brooke yeager, msc, rrt program coordinator, emergency and inpatient telemedicine services medical...

B R O O K E Y E A G E R , M S C , R R T

P R O G R A M C O O R D I N AT O R , E M E R G E N C Y A N D I N PAT I E N T T E L E M E D I C I N E S E R V I C E S

M E D I C A L U N I V E R S I T Y O F S O U T H C A R O L I N A

WHAT IS TELEMEDICINE?TelehealthBroad definition of health services provided across a

distance through electronic medical information exchange

Telemedicine The use of electronic communications to exchange

medical information from one site to another to provide medical care to a patient.

TELEHEALTH ON THE RISE

Year Georgia TeleHealth Encounters

2006 82007 8,000+2008 9,900+2009 18,000+2011 40,000+2012 70,000+

TELEHEALTH ON THE RISEConsumer Demands Fast, convenient tech

Value-Based Care Changing payer system

Politicians Agree!

High-speed Broadband Connectivity 3% homes in 2000 70% homes in 2013

Source: http://venturebeat.com/2014/10/20/why-telemedicines-window-is-finally-opening/

ORGANIZATION OF SERVICES

MUSC PROGRAMSOperational School-Based Clinics (RTs and asthma management) Maternal-Fetal Medicine Neurology EEG Pediatric Emergency and Critical Care Pediatric GI Pediatric Burn ICU (and ICU Innovations) Psychiatry (Victim/Trauma Specialty) Outpatient Services (Nutrition, Sickle Cell, Pediatrics, Transplant follow-up, Surgical follow-up, etc.)

In Development Sexual Assault Pediatric Heart Transplant Neonatology Cardiology Child Abuse Wound Care/Skilled Nursing

BARRIERS TO SUCCESS

(DIMINISHING) BARRIERS Lack of reimbursement (improving) Parity Laws and

Medicare Coverage Credentialing (by proxy) Connectivity (increasing) Cost of technology (decreasing) Fear of change/unknown (we have to change this)

PARITY LAWS

CREDENTIALINGCredentialing of individual providers at each outlying facility has

traditionally been a big road block

New CMS and Joint Commission standards allow for credentialing-by-proxy

Referring facility agrees to accept credentialing decisions by the consulting facility

Consulting facility must be Joint Commission accredited Consulting facility provides a list of physicians credentialed to provide the

selected services Referring facility provides performance review information to assure quality

of care

These options should substantially reduce the time and resources required for credentialing procedures.

EVOLUTION OF TECHNOLOGY

The speed of innovation is both a blessing and a curse.

“State of the Art” three years ago may now be obsolete.

Must avoid “New Toy Syndrome”

Adaptability and flexibility of system is absolutely essential Standard communication platform Wireless capability Ability to integrate with or transition to handheld devices Constant feedback and process improvement

TELEHEALTH EQUIPMENT

TELEMEDICINE UNITS

PERIPHERALS

OPPORTUNITIES FOR RESPIRATORY THERAPISTS

Outpatient monitoring (COPD, Asthma, and home vent patients)

Physician offices (telespirometry)

Education

Management

Questions