have asked for anything more, even if Mom had been sitting across from me in Pittsburgh. Arvind Srinath, MD, assistant professor of pediatrics, Division of Pediatric Gastroenterology, Children s Hospital of Pittsburgh of UPMC Continued on next page >

5 UPMC Teleconsult Centers are a new model of care, bringing specialty physicians close to our patients and their communities by utilizing video conference technology. When a specialist is not available locally, UPMC Teleconsult Centers bring the expert to the patient via our Teleconsult Center locations. Through this technology, UPMC provides patients not only better access to its world-class specialty services and high-quality health care, but all of this in a timely manner close to home. Using HIPAA-secure teleconferencing technology and dedicated on-site staff, UPMC Teleconsult Centers connect patients directly to specialists in Pittsburgh. The patient and expert physician can see and hear each other during the consultation, and medical staff on location can perform an exam and share their findings in real time with the expert physician. UPMC continues to expand its Teleconsult Centers across western Pennsylvania to allow greater patient access to clinical specialty services ranging from emergency care and maternal fetal medicine, to pediatrics, radiology and surgery, and more. Locations where UPMC Teleconsult Centers are available: UPMC Bedford Memorial UPMC Hermitage (located within the UPMC Hermitage Urgent Care) UPMC Northwest Setting the pace for technology development It was at this year s American Telemedicine Association conference in Baltimore, where 5,000 people had registered to attend from the United States and internationally, that I realized just how much leadership UPMC is showing in this area of health care. We were involved in many of the presentations, and there were so many questions and comments about innovations and practices that we have developed. The early investments in technology, equipment, and training have really paid off. Mike Kistler, project manager, Information Technology team, UPMC More than $1 billion has been spent in the last several years to improve technology, including connectivity, patient data collection, storage, analysis, and integration. This is a solid foundation that enables continuous development of a robust telemedicine program in the areas of quality protocols, applications, and ongoing system enhancements. The significant investment, along with a systemwide commitment to continuous technological innovation, has made UPMC an international leader among health care systems offering telemedicine service. The dedicated members of UPMC s IT team have earned numerous awards for their work in building virtualphysician-visit capabilities. The improvements have helped UPMC s Technology Development Center win the prestigious Innovator Award from Hospitals & Health Networks, the journal of the American Hospital Association (AHA) and for the 16 th consecutive year, designation as one of the Most Wired health systems in the country the only one in the nation to achieve that distinction.

6 Telemedicine Services Adolescent Medicine Anesthesiology AnywhereCare Visits AnywhereCare: Convenience of Care AnywhereCare: Continuity of Care Cardiology Cardiac Electrophysiology Children s Home of Pittsburgh Colon and Rectal Surgery Dermatology (Adult and Pediatric) Employer On-Site Clinics Endocrine Surgery Endocrinology Diabetes Management Genetic Counseling Heart Failure Infectious Diseases Inflammatory Bowel Disease Maternal Fetal Medicine MFM: Diabetes Management Neurology: Movement Disorder Neurology: Multiple Sclerosis Neurosurgery: Cranial Nerve Neurosurgery: General Neurosurgery: Oncology Oncology Oncology: Breast Consultations Ophthalmology Pain Management Pathology Pediatric Cardiac ICU Pediatric ED/Transport/NICU Pediatric Gastrointestinal Pediatric General Surgery Pediatric Hematology/Oncology/ Sickle Cell Program Pediatric International Transplant and ICU Pediatric Neurology Pediatric Nutrition Pediatric Rare Disorders Physical Medicine and Rehabilitation Plastics: Breast Reconstruction Oncology Plastics: Hand Surgery Plastics: Oncology Head and Neck Plastics: Post Weight Loss Preoperative Evaluation Center Psychiatry Pulmonary Radiology Remote Monitoring Home Health (Diabetes, COPD, Heart Failure) Reproductive Endocrinology and Infertility Rheumatology (Adult and Pediatric) Rounding Second Opinion Skilled Nursing Facilities Sleep Medicine Stroke Stroke: Interventional Follow-Up Transplant: Behavioral Health Transplant: Nutrition Vascular Surgery Voice Therapy Wound Care Post Liver Transplant Consults: Pediatrics UPMC Telemedicine s international connectivity UPMC provides telemedicine services to overseas hospitals and other health care institutions around the world. Our program is continually improving and evolving so that we can provide our global partners with added support in administering the best possible medical care to their patients, regardless of where they live.