A Kaleidoscope of Telehealth gptrac Conference April 3, 2014

Transcription

1 A Kaleidoscope of Telehealth gptrac Conference April 3, 2014 Presented By: Wanda Kjar-Hunt, RN Kearney, NE Kathy Gosch, RN Kearney, NE Diane Vogel, RN Lincoln, NE

2 Wanda Kjar-Hunt Telehealth Program Manager Good Samaritan Hospital Kearney, Nebraska (308)

3 The Nebraska Statewide Telehealth Network (NSTN) Formed in Hospitals and Public Health Departments Closed T1 Network Not a formal legal entity 2014 become a legal entity Charge membership fees Contract with University of Nebraska Lincoln for Technical support 3

4 Nebraska Statewide Telehealth Network (NSTN) Scottsbluff 11 Phd Gering 1 Mhc Kimball Chadron Public Health Departments/Labs Nebraska Critical Access Hospitals Kansas Critical Access Hospitals Rural Hospitals Mental and Rural Health Clinics Regional Hub Hospital University of Nebraska Hubs Alegent Fiber ring RNHN Fiber ring Hemingford 5 Phd 3 Rhc Bayard 3 Mhc Alliance Bridgeport Sidney 100 Mb Backbone Connection between Hub Hospitals ByranLGH/HHA FastEthernet Gordon Mhc Single T-1 Connection between Hub and End sites University of Nebraska DWDM Backbone Connections Revised: LLR 03/25/2014 S:/networking/telehealth network/telehealth network maps and other info/nebraska telehealth network RNHN Fiber ring Oshkosh 16 Phd Ogallala Benkleman 38 Imperial Mb North Platte 12 Phd 51 Valentine Phd McCook 31 Gothenburg Ainsworth 1 Broken Bow Callaway 100 Mb Cambridge Cozad Bassett 8 4 Phd Holdrege 38 Alma 4 3 Phd Atkinson Burwell 57 Ord Kearney Minden 25 Franklin Lynch Phd O Neill Mb Smith Atwood, Ks a Oberlin, Ks b Norton, Ks c Phillipsburg, Ks d e Center Mankato 5 St. Paul 69 Hastings 1 Phd 35 Neligh 48 Red Cloud 64 Superior 70 f 100 Mb Creighton 20 Tilden 73 2 Albion Genoa Central City Osmond Plainview Norfolk 8 Phd 18 Columbus Osceola Mb 28 Geneva 35 Hebron 7 Phd 76 Wayne Schuyler 65 David City G 22 Crete Phd Friend Fairbury 23 Dakota City Pender 62 Wisner 15 Phd 77 Westpoint Grand Island 78 6 Phd Seward 67 7 York Phd Lincoln 33 Aurora 43 Henderson Mb Sioux City, Iowa aa H Wahoo 75 N 9 Beatrice 81 Fremont I Mb 100 Mb Winneabago 51 Oakland Syracuse Pawnee City 11 Blair Tecumseh Omaha area 47 Nebraska City Alegent Fiber ring 6 Auburn 13 Phd Falls City 24

5 NSTN Hubs 7 Hubs Scottsbluff (Regional West Medical Center) Kearney (Good Samaritan Hospital) Grand Island (St. Francis Medical Center) Lincoln (St. Elizabeth Medical Center) Lincoln (Bryan Health) Omaha/Norfolk (University of Nebraska Medical Center/Faith Regional Health Center) 5

6 NSTN Continued Nebraska Public Service Commission $900,000 per year for Telehealth $240 is NE T-1 Urban rate NPSC pays $140 per month per site Provided new bridges for 5 Hubs 6

7 NSTN continued Governing Committee Education Committee Technical Committee Special Committees Security Clinical 7

8 NSTN Collaboration NSTN Scheduling Website ( Administrators & Coordinators View Educations, Administrative offerings Clinical times and places Post Information Share resources: 1-5 Hubs bringing in sites 8

9 Desktop/Mobile Technology UNMC Vidyo Pilot Polycom RealPresence Richard Young Hospital 7 Providers Contract with Region IV Behavioral Health Clinics Northern and North Eastern Nebraska Orthopedic Clinic, Behavioral Health Clinic, Jail 9

10 School Telehealth USDA Grant 2013 Provided equipment at clinic site & school site Slow to implement Contract with small rural town Policies, procedures, training, reimbursement o Implement Fall of

11 Catholic Health Initiatives (CHI) CHI Nebraska Telehealth Hubs Good Samaritan Hospital, Kearney NE o 1994: First Telehealth in Nebraska o 5 endpoints now 24 St. Francis Medical Center, Grand Island NE St. Elizabeth Medical Center, Lincoln NE New Hub Alegent Creighton Omaha NE 11

12 CHI NE Telehealth Cont One Director Staff at each Hub Connect to 52+ sites routinely One Technical Support Person 12

13 CHI Nebraska Telehealth Valentine Ainsworth Bassett Atkinson O Neill South Sioux Plainview Burwell Norfolk Oakland l CHI Telehealth Sites Nebraska Counties Kansas Counties Hub Sites l Imperial Benkelman North Platte Gothenburg Cozad Callaway Cambridge McCook Broken Bow Lexington Holdrege Ord Minden l Kearney Grand Island Alma St. Paul Hastings Franklin Red Cloud Genoa Central City Aurora Columbus Schuyler Osceola Geneva Superior Hebron Friend Fairbury Lincoln Omaha Papillion Nebraska City Tecumseh Pawnee City Missouri Valley Falls City Corning, IA Atwood Oberlin Norton Phillipsburg Smith Center

14 Diane Vogel Telehealth Program Coordinator Saint Elizabeth Regional Medical Center Lincoln, Nebraska (402)

15 Burn Consultations 1 of 39 Verified Burn Centers in US & Canada (ACS & ABA) Serves facilities across NE, IA, KS, SD Clear value-add over and above telephone consultation & still image transfer Provides ability for specialist care to be accessed less urgently Averts unnecessary transfers Cost effective for patients Evaluate burn thickness Physician & staff education 15

16 Inpatient Psychiatric Consultations Lack of in-house psychiatrists Longer waits therefore increased LOS Partnership Liaison services Consultation & treatment Highly successful Depression Anxiety Psychosis Attempted suicide BiPolar Disorder 16

17 Bariatric Surgery Follow-Ups Office specializes in general, bariatric, and colorectal surgery Credentialing & Privileging by proxy Allows rural patients to see their surgeon for follow-ups Keeps patients in home towns so there is no out-migration - - economic benefit Less time away from work Helps the surgeons garner patients that might not come to them otherwise Everyone in the state needs to be on board & accessible - - it improves patient care. Surgical Office Manager 17

18 Cancer Conference Joint Accreditation for Commission on Cancer Multidisciplinary Conference Surgeons Pathology Cardiology Family Practice Presentation of Cases Plan of Care Medical Oncologists Radiation Oncologist Pulmonology Physical Therapy 18

19 Education Director of Education at Saint Elizabeth Regional Medical Center comments on telehealth: It is imperative for every patient in the state to be taken care of by a health care team that is up-to-date on evidence based practice. Telehealth is one of the ways we offer education across the entire state. We want to be a leader in providing and also reaching out to bring experts to our health care team. 19

20 Educational Offerings Concepts in the Care of Complex Patient Conferences Over 100 Participants: Maternal Fetal Conference Orthopedic Conference Nebraska Sports Concussion Network STABLE (Sugar, Temperature, Airway, Blood Pressure, Lab Work, Emotional Support) Fetal Monitoring IT Networking ICD-10 EMS Physician Grand Rounds 20

21 Radiation Oncology Solo Practitioner Use to meet the requirements of the American College of Radiology for Quality Assurance Case Discussion Appropriate for Cyber Knife? Present Prospective Cases Review CT & MRI film for treatment opinions 21

22 On The Cutting Edge Nebraska Heart Hospital 54 Outreach Clinics 28 Physicians How o Heart Failure o Follow-Up Clinics o Case Reviews o Education Equipment & Education 22

23 On The Cutting Edge Cont Palliative Care Early stages of development Ready to poll rural hospitals Medical Care for people with serious illnesses Focus on symptoms, pain, & stress of serious illness Work with rural Dr. s and patients Dermatology Wound Care 23

24 On The Cutting Edge Cont NICU WHY: Neonatologists using video connections can allow experts to collaborate, diagnose & treat rural Nebraska s tiniest, at-risk babies Provide coordinated care and a bridge to transport Can possibly provide a way to keep babies out of the NICU 24 hour access to experts 24

25 On The Cutting Edge Cont HOW: Pilot Project o Lead Neonatologist Champion o Identified 8 sites - - hoping for at least 4-5 participating sites o 1 year commitment Initial Introduction Letter Follow Up site visit o Comparing desk-top applications & video conference equipment o Working with Foundation 25

26 Kathy Gosch Telehealth Program Coordinator Good Samaritan Hospital Kearney, Nebraska (308)

27 Clinical Consults 2013 over 4,000 consults Infectious Disease Pediatric Neurology Future-Primary Care at Jail 27

28 Compassionate Calls When it s the right thing to do. Funerals Weddings Interviews 28

29 Compassionate Calls cont Births when Dad is far away... 29

30 Compassionate Calls cont In-Patient Connections 30

31 Compassionate Calls cont 31

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