Beth O’Connor, M. Ed. Virginia Rural Health Association
What is telehealth? <ul><li>Telehealth is the utilization of information and telecommunications technologies to electronic...
What? <ul><li>Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vi...
What does it mean for rural? <ul><li>Access to specialists  </li></ul><ul><ul><li>Do without or local doc goes beyond trai...
For example… <ul><li>Southwest Virginia Community Health Systems (SVCHS) </li></ul><ul><ul><li>Clinics in Saltville, Tazew...
<ul><li>Cardiology </li></ul><ul><li>Dermatology </li></ul><ul><li>Diabetes </li></ul><ul><li>Emergency Medicine </li></ul...
Child Telepsychiatry <ul><li>Child Psychiatry is the most underserved medical specialty </li></ul><ul><li>Complicated diag...
UVA Provides… <ul><li>Initial Child Psych Evaluations  </li></ul><ul><li>Medication Follow-Up Visits and Management </li><...
Type of diagnosis <ul><li>ADD/ADHD </li></ul><ul><li>Oppositional Behavior </li></ul><ul><li>Psychotic Disorder </li></ul>...
Does it work? <ul><li>As reliable  as in-person for clinical diagnosis and neurological exams </li></ul><ul><li>As effecti...
Major implementation issues <ul><li>Reimbursement  </li></ul><ul><li>Start-up & Capital Costs </li></ul><ul><li>Licensing ...
Reimbursement - who pays? <ul><li>Rules vary from state to state </li></ul><ul><li>Effective 2011 - most insurance in Virg...
Start-up & Capital Costs <ul><li>Rural T-1 connection = $1,200/month (less fed assistance) </li></ul><ul><li>Broadband fib...
Licensing of providers <ul><li>Rules vary from state to state </li></ul><ul><li>North Carolina license not valid in Virgin...
Broadband <ul><li>No broadband = no telemedicine </li></ul>
Contact: Beth O’Connor Virginia Rural Health Association 540-231-7923 [email_address]
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Beth O'Connor, M. Ed. Virginia Rural Health Association at Yahoo:

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Beth O'Connor, M. Ed. Virginia Rural Health Association at Yahoo:

  1. 1. Beth O’Connor, M. Ed. Virginia Rural Health Association
  2. 2. What is telehealth? <ul><li>Telehealth is the utilization of information and telecommunications technologies to electronically distribute health care services and health care data between health care providers, or between health care providers and patients. - Virginia Telehealth Network </li></ul>
  3. 3. What? <ul><li>Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. - American Telemedicine Association </li></ul>
  4. 4. What does it mean for rural? <ul><li>Access to specialists </li></ul><ul><ul><li>Do without or local doc goes beyond training </li></ul></ul><ul><ul><li>Often only option for indigent/uninsured </li></ul></ul><ul><li>Reduces rural isolation for docs </li></ul><ul><li>Access to provider training & other resources </li></ul><ul><li>Patient education </li></ul>
  5. 5. For example… <ul><li>Southwest Virginia Community Health Systems (SVCHS) </li></ul><ul><ul><li>Clinics in Saltville, Tazewell, Meadowview, Troutdale </li></ul></ul><ul><ul><li><10,000 combined population </li></ul></ul><ul><li>University of Virginia Telemedicine provides access to specialists of... </li></ul>
  6. 6. <ul><li>Cardiology </li></ul><ul><li>Dermatology </li></ul><ul><li>Diabetes </li></ul><ul><li>Emergency Medicine </li></ul><ul><li>Endocrine </li></ul><ul><li>ENT </li></ul><ul><li>Gastroenterology </li></ul><ul><li>Genetics </li></ul><ul><li>Geriatrics </li></ul><ul><li>Gynecology </li></ul><ul><li>Hematology </li></ul><ul><li>Infectious Disease </li></ul><ul><li>Nephrology </li></ul><ul><li>Neurology </li></ul><ul><li>Neurosurgery </li></ul><ul><li>Ophthalmology </li></ul><ul><li>Orthopedic </li></ul><ul><li>Obesity </li></ul><ul><li>Oncology/Tumor boards </li></ul><ul><li>Pain management </li></ul><ul><li>Pediatric cardiology </li></ul><ul><li>Pediatric nephrology </li></ul><ul><li>Pediatric oncology </li></ul><ul><li>Plastic surgery </li></ul><ul><li>Psychiatry </li></ul><ul><li>Pulmonary medicine </li></ul><ul><li>Radiology </li></ul><ul><li>Rheumatology </li></ul><ul><li>Surgery </li></ul><ul><li>TCV </li></ul><ul><li>Toxicology/Poison control </li></ul><ul><li>Urology </li></ul><ul><li>Wound care </li></ul>
  7. 7. Child Telepsychiatry <ul><li>Child Psychiatry is the most underserved medical specialty </li></ul><ul><li>Complicated diagnostic and medication issues can stress primary care providers </li></ul><ul><li>Long commutes to treatment sites are costly and lead to school absences </li></ul>
  8. 8. UVA Provides… <ul><li>Initial Child Psych Evaluations </li></ul><ul><li>Medication Follow-Up Visits and Management </li></ul><ul><li>24/7 On Call for Urgent Medication Issues </li></ul><ul><li>Necessary Administrative Support and Record Management </li></ul><ul><li>Care Supervised by 2 board certified Child Psychiatrists </li></ul><ul><li>4500 visits 2007 - 2009 </li></ul>
  9. 9. Type of diagnosis <ul><li>ADD/ADHD </li></ul><ul><li>Oppositional Behavior </li></ul><ul><li>Psychotic Disorder </li></ul><ul><li>Bipolar Disorder </li></ul><ul><li>Depression </li></ul><ul><li>Anxiety </li></ul><ul><li>Substance Abuse </li></ul><ul><li>And more! </li></ul>
  10. 10. Does it work? <ul><li>As reliable as in-person for clinical diagnosis and neurological exams </li></ul><ul><li>As effective as in-person treatment for depression and serious mental illness </li></ul><ul><li>Would you prefer face to face? </li></ul><ul><ul><ul><li>54% = disagree </li></ul></ul></ul><ul><li>Did it save you money? </li></ul><ul><ul><ul><li>92% = agree </li></ul></ul></ul>
  11. 11. Major implementation issues <ul><li>Reimbursement </li></ul><ul><li>Start-up & Capital Costs </li></ul><ul><li>Licensing of providers </li></ul><ul><li>Broadband Access </li></ul>
  12. 12. Reimbursement - who pays? <ul><li>Rules vary from state to state </li></ul><ul><li>Effective 2011 - most insurance in Virginia valid for telemedicine </li></ul><ul><li>10 others: CA, CO, HI, KY, LA, ME, NH, OK, OR, TX </li></ul><ul><li>Medicare rules convoluted </li></ul>
  13. 13. Start-up & Capital Costs <ul><li>Rural T-1 connection = $1,200/month (less fed assistance) </li></ul><ul><li>Broadband fiber = $400/month </li></ul><ul><li>Equipment = $22,000 </li></ul>
  14. 14. Licensing of providers <ul><li>Rules vary from state to state </li></ul><ul><li>North Carolina license not valid in Virginia </li></ul><ul><li>17 states have telehealth provisions for out of state providers (AL, HI, LA, MD, MN, MO, MS, MT, NV, NM, OH, OK, OR, TN, TX, WA, WV) </li></ul><ul><li>Discussion surrounding model of nurse compact </li></ul>
  15. 15. Broadband <ul><li>No broadband = no telemedicine </li></ul>
  16. 16. Contact: Beth O’Connor Virginia Rural Health Association 540-231-7923 [email_address]

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