Telemedicine and Stroke Care in Maryland


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Presentation by Dr. Eric M. Aldrich, VP for Medical Affairs, Howard County General Hospital, Johns Hopkins Health System

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Telemedicine and Stroke Care in Maryland

  1. 1. Telemedicine and Stroke Care in Maryland Dr. Eric M. Aldrich Vice President for Medical Affairs Howard County General Hospital Johns Hopkins Health System
  2. 2. Maryland Demographics  Population : 6 Million  Racial/Ethnic Composition:  White (60%)  Black or African-American (30%)  Hispanic (5%)  Asian or Pacific Islander (5%),  Native American(< 1%)  Rural Demographics :  29% live in state-designated rural jurisdictions (1.6 million)  7% live in federally-designated rural jurisdictions (390,000)  Over-65 population is highest in federally-designated rural areas (15.6%)  Lower Median household income in state rural and federal rural areas compared to state  Higher prevalence of poverty and unemployment, lower educational attainment in federal rural areas
  3. 3. Emergency Medical Services: MIEMSS     Maryland Institute for Emergency Medical State Systems Independent state agency Directed by Governor’s EMS Board Oversees and coordinates all aspects of Maryland’s EMS system  Education  Communications  Designation  Licensure/regulation  Public education/prevention
  4. 4. A Brief History of Stroke in Maryland 1996 1999 2002 2003 2004 2004 2005 2006 2007 FDA approves tPA ASA “Operation Stroke” Program State Advisory Council on Heart Disease and Stroke MIEMSS creates pre-hospital stroke care protocols JCAHO Primary Stroke Center Certification Program “Operation Stroke” program ends ASA Stroke Systems of Care Program Maryland State Stroke Systems Plan MIEMSS Stroke System created MIEMSS certification of stroke centers
  5. 5. History of Telestroke in Maryland 2007 2009 2010 2011 2012 Bi-annual Report of the State Advisory Council on Heart Disease and Stroke identifies the need for telemedicine State Advisory Council on Heart Disease and Stroke again identifies the need for telemedicine. Preliminary discussions with DHMH begin Maryland Health Care Quality and Cost Council Telemedicine Task Force (White Paper) Telemedicine bills proposed to the General Assembly DHMH assigns MIEMSS and MHCC to direct a broader Maryland Telemedicine Task Force (Full Report) New Telemedicine bills proposed to the General Assembly
  6. 6. Maryland Telemedicine Task Force     Clinical Advisory Group Technology and Standards Advisory Group Financial and Business Model Group Final Report: December 2011
  7. 7. Telemedicine in 2012    Currently several bills before the General Assembly Cover a variety of topics including: Medical Issues, Licensing, Credentialing, Technical Standards and Reimbursement Efforts hindered by the current economic environment
  8. 8. Lessons Learned         All politics is local: Originally began as a grass roots effort Played to our strengths: MIEMSS Friends in high places: Gained real momentum by handing off the leadership role to key state agencies Know your enemy: Maryland tends to take the approach of plan, coordinate and centralize Divide and conquer: Identified specific problems to work on Money talks BS walks: Kept the business aspects in mind Strength in numbers: Went beyond just stroke (other clinical uses) Patience hath virtue: Keep the long term goal in mind