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(slides) (slides) Presentation Transcript

  • Telemedicine: Re-envisioning The Telephone Consultation Julie J. McGowan, Ph.D., FACMI IU School of Medicine Regenstrief Instutute
  • Coming to You through the Miracle of Modern Technology – The Telephone
  • The Consultation
    • In Person
    • Letter
    • Express Delivery
    • Telegraph
    • Telephone
    • Telehealth
    • In Person, Virtually
  • TELEMEDICINE DEFINED
    • “ ...the use of electronic information and
    • communications technologies to provide
    • and support health care when distance
    • separates the participants...”
    from: Institute of Medicine: Telemedicine: A Guide to Assessing Telecommunications in Health Care
  • What is Telehealth?
    • Video Conferencing
    • Distance Learning
    • Telemedicine
      • Asynchronous – Provider to Provider
      • Synchronous – Provider to Patient & Provider
      • Synchronous – Provider to Patient
  • Early History of Telemedicine 1950s and 1960s
    • Nebraska Psychiatric Institute - UN & state mental hospital & Interact System - Dartmouth and UVM Medical Schools [Microwave]
    • STARPAHC [Space Technology Applied to Rural Papago Advanced Health Care - Papago Indian Reservation & Public Health Hospital in Arizona
    • Alaska Satellite Biomedical Demonstration Project used NASA technology to link 26 sites across Alaska.
  • WHY PROGRESS TO TELEMEDICNE
  • The Rationale
    • Just-in-time Care
    • Improved Quality
    • Enhanced Efficiency
    • Better Professional Communication
    • Patient Satisfaction
    • Enlarged Catchment Area
    • Cost Savings?
  • Culture – Medical &
    • Re-engineering practice
    • Crossing referral lines
    • Comfort with and understanding of Technology as a Tool
    There are no problems…. just insurmountable opportunities
  • “REPORT CARD” OF TELEMEDICNE EFFECTIVENESS
    • Define Desired Outcomes
      • Quality Improvement
      • Reduced Costs
      • Provider Satisfaction
      • Patient Satisfaction
    • Develop Evaluation to Assess Desired Outcomes
  • The Report Card Continued
    • Disseminate Findings
      • Select appropriate recipients
      • Combine findings with marketing strategy
    • Be Willing to Modify Program as Necessary
    • Re-Evaluate Frequently
  • EVALUATING TELEMEDICINE
  • Need for Evaluation
    • Administrative Justification
    • Sociological
      • Consulting and Referring Providers
      • Patients
    • Political
      • Patient Safety
      • Competitive Health Care Marketplace
  • Types of Evaluation
    • Technology
    • Provider and Patient Satisfaction
    • Economic Issues
    • Quality Improvement
  • Technology
    • Image vs. Use
      • Store and Forward
      • Human Interaction
        • Patient / Provider Consultation
        • Psychiatry; Orthopedics
      • Image Quality
        • Color Reliability
        • Movement Artifacts
  • Technology
    • Reliability of Technology
      • Connections
        • Ease and Reliability of Contact
        • Interface Standards
      • Peripheral Equipment
        • Quality – Digital vs. Digitized
        • Transmission Protocols
  • Provider Satisfaction
    • Comfort level with technology
    • Comfort level with process
    • Comfort level with patient communication
    • Comfort level with provider interaction
    • Unanticipated Benefits
    • Unanticipated Problems
  • Patient Satisfaction
    • Patients Follow Images
    • The Value Equation
    • Home is Where…
      • Comfort issues
      • Environmental issues
      • Economic issues
  • Economic Analysis of Telemedicine
  • 4 Ways to Look at $$$
    • Managed Care Environment
    • Multi-Payer Environment
    • Alternative Savings [Training, Patients]
    • Cost-Plus in Captive Patient Populations
  • Crossing the Quality Chasm
    • Application of standard quality measures to health care using a new tool
    • Consider:
      • QOL
      • Unintended Consequences
      • Unintended Confounders
    • Grand Canyon of Research Opportunities
  • For More Information
    • http://www.va.gov/occ/THinVA.asp
    • http:// healthit.ahrq.gov/portal/server.pt?open =514&objID=5554&mode=2&holderDisplayURL=http://prodportallb.ahrq.gov:7087/publishedcontent/publish/communities/k_o/knowledge_library/key_topics/health_briefing_01242006121308/telemedicine.html
  • ??? QUESTIONS ???