The New Wave of Health Care: Telehealth FHCC 2014 Annual National Conference April 22-23, 2014
The New Wave of Health Care: Telehealth Plenary Session III Moderator: Ken Peach, Executive Director - Health Council of East Central Florida Panel Members: Rena Brewer, RN, MA - SE TeleHealth Resource Center John K. Holland, Senior VP for Research - AMC Health Anna Baznik, President/CEO IMPOWER
Can you imagine what health care would be like if....healthcare was available anytime and anywhere..clinicians / patients could obtain consultations with medical centers of excellence anytime and anywhere..home bound patients could be monitored remotely anytime and anywhere..medical education programs were available anytime and anywhere This is the potential of telehealth!!!
Healthcare: Any Time.Any Place.
The healthcare system is coming under increasing pressure to: improve the quality of care while; decreasing the cost to provide this improved care. Telehealth has the potential to address some of the pressing issues facing today s stretched and stressed healthcare system.
Telehealth is simply. The use of telecommunications technology to support and deliver healthcare from a distance.
On Site Telehealth Services help organizations keep employees where they are needed the most... On the job!
Corporate Telehealth Benefits Access to on-site healthcare Convenience for employees Minimizes employee downtime Early diagnosis & treatment can minimize spread of disease Applicable to many common conditions Supplements current on-site health program Suitable within the corporate environment and adaptable to company culture
Cost Savings Onsite Provider Cost Savings Improved Health Outcomes Timely Acute Care Treatment for Common Illnesses Potential for Improved Disease Management Decreased Need for Crisis Care Decreased Employee Absenteeism Healthier Workforce
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TELEHEALTH APPLICATIONS Clinical Services Patient / Provider Consultations; such as Primary Care, Specialty Care, ICU Monitoring, Emergency/ Stroke Services, Chronic Care Monitoring / Home Monitoring, Employee Health Care Live / Synchronous Video, Interactive, Face to Face Both the patient and the healthcare provider are available in real time and can communicate as though in the same room. Store & Forward / Asynchronous Used when face to face interaction is not required ; Radiology, Dermatology, Pathology, Home Monitoring, etc. Educational Services Patient and Clinical Staff Education. Administrative Support Video Conferencing for One-One Meetings or Multi-Point Meetings.
Barriers and Possible Reasons for the slow adoption of Telehealth: Human Factor Low awareness by providers & receivers of telehealth and its benefits Reluctance to change or embrace technology Lack of Wide-Scale Reimbursement Reluctance of many insurers to pay for services Medicare reimbursement restrictions Medicaid reimbursement varies from state to state Regulations Licensure of physicians / providers in multiple states Credentialing of providers Technology Hardware/Software Cost* (*Note: The industry is moving to higher quality / lower cost solutions) Disconnected Health Information because of the lack of standards & interoperability between systems / networks Limited broadband access for patients in some regions
Final Thoughts Telehealth is one of the most promising evolutions in the health care landscape. Remote healthcare services and technology are quickly becoming commonplace in the healthcare setting. Now is the right time for telehealth to gain prominence in helping the healthcare industry resolve cost and care quality challenges.
The Florida Telehealth Workgroup The Florida Telehealth Workgroup is a volunteer group of telehealth stakeholders interested in advancing telehealth services in Florida. Workgroup Objectives: To provide insight and direction regarding the advancement of telehealth in Florida To encourage collaboration among existing telehealth networks and programs. The Florida Telehealth Workgroup is Facilitated by the Southeastern Telehealth Resource Center
Southeastern Telehealth Resource Center (SETRC). www.setrc.us SETRC is one of 14 Regional/National Resource Centers funded by the Office for the Advancement of Telehealth through a grant program to provide support and guidance to telehealth programs. (# G22RH20212-04-00) SETRC serves Alabama, Florida, Georgia, & South Carolina and is operated by the Georgia Partnership for TeleHealth, Inc., Georgia s successful nonprofit statewide telehealth network. rena.brewer@gatelehealth.org
14 TRCs are located across the country..
Telemedicine Goes Mobile John Holland Sr. VP for Research & Business Development
It s Nothing New Collect data at home, transmit electronically to clinician who prescribes treatment Take 2 aspirins and call in the morning. Objective data: 101 o F Subjective data: sore throat and cough Transmitted to clinician electronically MD prescribes treatment and follow-up Telemedicine Goes Mobile 4/20/2014 2
Today, It s Automated Bluetooth to Mobile BP HR BG Weight Temperature ECG FEV 1 PEF PT/INR Fluid status Lipids HbA1c Stethoscope Telemedicine Goes Mobile 4/20/2014 3
Video Visits Can replace many office & home visits Supervise biometric monitoring Affect, posture, gait, speech quality, etc. Fine motor coordination Psychological assessment Telemedicine Goes Mobile 4/20/2014 4
Monitor Physical Activity and Sleep Quality GPS and accelerometers in smartphones track activity over time 2-3 days total activity may be a better indicator of recovery than an office assessment Wrist bands monitor sleep quality Measure the things that matter to patients Telemedicine Goes Mobile 4/20/2014 5
Drugs Don t Work in Patients Who Don t Take Them Major cause of treatment failure Monitors remind patients to take medication If patients fail to take R x on time, clinicians &/or family are alerted Oral R x in single container or multi-compartment tray Inhaled R x in MDI or DPI Telemedicine Goes Mobile 4/20/2014 6
Reducing Readmissions Geisinger patients with high readmission risk Automated phone calls identify care gaps Unfilled prescriptions and poor adherence No follow-up appointment Symptoms Psychosocial support Nurse case managers address problems Risk of 30-day readmission reduced 44% n= 3,195, p=.0004 Medical Care, 2012; 50(1):50-57 Telemedicine Goes Mobile 4/20/2014 7
Controlling Diabetes 330 NYC HHC Medicaid patients with high HbA1c Blood glucose and blood pressure telemonitoring Nurse case managers coordinated care Primary health care contact for many patients Advocated with clinic staff, counseled patients Reduced HbA1c by 1.8 points! Lower risk of HF, PVD and microvascular complications Even patients who didn t complete benefited Journal of Managed Care Medicine October 2012 Telemedicine Goes Mobile 4/20/2014 8
Blood Pressure Health Partners (MN) patients with elevated BP Home BP telemonitoring managed by PharmDs Adherence counseling MD-approved protocol to escalate R x as needed Randomized trial compared telemonitoring and pharmacist care with MD office management BP reduced 21.6/9.3 mmhg in 6 months 50% more patients achieved goal BP than usual office care by MDs JAMA July 3, 2013 Telemedicine Goes Mobile 4/20/2014 9
Back to the Future TELEMEDICINE ON YOUR PHONE DEMONSTRATION Telemedicine Goes Mobile 4/20/2014 10
TELEHEALTH Anna M. Baznik President/CEO
Why Telehealth? Why Now? Behavioral Health Well-Suited Affordable Care Act 4 Million New in Florida to be Insured Shortage of Practitioners Rural / Geographic Challenges Insufficient Transportation
Telehealth Benefits Brings Care to Patient; Reconceptualization Increases Access to Care Reduces Travel Time and Costs Improves Satisfaction in Health Care Reduces Delays & No-Shows Enables Continuity of Care Reduces Stigma
Our Pilot Partnered with Value Options and American Well Designed Virtual Provider Connect (vpc) Breakthrough epsychtoday
Our Pilot Developed P&Ps & Best Practices Trained Docs in vpc Brevard Family Partners - Hub The Haven - Hub Went Live in May 2013 Over 100 Individual Sessions All Children
Legislative Update House and Senate Bills Agency for Healthcare Administration
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BIG PICTURE: HEALTH CARE EXPENSES WILL RISE Source: Centers for Medicare & Medicaid Services, Estimated Financial Effects of the Patient Protection and Affordable Care Act, as Amended, April 22, 2010.
REFORM WON T FIX THAT.
CHANGING WHERE CARE IS OFFERED WILL HELP REDUCE COSTS. $ GOAL
CHANGING LOCATION REQUIRES TECHNOLOGY AND NEW TEAM ROLES. Telehealth Team Care Self-Care mhealth