Reaching Out With
Telehealth

Lloyd Sirmons
Executive Director
Alabama Partnership for Telehealth
Can you imagine what
healthcare would be like if…
• Clinical care was available anytime and anywhere
• Clinicians could ob...
What is Telehealth
Telehealth is the use of
telecommunications and information
technology to provide access to
health asse...
APT
Alabama Partnership for TeleHealth,
Inc. (ATP), is a 501(c)3, nonprofit
corporation, with a focus on
increasing access...
Business Model
• 501(c)3 – Not for Profit
• Network of Partners
• Services Provided:
• Field-Based Telehealth Liaisons
• S...
The Need for Telehealth
•
•
•
•
•
•
•

Clinician shortages
Rural/Urban underserved
Aging population
Administrative meeting...
The Need for Telehealth
• Healthcare providers are coming under increasing
pressure to improve the quality of care deliver...
Telehealth Applications
•
•
•
•
•
•
•
•

Hospitals
SNF (Skilled Nursing Facilities)
Clinics
Schools
Corrections
Physician’...
Barriers to Telemedicine
•
•
•
•
•
•
•

Reimbursement
Physician buy-in
Infrastructure and Hardware costs
Limited bandwidth...
Telehealth Reimbursement
Medicaid and private insurance coverage
Medicaid
Private insurance
No required coverage
Ethics in Telemedicine
• Security & Confidentiality
• Diminished level of care
• Overuse or Abuse
– Doctor shopping
Not For
Everyone/Everything
Telepharmacy Services
•
•
•
•
•

drug review/monitoring
oral and sterile compounding verification
medication therapy manag...
Evaluating The Impact of Telepharmacy by
Philip J. Schneider, looked at the Impact of remote
pharmacist review of medicati...
The number of times that nurses obtained and
administered medications without pharmacist review
declined by 35.3% after im...
Remote review of medication orders by
pharmacists when the hospital pharmacy was
closed decreased the number of potential
...
“The best cure for a sluggish
mind is to disturb its routine.”
William H. Danforth
Lloyd Sirmons
Executive Director
912-337-6183
lloyd.sirmons@alabamatelehealth.org
Alabama Pharmacy Association Mid Winter Conf. 2014
Alabama Pharmacy Association Mid Winter Conf. 2014
Alabama Pharmacy Association Mid Winter Conf. 2014
Alabama Pharmacy Association Mid Winter Conf. 2014
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Alabama Pharmacy Association Mid Winter Conf. 2014

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Alabama Pharmacy Association Mid Winter Conference - Feb. 23, 2014

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  • Unique Features (Open vs. H&S) -
    - Multiple specialty centers allow for more resources, more competition and more support for patient population
    - Flexibility for accessing services
    - Flexibility for adding/augmenting new locations based on needs
    - Creation of a new market force for the specialty centers (augment their clinical panel to address needs)
    - Improved Access “Webbing”
    - primary to primary - peer review, education
    - primary to specialty - more options to address needs
    - Access any specialty center - e.g., added independent derm based on need
  • Alabama Pharmacy Association Mid Winter Conf. 2014

    1. 1. Reaching Out With Telehealth Lloyd Sirmons Executive Director Alabama Partnership for Telehealth
    2. 2. Can you imagine what healthcare would be like if… • Clinical care was available anytime and anywhere • Clinicians 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!!!
    3. 3. What is Telehealth Telehealth is the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across distance.
    4. 4. APT Alabama Partnership for TeleHealth, Inc. (ATP), is a 501(c)3, nonprofit corporation, with a focus on increasing access to healthcare through the innovative use of technology.
    5. 5. Business Model • 501(c)3 – Not for Profit • Network of Partners • Services Provided: • Field-Based Telehealth Liaisons • Support for Credentialing • Scheduling System • Centralized PACS System • 24/7 support for network partners
    6. 6. The Need for Telehealth • • • • • • • Clinician shortages Rural/Urban underserved Aging population Administrative meetings Clinical education programs Travel time Delayed treatment
    7. 7. The Need for Telehealth • Healthcare providers are coming under increasing pressure to improve the quality of care delivered to patients while decreasing the cost to provide this improved care. • As the population ages and chronic disease explodes, the healthcare delivery system will be forced to treat larger numbers of patients with fewer and limited resources. • The main DRIVERS behind the expanding application of telehealth: 1. 2. the desire to improve healthcare services for all, especially in rural areas and the need to decrease costs and increase efficiencies while improving workflow.
    8. 8. Telehealth Applications • • • • • • • • Hospitals SNF (Skilled Nursing Facilities) Clinics Schools Corrections Physician’s Office Remote Patient Monitoring Pharmacies
    9. 9. Barriers to Telemedicine • • • • • • • Reimbursement Physician buy-in Infrastructure and Hardware costs Limited bandwidth Program Sustainability Resistance to new technology Political agendas that can derail progress and health system reform
    10. 10. Telehealth Reimbursement Medicaid and private insurance coverage Medicaid Private insurance No required coverage
    11. 11. Ethics in Telemedicine • Security & Confidentiality • Diminished level of care • Overuse or Abuse – Doctor shopping
    12. 12. Not For Everyone/Everything
    13. 13. Telepharmacy Services • • • • • drug review/monitoring oral and sterile compounding verification medication therapy management (MTM) patient assessment patient counseling
    14. 14. Evaluating The Impact of Telepharmacy by Philip J. Schneider, looked at the Impact of remote pharmacist review of medication orders in three small community hospitals A longitudinal study was conducted in three community hospitals without 24-hour pharmacy services before and after the implementation of telepharmacy services. Override reports from automated dispensing cabinets were reviewed. Charts were reviewed for errors and potential adverse drug events. Pharmacist interventions during times when the pharmacy was closed were evaluated. Cost estimates were based on a proprietary intervention tracking program. Surveys were administered to staff nurses and pharmacists to assess concerns about medication-use, safety and job satisfaction.
    15. 15. The number of times that nurses obtained and administered medications without pharmacist review declined by 35.3% after implementation of the telepharmacy service. There was a significant reduction in the percentage of high-risk medications obtained without a pharmacist review. Three potential adverse drug events were discovered before implementing remote order review versus none in the postimplementation period. The number of pharmacist interventions increased from 15 to 98 per week after implementing remote order review by pharmacists. Estimated cost savings resulting from preventing, identifying, and resolving medication-related problems were $261,109 per hospital in total cost saved or avoided. Nurses’ survey scores reflected increased comfort with the medication-use system, patient safety, and job satisfaction.
    16. 16. Remote review of medication orders by pharmacists when the hospital pharmacy was closed decreased the number of potential adverse drug events reported and improved job satisfaction among nurses. http://www.ajhp.org/content/70/23/2130
    17. 17. “The best cure for a sluggish mind is to disturb its routine.” William H. Danforth
    18. 18. Lloyd Sirmons Executive Director 912-337-6183 lloyd.sirmons@alabamatelehealth.org
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