Don't miss our upcoming webinars! Subscribe today!
In April, CCSN virtually met with MPPs throughout Ontario to discuss our COVID-19 and Cancer Care - Wave 2 Survey. During these meetings, we discussed the difficulty cancer patients and pre-diagnosis patients have had with accessing cancer services during the pandemic and the importance of ensuring the cancer patients receive their 1st and 2nd vaccine doses in a timely manner.
In this webinar, CCSN's Public Policy Analyst Conrad will begin by sharing some of the highlights from our meetings with Ontario MPPs. He will then turn things over to our patient advocates and they will share some of their reflections from our meetings as well as their own experiences with accessing cancer care during the pandemic. Lastly, Conrad will take a closer look at the Ontario data from our survey.
View the YouTube video: https://youtu.be/05u4i89WFfQ
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Don't miss our upcoming webinars! Subscribe today.
In this webinar:
Our presenters will talk about the work the LAO does, provide information about the causes and symptoms of lymphedema, and inform lymphedema patients on how to access help and support. They will also include the physiotherapist perspective and discuss what treatments are available.
View the YouTube video: https://youtu.be/Wg1dzEOBPEA
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Don't miss our upcoming webinars! Subscribe today!
In April, CCSN virtually met with MPPs throughout Ontario to discuss our COVID-19 and Cancer Care - Wave 2 Survey. During these meetings, we discussed the difficulty cancer patients and pre-diagnosis patients have had with accessing cancer services during the pandemic and the importance of ensuring the cancer patients receive their 1st and 2nd vaccine doses in a timely manner.
In this webinar, CCSN's Public Policy Analyst Conrad will begin by sharing some of the highlights from our meetings with Ontario MPPs. He will then turn things over to our patient advocates and they will share some of their reflections from our meetings as well as their own experiences with accessing cancer care during the pandemic. Lastly, Conrad will take a closer look at the Ontario data from our survey.
View the YouTube video: https://youtu.be/05u4i89WFfQ
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Don't miss our upcoming webinars! Subscribe today.
In this webinar:
Our presenters will talk about the work the LAO does, provide information about the causes and symptoms of lymphedema, and inform lymphedema patients on how to access help and support. They will also include the physiotherapist perspective and discuss what treatments are available.
View the YouTube video: https://youtu.be/Wg1dzEOBPEA
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
To understand the definition of telemedicine
Knowing the history of telemedicine
To understand the advantages of telemedicine
Telemedicine during COVID 19
Future of telemedicine
Benefits of telemedicine
Don't miss our upcoming webinars. Subscribe today!
In this webinar:
Attendees will learn about the role of exercise in the cancer care pathway, and the potential benefits from building a habit of moving more. We will also discuss the EXCEL study: EXercise for Cancer to Enhance Living Well, and how it is providing a sustainable exercise and behaviour change program to those living with cancer in rural and remote regions across Canada. Learn what is involved in this exercise research program and how to get involved online now!
View the YouTube video: https://youtu.be/BIOviCzESwA
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
During March, CCSN and patient advocates met with Alberta MLAs to discuss our COVID-19 and Care Care Disruption - Wave 2 Survey and the importance of prioritizing cancer patients in the vaccine rollout. In this webinar, we will hear from Tim Monds, a lung cancer patient advocate, share some outcomes from our meetings, discuss the key findings from our survey, and take a closer look at the Alberta data.
View the YouTube video: https://youtu.be/Tq5OJqA5_Rc
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Project ECHO (Extension for Community Health Outcomes)icornpresentations
Sanjeev Arora MD, Distinguished Professor of Medicine (Gastroenterology/Hepatology); Director of Project ECHO®
Department of Medicine, University of New Mexico Health Sciences Center
Tele-ophthalmology: the new normal in current timesObaidur Rehman
Covers telehealth and telemedicine in general. Tele-ophthalmology development in India. Practice and patterns as defined by concerned authorities. Guidelines as set up Govt of India. Current tele-ophthalmology projects in India
Prof Diana Schmidt's Talk at AIIMS on 8th January 2008Sukhdev Singh
Prof Diana Schmidt, School of Medical Informatics of Heidelberg University and Heilbronn University Germany, would be gave a talk on “Factors for success and failure of Telemedicine in Germany and USA” on 8th January 2008. She has permitted me to upload her presentation for the benefit of "Indian Association for Medical Informatics" members. It is being shared through IAMI Delhi Chapter Blog - http://iamidelhi.blogspot.com
The 10th Annual Utah Health Services Research Conference: A High-Quality Electronic Health Record and EDW: Tools to Eliminate Health Disparities. By: Carrie L. Byington, H.A. and Edna Benning Presidential Professor of Pediatrics Director, Utah Center for Clinical and Translational Science AVP Faculty and Academic Affairs, Health Sciences
Health Services Research Conference: March 16, 2015
Patient Centered Research Methods Core, University of Utah, CCTS
This presentation is an introduction to telemedicine and telehealth. It explains common terminology and the different types of technology used. It concludes with findings from the American Medical Association on national physician use and links to additional resources.
The 2017 Texas Legislature adopted a new definition and a new approach to telemedicine and the remote delivery of health care. Two health care lawyers prepared this deck to help Texas physicians understand the new law, how it came about, and what it could mean for the practice of medicine in Texas.
"Telemedicine and Digital Health: New Texas Law, Opportunities, and Challenges" was presented at the Texas Medical Association 2017 Fall Conference, Sept. 16, 2017, as the Philip R. Overton Annual Lectureship in Medicine and the Law.
First of three presentations on "What is Telehealth, Why Telehealth and Telehealth Demo" as part of the Pennsylvania Telehealth Roundtable that took place on September 30, 2014.
To understand the definition of telemedicine
Knowing the history of telemedicine
To understand the advantages of telemedicine
Telemedicine during COVID 19
Future of telemedicine
Benefits of telemedicine
Don't miss our upcoming webinars. Subscribe today!
In this webinar:
Attendees will learn about the role of exercise in the cancer care pathway, and the potential benefits from building a habit of moving more. We will also discuss the EXCEL study: EXercise for Cancer to Enhance Living Well, and how it is providing a sustainable exercise and behaviour change program to those living with cancer in rural and remote regions across Canada. Learn what is involved in this exercise research program and how to get involved online now!
View the YouTube video: https://youtu.be/BIOviCzESwA
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
During March, CCSN and patient advocates met with Alberta MLAs to discuss our COVID-19 and Care Care Disruption - Wave 2 Survey and the importance of prioritizing cancer patients in the vaccine rollout. In this webinar, we will hear from Tim Monds, a lung cancer patient advocate, share some outcomes from our meetings, discuss the key findings from our survey, and take a closer look at the Alberta data.
View the YouTube video: https://youtu.be/Tq5OJqA5_Rc
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Project ECHO (Extension for Community Health Outcomes)icornpresentations
Sanjeev Arora MD, Distinguished Professor of Medicine (Gastroenterology/Hepatology); Director of Project ECHO®
Department of Medicine, University of New Mexico Health Sciences Center
Tele-ophthalmology: the new normal in current timesObaidur Rehman
Covers telehealth and telemedicine in general. Tele-ophthalmology development in India. Practice and patterns as defined by concerned authorities. Guidelines as set up Govt of India. Current tele-ophthalmology projects in India
Prof Diana Schmidt's Talk at AIIMS on 8th January 2008Sukhdev Singh
Prof Diana Schmidt, School of Medical Informatics of Heidelberg University and Heilbronn University Germany, would be gave a talk on “Factors for success and failure of Telemedicine in Germany and USA” on 8th January 2008. She has permitted me to upload her presentation for the benefit of "Indian Association for Medical Informatics" members. It is being shared through IAMI Delhi Chapter Blog - http://iamidelhi.blogspot.com
The 10th Annual Utah Health Services Research Conference: A High-Quality Electronic Health Record and EDW: Tools to Eliminate Health Disparities. By: Carrie L. Byington, H.A. and Edna Benning Presidential Professor of Pediatrics Director, Utah Center for Clinical and Translational Science AVP Faculty and Academic Affairs, Health Sciences
Health Services Research Conference: March 16, 2015
Patient Centered Research Methods Core, University of Utah, CCTS
This presentation is an introduction to telemedicine and telehealth. It explains common terminology and the different types of technology used. It concludes with findings from the American Medical Association on national physician use and links to additional resources.
The 2017 Texas Legislature adopted a new definition and a new approach to telemedicine and the remote delivery of health care. Two health care lawyers prepared this deck to help Texas physicians understand the new law, how it came about, and what it could mean for the practice of medicine in Texas.
"Telemedicine and Digital Health: New Texas Law, Opportunities, and Challenges" was presented at the Texas Medical Association 2017 Fall Conference, Sept. 16, 2017, as the Philip R. Overton Annual Lectureship in Medicine and the Law.
First of three presentations on "What is Telehealth, Why Telehealth and Telehealth Demo" as part of the Pennsylvania Telehealth Roundtable that took place on September 30, 2014.
World medical tourism and global health conference providing low cost child h...Gordon Otieno Odundo
7th World Medical Tourism and Global Healthcare Congress presentation to the 3rd Annual Medical Director Summit held on Sept. 21st during the Annual Congress. The Congress took place September 20th -24th 2014 at the Gaylord National Resort & Convention Center in the Washington, DC area. The esteemed presenters were CEOs and Healthcare Leaders from around the world who recognize the value of the event as the largest medical tourism event in the world where people come together for prearranged business to business meetings to maximize their ROI. The Summit gathered Chief Medial Officers and Medical Directors from top hospitals and insurance companies from around the world to collaborate and network regarding the challenges in providing quality healthcare and insurance to local and international patients, and allowed discussion with peers in other countries and learn best practices to strategically improve our organization’s planning. The presentation centered on Delivering High Quality, Low Cost Care at Scale through Primary Care : A case Study from Gertrude's Childrens' Hospital, Nairobi Kenya.Gertrude's Children's Hospital, Nairobi Kenya is the longest established paediatric hospital in East and Central Africa. The hospital is reaching out into peripheral clinics to offer child health services, vaccination and primary care. Seven day working, a shared record and IT for scheduling ensures that waiting times are very low and that continuity of care is maintained. In a competitive market forming an early relationship with children and their families is important and a well organised clinic, in a convenient location and staffed with skilled and well qualified professionals is an important part of this strategy. The model is very successful and won a Millennium Development Goal Award and is being copied by other providers in the country.
Dr Michael Sullivan
Associate Professor of Paediatric Oncology, University of Otago; Consultant Paediatric Haematologist/Oncologist in the Children’s Haematology Oncology Centre, Christchurch Hospital
Health Care Panel presented to the Minnesota Ultra High-Speed Broadband Task ...Ann Treacy
Presentations from the Health Care Panel presented to the Minnesota Ultra High-Speed Broadband Task Force on March 20, 2009. Presenters include: Stuart Speedie, Professor, U of M Medical School, Health Informatics, Karen Welle, Asst Director, MN Dept of Health, Office of Rural Health & Primary Care, Maureen Ideker, Rice Memorial Hospital, Chief Nursing Officer, Steve Mulder, Hutchinson Area Health Care Director of Quality and Clinical Services, Joe Schindler, MN Hospital Association, Mark Schmidt, SISU Chief Information Officer, Dr Eduard Michel, Emergency Physician.
Telemedicina i pacients crònics / Telemedicine in chronic patientsAntoni Parada
Telemedicina i pacients crònics. Conferència impartida pel Professor canadenc Denis Protti Health Information Science - Victoria University. Barcelona, 2 de febrer de 2012. Organitzada per la Fundació TicSalut i l’Agència d’Informació, Avaluació i Qualitat en Salut.
1. Telehealth:
A tool for the 21st century
Karen S. Rheuban MD
Professor of Pediatrics
Medical Director, Telemedicine
University of Virginia
ATA President
VTN Board Chair
Board Member, CTEL
3. Definitions
“Telemedicine” is the use of medical information
exchanged from one site to another via electronic
communications to support
• Medical diagnosis
Ongoing patient care
Remote patient monitoring
“Telehealth” encompasses a broader definition of
remote healthcare that does not always involve
clinical services
Health-related distance learning
5. Services
Videoconferencing for patient care
Store and forward applications
Distance learning
health professionals
patients
students
6. UVA Specialty/Subspecialty Participants
Cardiology Obesity
Dermatology Oncology/Tumor boards
Diabetes Pain management
Emergency Medicine Pediatric cardiology
Endocrine Pediatric nephrology
ENT Pediatric oncology
Gastroenterology
Plastic surgery
Genetics
Geriatrics Psychiatry
Gynecology Pulmonary medicine
Hematology Radiology
Infectious Disease Rheumatology
Nephrology Surgery
Neurology TCV
Neurosurgery Toxicology/Poison control
Ophthalmology Urology
Orthopedics
Wound care
7. Partnerships
Academic-community hospital linkages
Academic-academic hospital linkages
Rural clinics (FQHCs, Veteran’s clinics)
Virginia Department of Health
Virginia Department of Corrections
School health
Nursing home
Home telehealth – remote monitoring
Habitat for humanity
8. Benefits of telehealth
Patients:
• Timely access to locally unavailable services
• Spared burden and cost of transportation
• Improvement in quality of care
Health professionals (workforce shortages)
• Access to consultative services
• Access to CME
• Primary care retains oversight of patient care
Rural communities
• Enhanced healthcare/economic empowerment
9. Federal investment in telehealth
Department of Health and Human Services Department of Veterans Affairs
• National Institutes of Health Department of Commerce
• Health Resources Services Administration Department of Agriculture
• Agency for Health Research Quality Department of Labor
• Centers for Medicare and Medicaid Services Department of State
• Centers for Disease Control and Prevention
• Substance Abuse and Mental Health Services INDEPENDENT AGENCIES AND COMMISSIONS
Administration • NASA
• Food and Drug Administration •National Science Foundation
• Indian Health Service •Federal Communications Commission
•Social Security Administration
Department of Homeland Security •Office of Personnel Management
Department of Housing and Urban Development •Consumer Products Safety Commission
CDC •Appalachian Regional Commission
Department of Defense •US Agency for International Development
• Army Telemedicine Activities
• Navy Telemedicine Activities
• Air Force Telemedicine Activities
• DARPA
• Armed Forces Institute of Pathology
• Uniformed Services University of the Health
Services
10. State commitments to telehealth
Medicaid
State Rural Health Plan
State Stroke Systems of Care Task Force
Diabetes Council
Center for Innovative Technologies
Virginia Telehealth Network
Office of Minority Health and Policy of VDH
Joint Commission on Health Care
• Workforce analysis
Tobacco Indemnification Commission
Medical schools and large hospital systems
Virginia General Assembly
11.
12.
13. Patients served: UVA program
>18,000 patient encounters
> 30,000 teleradiology services/year
Services in >30 different specialties
• Emergency
• Urgent
• Single consults/follow up visits
• Block scheduled clinics
• Screenings with store forward technologies
• New mobile digital mammography van
• Retinopathy
14. More than technology and numbers:
Saving lives: Infant with Interrupted aortic arch
17. Educational programs
Broadcast continuing health
professional education
UME, GME
Patient education*
School Health Projects
18. Clinical Telemedicine – examples
High risk obstetrics
Antenatal Neonatal Guidelines, Education and
Learning System (ANGELS)
• 26% reduction in neonatal mortality in Arkansas
UVA High Risk Obstetrics Telehealth Program
• Virginia PIF grant – from Secretaries Chopra and Tavenner
• Shortage of maternal-fetal medicine specialists
• High risk population
partner with FQHC in Harrisonburg and community obstetricians
• 1st year – no NICU admissions
19. Tele-ophthalmology
Tele-ophthalmology technologies: live or store forward
Screening for diabetic retinopathy (primary cause of blindness in working
adults)
Retinopathy of prematurity
ATA: Tele-ophthalmology standards
20. Pediatric cardiology
Incidence of CHD is 8/1000 live births
Traditional models of care:
Schedule appointment
Emergency transfer
Wait for field clinic
Obtain echo and mail, courier
Tele-echocardiography has become standard of care
Live interactive support of remotely located technologists
Store forward images sent in digital format
21. Acute stroke intervention
Challenge of lack of access to stroke
neurologist in rural areas
High cost, high morbidity condition
Time is of the essence (3 hour window for
thrombolytic agents
Increase use of TPA in rural hospitals
• <0.5% utliliization in Virginia
• >25%
Medicare FLEX Health IT grant
• Bath County Community Hospital
22. HIV/AIDS
Outcomes: UVA Telehealth HIV Program1
213 correctional patients treated with 1812 visits over 5 year
period
Of patients naïve to therapy:
– 77% attained undetectable viral load (<50 copies/ml)
– 50-60% in HIV clinic
– 40% receiving community based care by non-HIV specialists
1Rheuban,KS, Wispelwey B et al HIV/AIDS, HRSA Telemedicine Technical
Assistance Documents 2004
24. Tele-pathology
Second opinions
Collaborative tumor boards
Remote access to clinical trials
25. Tele-mental health
Shortage of mental health providers in rural
areas
Consultations, medication management
• Improve access, shorter wait times
• High rates of patient satisfaction in all age groups
• Controlled studies show efficacy = face to face psychiatry
• Huge cost savings in geriatric care facilities
26. e-ICU
Two Models
• VISICU model with continuous monitoring
– Hospital mortality decreased from 12.9-9.4%, ICU
length of stay shorter 4.35-3.63 days
• Consultation model (UC Davis model) using VTC
27. Pediatric emergency medicine
Geographic disparities in pediatric emergency services
(ratio:1.6/100,000 children)
92% of children seen in non CH emergency rooms
2-3% of seriously injured children receive initial treatment at a
pediatric trauma center
Rural EDs have limited access to pediatric specialists, and may
not be trained in PALS, NALs, nor equipped
UC Davis PICU connects with rural ERs in northern California
Parsapour,K, Presentation Pediatric Telehealth Colloquium, 9/07
28. Tele-otolaryngology
AFCHAN telehealth project and use of video-
otoscopy1
• 31% decrease in the use of antibiotics when video-
otoscopy services added to community health clinic
services1
Medicare permits payment for store forward in Alaska*
29. Chronic Disease Management
Remote monitoring and Home telehealth
10% of Medicare beneficiaries account for
66% of Medicare costs
VA Care Coordination and Home Telehealth
19% reduction in readmission for the same
diagnosis,
25% reduction in hospital days
31. Challenges:2010
Funding of telehealth (Stark, Anti-kickback Laws)
Reimbursement
Confidentiality
Credentialing and Privileging
Licensure
Malpractice
Telecommunications venue/costs
Integration with EMRS/HIE
Interagency alignment related to policies
ARRA, Health reform
Outcomes
32. Reimbursement varies by state
Reimbursement
- Virginia Medicaid (urban and rural) - ~ 30 Medicaid states
- Medicare (rural, non-MSA, store forward Alaska and Hawaii)
- ~ $2 million/year
- Private payers:
- Virginia becomes the 12th state to mandate
- Anthem grant for Virginia
- Contracts
- Peds cardiology
- Psychiatry
- Dept of Corrections
34. Credentialing and Privileging
2004 JCAHO standards
Credentialing and privileging by proxy
Remote hospital medical staff agree to telehealth
relationship
Link to quality data
Legal agreements between institutions
2010 Medicare Conditions of Participation, medical
staff standards
July 15, 2010 Credentialing and privileging at all sites
THANK YOU CMS for considering alternative solutions
35. Malpractice
Serve primarily Virginians
Malpractice cap in Virginia
UVA faculty are self insured
Informed consent
New local standard of care?
Limited precedents in case law
37. Telecommunications
POTS – Fiber
Universal service fund
Rural healthcare pilot program
NATIONAL BROADBAND PLAN !!!!
Addresses interagency lack of coordination
Addresses barriers to adoption
Universal service reform
If we build it, will they come?
38. Confidentiality
HIPAA
Encrypted data
Network design and architecture
39. ARRA, Health Reform opportunities
Health Reform:
CMS Innovation center
Independence at home – care coordination program
Multi-billion dollar funding ARRA
NIH
DoC/NTIA
USDA
HRSA
ONC
40. The future of telehealth
Outcomes
Standards
Demonstration projects (ARRA, Health reform)
Broadband plan
Integration into mainstream medicine
Innovation
Collaboration amongst providers, policymakers
Champions at all levels