Integration of a Standardized Scalable Solution for Video Telemedicine into the Traditional Practice Model Stacia Lynch gptrac Regional Forum 2014 April 3, 2014 2014 MFMER slide-1
Mayo Clinic in Minnesota The Mayo Clinic campus in Rochester, MN is an integrated medical center which includes both outpatient and inpatient services. Patient care at Mayo Clinic is supported by medical education and research. Staff 2,100 physicians and scientists 28,000 allied health staff Clinic 370,000 unique patients seen in 2012 1,550,000 outpatient visits Hospitals 2,000 licensed beds and 110 operating rooms 68,000 admissions 72,000 surgical procedures Level One Trauma Center Mayo Eugenio Litta Children s Hospital 2014 MFMER slide-2
Mayo Clinic Model of Care: The needs of the patient come first A collaborative approach that relies on specialists working together to diagnose and recommend courses of treatment Every patient is assigned a physician who takes personal responsibility to manage their care An integrated EMR and coordinated systems ensure that patient information is immediately available Access to advanced, innovative diagnostic and therapeutic technologies and techniques Patients experience a unique, caring environment 2014 MFMER slide-3
Mayo Clinic Connected Care Overview Integrates new care models and clinical work flow into traditional outpatient and inpatient care Enables standardized, scalable, asynchronous and synchronous/video communication solutions for patients and providers Improves access, service and affordability - regardless of time or location by leveraging web/mobile/video technologies Supports business model for external providers and their patients 2014 MFMER slide-4
Store and Forward Interactions (Asynchronous) econsults and evisits Secure messaging Remote monitoring Real-Time Interactions (Synchronous) Video Consults and Video Visits Consults or F/U visits Telestroke etumor Board Micro Consults Video Curbside Monitoring - eicu 2014 MFMER slide-5
Objectives Develop a standardized scalable solution Integrate the solution into the practice workflow Leverage current processes to create a quality experience 2014 MFMER slide-6
Why Standardize? Over 30 different types of telemedicine activities A variety of non-interoperable technologies Multiple care models Inefficiency in practice Inconsistency in the approach to telemedicine 2014 MFMER slide-7
Developing the Model What is the problem we are trying to solve? Benefit to the patient by adding video services Understand the practice similarities & differences At hub (MD site) At spoke (patient site) 2014 MFMER slide-8
Integration into the Practice Leverage traditional in office face-to-face care processes Familiar Scalable Supported Add the appropriate technology to facilitate the interaction 2014 MFMER slide-9
Integration into the Practice Mimic the traditional face-to-face appointment Standardization of processes for: Scheduling Rooming Medical record review Patient / provider interactions Billing Clinical documentation 2014 MFMER slide-10
Video Consults & Visits Process Hub Site (MD) Block on MD calendars for video appointments Direct scheduling into calendar blocks Tee-up/check-in patient Connect via video Provide care Document interaction Bill professional fees Spoke Site (Patient) Schedule resources (room, telepresenter) Communicate with patient Check-in patient/standard intake process Assist with visit and future orders as directed Bill origination fees 2014 MFMER slide-11
Leverage Current Process to Create a Quality Experience Consistent look and feel as a traditional face-to-face appointment Value to patients Report to local facility Comfort with the local care team Ability to see the specialist more quickly Decreased cost of care due to travel expenses, time off work Value to providers Scheduling flexibility Managed by clinical practice Access to information in a consistent platform 2014 MFMER slide-12
Adding Value Providers and Patients Refine processes to standardize and scale operations between Hub (MD site) and Spoke (Patient Site) Leverage specialty care access for patients in the region Support the growth of the community care practices in the region Maximize capacity by reducing travel time for faceto-face outreach, where appropriate 2014 MFMER slide-13
Additional Operations Out of state licensure Credentialing and privileging Service agreements & contracts Technology and systems interoperability Privacy and security Practice adoption Education and training 2014 MFMER slide-14
Challenges EMR separation Medication reconciliation processes Future Orders processes Financial implications Billing / reimbursement Patient out of pocket/higher deductible Two bills; one from each facility Scheduling of spoke resources Telepresenter staffing Communication 2014 MFMER slide-15
Disclosure Relevant Financial Relationships None Off-Label/Investigational Uses None 2014 MFMER slide-16
Questions & Discussion 2014 MFMER slide-17