the it landscape preparing telehealth as the new...
TRANSCRIPT
The IT Landscape Preparing TeleHealth as the New Norm
The IT Landscape: Preparing for TeleHealth as The New Norm
I. The Role of IT in TeleHealth II. How to Determine Guidelines & Considerations for
TeleHealth III. Interoperability with an EMR IV. Vendor Selection – Creating a TeleHealth Platform V. Turnkey versus In-House Build VI. HIPAA and TeleHealth
Contact Information
Amy Dorrington RN, BSN UC Health IT Epic Ambulatory Manager
• Background - Ambulatory • Clinical Educator • Operations • Clinical Compliance Officer • Coding / Auditor
TeleHealth The practice of medicine at a distance
What is the Role of IT in TeleHealth?
§ IT is a vehicle to support TeleHealth initiatives § Understand from end user perspective
§ Clinical / Revenue Cycle / Patient § Physician buy in – Operations / TeleHealth team § Working with educating the physicians – Operations /
TeleHealth team
How to Work with IT?
§ Strategic Development § Technical Strategy § Member of the team
§ IT is not responsible to lead the team § CIO partnering with strategic development § Operational decision points
§ Validation sessions
Successful IT Examples
§ Implementation of our EMR § Physician Advisory § Clinical Informatics Steering Committee § Importance of SMEs
§ Mobile Mammography / Phlebotomy § OB Services West Chester Hospital
Determining Guidelines & Considerations for TeleHealth
§ IT Guidelines for TeleHealth Programs § Maximizing interoperability
§ Utilize existing or recommended platform vendors § Unable to utilize existing TeleHealth platforms?
§ Propose optimal solution to Informatics Committee § Utilize EMR as the repository for all clinically relevant
patient data § Collaborate with IS&T to integrate relevant patient data
into EMR
How to Determine Guidelines & Considerations?
§ Who? § IT Leadership § TeleHealth Strategic Committee § Senior Leadership § Physicians
§ Setting a baseline § Provides clarity to guidelines
How to Determine Guidelines & Considerations?
§ What? § Determining use cases § Inpatient / Outpatient / Home § UCH Patients vs. Non UCH patients
How to Determine Guidelines & Considerations
§ When / Where? § Need to be set early and communicated
§ Third party vendor requests § Nurse Navigation Tool – not involving IT early
§ Why? § Mission for the TeleHealth initiative § Vision – to be the best academic organization
What will an EMR bring?
§ Components / care delivery we want to offer § Physician to Patient § Physician to Physician § Hospital to Hospital
What will an EMR bring?
§ Operational Impact § Patients exist in EMR vs. Doesn’t exist in EMR § Revenue § Scheduling / Billing / Referrals § Medical Records
Interoperability
Vendor Selection: Creating the TeleHealth Platform
§ Vendor selection Process § Creating a TeleHealth Platform
§ Interoperability with existing systems § Comparing vendors
§ Who are the right people to evaluate? § Physicians § CIO / IT Managers § TeleHealth Director
Vendor Selection: Creating the TeleHealth Platform (cont)
§ Comparing vendors § Finding a partner
§ IT not able to serve all TeleHealth needs § What can be done in house with current
systems?
Vendor Selection: Evaluation
§ Comparing Vendors § What is important to evaluate?
§ Video Capability § PACS / Imaging Capability § EMR Integration § Peripherals (scopes, etc)
Vendor Selection – Evaluation (cont)
§ Comparing vendors § What is important to evaluate?
§ Care Pathways § Mobility (carts vs. hand-held) § Cost § Support / Service § Data Storage (EMR-lite) § Flexibility and Responsiveness
Vendor Selection – Evaluation (cont)
§ Demonstration § Inpatient consults § Outpatient consults § Home Visits § Device Integration
§ Overall Fits
Determining Hardware Needs
§ Determining Hardware Needs § Workstations § Cameras § Tablets / iPads § Video equipment
Who Needs to be Involved
§ Involving necessary teams from the beginning is essential for a successful implementation § Legal § IT § Physician Champion § Hospital Administration § Credentialing
Turnkey versus In-House Build
§ Points to consider when analyzing Pros/Cons: § Time to market § Cost § Support § Scalability § Full Package with services § Working with other Health System IT Departments
Turnkey Solution
§ Fits into “any” infrastructure § No additional FTE to support remote locations § Likely to come with additional services (i.e., EMR) § HIPAA compliant
§ Data encryption § Full Package with services § Easy to maintain with vendor support
In-House Build
§ Able to build system to meet exact specifications § How do you support hardware located at other Health
Systems? § Less costly hardware
§ Industry standard hardware § Open Architecture versus Proprietary
Other Considerations
§ Access to other tools: PACS, EMR § How do you get consultation notes to/from outside of
the Health System? § HIPAA
How does HIPAA apply?
§ Privacy and Confidentiality in the medical realm § Safeguarding a patient’s medical records § Storage of electronic files, images, audio/video tapes
§ Handled with caution ascribed to paper documents
The HIPAA Challenge
§ Increased number of people have potential access to a patient’s records
§ Transmission of information § Lends itself to hackers and other potential
exposure § Protocols must be scrupulously followed
§ Ensure that patients are informed about all participants in a TeleHealth consultation
Maintaining HIPAA in TeleHealth
§ Encryption in communication § Encryption in video/audio storage § Verifying Participant have a medical need § Disable TeleHealth devices when not being used § Password and User ID protected
In General…
§ HIPAA rules apply with TeleHealth § Be aware of others hearing what you are discussing § Clearly identify participants
§ Define consultative role § Perform periodic security reviews of the telemedicine
devices § Also includes the vendor’s IT support teams
TeleHealth Conclusion
§ TeleHealth needs to work with your electronic health record § Synchronization of patient data to support patient
care § Involve IT early § Operational support is key
§ TeleHealth is not an IT project
Questions - ?