MN Broadband Conference 2019: Blandin Foundation

1. gpTRAC.org
Telehealth
The Importance of the “Last Mile”

3. gpTRAC.org
gpTRAC Provides
Resources
● www.gptrac.org (toolkits, assessments, sample forms)
Contacts
● A national network of telehealth programs, and
● Close relationships with many programs in the Great Plains region.
On-site Training and Consulting (by contract)
● Clinician effectiveness with video and other technologies
● Site evaluation and readiness
● Resource for discussions/decision making
2020 Annual Conference – SAVE THE DATE
● May 17-19, Minneapolis, MN

4. Mobile Health
Name Game…

5. Word Salad…
Telehealth: (ATA)
● the remote delivery of
health care services and
clinical information using
telecommunications
technology
Telehealth: (HRSA)
● the use of electronic
information and
telecommunications
technologies to support and
promote long-distance
clinical health care
Telemedicine:
● (generally) real-time
delivery of a clinical
service involving both
a provider and a
patient (audio/video)
Remote Patient Monitoring:
● a modality that
monitors physiology
and behavior to
maintain best function

7. Now…Future…

8. gpTRAC.org
The Patient Perspective
Marsha Waind, Outreach & Telehealth
Altru Health

9. Altru
Telemedicine
Named Rural
Health Program of
the Year 2018

10. Oncology
Cardiology
Pulmonology
Urology
Wound care
Diabetes care
Infectious Disease
Psychiatry
OB
Neurology
Nephrology
Renal Care
GI
Dermatology
Psychiatry
Stroke Care
Burn Care
Telemedicine

11. Virtual Care
Manage appointments
Request med refill
See test results
Send photos or videos
Have a live video appointment
Manage health info and appointments for family
Capture health info
Billing and payment
Get estimates of costs
Accurate Vaccination List!

12. Connected Care
Send real time health information
to your provider and participate
in your healthcare from home,
work or school

14. Remote Patient Monitoring

15. Telemedicine
•Patient at rural facilities with
nurse telepresenter
connects with Altru provider
•Convenient
•Uses regional resources:
US, labs
MyChart
Video Visits
•Video to patient over mobile
device
•Reduces office visits, travel
•Further develops
relationship with OB doctor
MyChart
Virtual
Check-in
visits
•Patient uses portal to stay
connected with OB care
staff
•Sends BP, weight, fetal
heart rate
•Identifies need further care
Altru OB Virtual Care
Creates efficiencies for provider
with Regional Outreach

17. Face of Rural
Healthcare

18. Provide the care
Where they want it
When they want it
How they want it
So they can live where
they want

19. gpTRAC.org
Provider Perspective
Lisa Wahl, TeleHealth Business Analyst
Allina Health

20. The FCC defines broadband as
internet connection speeds of at
least 25 Mbps download and
3 Mbps upload speeds.

21. Network Access
21
Fiber – Ideal for telehealth
Cable modem – meets telehealth requirement
Digital Subscriber Line (DSL) – case by case evaluation
Wireless & Satellite – not ideal due to latency, instability

22. 2019 Provider Broadband
Service Inventory. (1)
“Wireline broadband Internet access
service, (…) is a service that uses
existing or future wireline facilities
of the telephone network to provide
subscribers with Internet access
capabilities.” (2)
Wireline broadband speeds of
at least 25 Mbps downstream and 3
Mbps upstream.

23. Percentage of population with access
to fixed broadband service of
23/3Mbps or higher advertised speed.
Less than 20%
20 – 40%
40 – 60%
60 – 80%
Greater than 80%
Fixed Broadband
Availability(3)

24. Fewer than 10% of U.S.
physicians practice in rural
communities, where 25% of
Americans live. (3)

25. 40.1 physicians per 100,000 rural residents as
opposed to 134.1 per 100,000 in urban areas. (4)
2493 patients per rural physician
745 patients per physician

26. Example: Overnight hospitalist service
Patient
Nurse
PhysicianAdministration
• Allows one physician to provide cross
coverage at more than one hospital at
a time
• Quick access to physicians, nurses no
longer need to stack request until they
feel waking the physician is justified
• Patient needs are address quickly and
efficiently
• Patients can remain close to home
• Allows local physicians better work life
balance.

27. Technology
27
30x optical zoom camera controlled by
physician or nurse
24” monitor
Wired speakerphone
Small form factor wireless PC
Aluminum cart with locking computer
storage and lithium iron battery for
better battery life

28. Citations
1. https://mn.gov/deed/programs-services/broadband/maps/general-maps.jsp
2. https://www.federalregister.gov/documents/2005/10/17/05-20830/appropriate-framework-for-
broadband-access-to-the-internet-over-wireline-facilities
3. https://www.fcc.gov/reports-research/maps/connect2health/index.html#ll=46.17983,-
94.3396&z=7&t=broadband&bbm=fixed_access&dmf=none
4. Drake C, Zhang Y, Chaiyachati KH, et al. The Limitations of Poor Broadband Internet Access for
Telemedicine Use in Rural America: An Observational Study. Ann Intern Med. [Epub ahead of print 12 May
2019]171:382–384. doi: 10.7326/M19-0283
5. https://www.ruralhealthweb.org/getattachment/Advocate/Policy-
Documents/QualityofLifeRecruitmentRetentionProvidersFeb2015.pdf.aspx?lang=en-US

29. gpTRAC.org
Questions

30. Resources:
● Great Plains Telehealth Resource &
Assistance Center: www.gptrac.org
● National Consortium of Telehealth
Resource Centers (all TRCs):
www.telehealthresourcecenter.org
● Medicare Learning Network –
Telehealth Services Fact Sheet
● Am I Rural – Go here to determine if
you are a qualified location
● Rural Health Information Hub:
www.ruralhealthinfo.org
● American Telemedicine Association:
www.americantelemed.org
● SEARCH - National Research Conference:
https://searchsociety.org/2019-telehealth-
research-symposium/
● RJW Center for Telehealth and eHealth Law:
www.ctel.org
● Rural Health Resource Center:
www.ruralcenter.org
● National Frontier and Rural Telehealth Education
Center (NFARtec): www.nfartec.org – Substance
abuse treatment and recovery support

31. gpTRAC.org
Thank you!

32. gpTRAC.org
Contact Information:
Marsha Waind
Altru Health
mawaind@altru.org
Lisa Wahl
Allina Health
Lisa.wahl@allinahealth.com
Mary DeVany
gpTRAC
medevany@umn.edu