UA Telemedicine:Connecting Across the State 2012 Alabama Broadband & Telehealth Summit October 19, 2012 Lloyda B. Williams...
University of Alabama College of Community Health Science Institute for Rural Health Research Telemedicine
The Problem Disparity between patient’s needs and  health care provider availability Inadequate public transportation I...
Resulting Status   Limited specialty services to many    vulnerable populations     Across  multiple specialties     In...
UA Telemedicine InitiativesFunded Partners: West Alabama Mental Health Center USDA Grant - 4 Rural Clinics Verizon Foun...
West AL Mental Health Center Center in Demopolis, covers 5  counties: Greene, Hale, Marengo,  Sumter, Choctaw Critical s...
WAMHC (cont.)   B-M Grant: 2 fellowship positions     Rural   Public Psychiatry & Behavioral Health   Absence of fellow...
USDA GrantPartnership with 4 rural clinics with goals to provide -telepsychiatry -obstetrical consultation - educational t...
USDA Grant Sites 1) Carrolton Primary Care Clinic* 2) Cahaba Medical Center Rural Track  Site 3) Primary Care Center Mo...
USDA Grant Benefits Psychiatry svcs to pts in rural areas Decrease travel time & cost for fuel OB/GYN consultation comp...
USDA Grant Challenges Grant provided equipment ONLY, not  broadband or financial support No reimbursement for Facility U...
Verizon Foundation Grant $18,771 for Diabetes Self-  Management Follow CCHS model for pt education &  groups - ADA Certi...
DeKalb County   DeKalb County Juvenile Court    1  Psychiatrist     Extensive pre-trial psychiatry evaluations,      as...
DeKalb County (cont.)   2) DeKalb County Youth Services    2  psychiatrists     1 social worker     Svcs for children ...
Dr. Thad Ulzen - Telepsychiatry
DCYS - Diagnoses Attention Deficit Hyperactivity Disorder Oppositional Defiant Disorder Depression Anxiety Disorders -...
Current Needs Organizational vision Telemedicine infrastructure Guidelines, policies, & procedures Involvement of spec...
Evidenced Based-Practice
Questions            ?
References American Telemedicine Association  Practice Guidelines for  Videoconferencing-Based Telemental  Health, Octobe...
References (cont.)   Ulzen, T, Williamson, L, Foster, P    Parris-Barnes, K. (2008) The Evolution    of a Community-Based...
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Dr. lloyda williamson ua telemedicine connecting across the state

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Dr. lloyda williamson ua telemedicine connecting across the state

  1. 1. UA Telemedicine:Connecting Across the State 2012 Alabama Broadband & Telehealth Summit October 19, 2012 Lloyda B. Williamson, M.D., Associate Professor Psychiatry & Behavioral Medicine University of Alabama – School of Medicine
  2. 2. University of Alabama College of Community Health Science Institute for Rural Health Research Telemedicine
  3. 3. The Problem Disparity between patient’s needs and health care provider availability Inadequate public transportation Inadequate insurance payment systems Inadequate access to care
  4. 4. Resulting Status Limited specialty services to many vulnerable populations  Across multiple specialties  In acute & chronic care settings
  5. 5. UA Telemedicine InitiativesFunded Partners: West Alabama Mental Health Center USDA Grant - 4 Rural Clinics Verizon FoundationCommunity Partner: DeKalb County Youth Services
  6. 6. West AL Mental Health Center Center in Demopolis, covers 5 counties: Greene, Hale, Marengo, Sumter, Choctaw Critical shortage of psychiatrists Bristol-Myers $1.2 Million Grant - telemedicine video-conferencing equipment UA provide telepsychiatry services
  7. 7. WAMHC (cont.) B-M Grant: 2 fellowship positions  Rural Public Psychiatry & Behavioral Health Absence of fellows UA psychiatrists provide telepsychiatry services Benefits: fellows provide service Challenges: lack of fellows, inadequate time for UA psychiatrist responsibilities
  8. 8. USDA GrantPartnership with 4 rural clinics with goals to provide -telepsychiatry -obstetrical consultation - educational telemedicine (lectures, case conference presentations & shared rounds) -cameras, monitors, & other equipment
  9. 9. USDA Grant Sites 1) Carrolton Primary Care Clinic* 2) Cahaba Medical Center Rural Track Site 3) Primary Care Center Monroeville* 4) Parrish Capstone Rural Health Center*TERM Site - 17 wks for 3rd year med. students (Tuscaloosa Experience in Rural Medicine)
  10. 10. USDA Grant Benefits Psychiatry svcs to pts in rural areas Decrease travel time & cost for fuel OB/GYN consultation complex cases Timely pt appointments & tx Bridge gap of healthcare delivery Obtain CME credits through video-conf Fellows provide psychiatry svc Telesleep disorder consultation
  11. 11. USDA Grant Challenges Grant provided equipment ONLY, not broadband or financial support No reimbursement for Facility Usage Fee, no show, unpaid rental fee Unable to consistently fill fellowships No reimbursement from Medicaid for services rendered for TeleOB, Tele Nutrition---LOSS of GRANT $$$$$ Not enough psychiatrists at CCHS to provide telepsychiatry svcs
  12. 12. Verizon Foundation Grant $18,771 for Diabetes Self- Management Follow CCHS model for pt education & groups - ADA Certified Partner with Maude Whatley System
  13. 13. DeKalb County DeKalb County Juvenile Court 1 Psychiatrist  Extensive pre-trial psychiatry evaluations, assessment for juvenile sex offenders, drug abuse offenders, etc.  Spend $ for room & board, 2 deputies transport across state for eval. & back  4 - 6 weeks before assessment complete  Contract delay due to April 2011 tornados
  14. 14. DeKalb County (cont.) 2) DeKalb County Youth Services 2 psychiatrists  1 social worker  Svcs for children and adolescents  Initial psychiatric evaluation  Follow up psychiatric evaluations  12 hours of consultation/mo. (3 half days)  As of 05/2012 seen 185 youth
  15. 15. Dr. Thad Ulzen - Telepsychiatry
  16. 16. DCYS - Diagnoses Attention Deficit Hyperactivity Disorder Oppositional Defiant Disorder Depression Anxiety Disorders - PTSD Sexual abuse & neglect Parent - Child conflict Reactive Attachment Disorder Gender Identity Disorder
  17. 17. Current Needs Organizational vision Telemedicine infrastructure Guidelines, policies, & procedures Involvement of specialties Development of more relationships Expansion and maintenance ***Business plan – insurance billing - other possibilities Equipment & space
  18. 18. Evidenced Based-Practice
  19. 19. Questions ?
  20. 20. References American Telemedicine Association Practice Guidelines for Videoconferencing-Based Telemental Health, October 2009 Meyer, BC, Clarke, CA, Troke, TM, Friedman, LS. (2012)“Essential Telemedicine Elements (Tele-Ments) for Connecting the Academic Health Center and Remote Community Providers to Enhance Patient Care. Academic Medicine, 87: 1032 - 1040.
  21. 21. References (cont.) Ulzen, T, Williamson, L, Foster, P Parris-Barnes, K. (2008) The Evolution of a Community-Based Telepsychiatry Program in Rural Alabama: Lessons Learned – A Brief Report. Community Mental Health Journal. February.

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