Learn how teleneurology can accelerate diagnosis and treatment of stroke and other acute neurology patients, and can prevent rural hospitals from having to transfer those patients to facilities in metropolitan areas to get the care they need. Hear from a rural hospital CEO that has successfully implemented a teleneurology program. Full recording:https://attendee.gotowebinar.com/recording/5576806911767181316

1. Teleneurology Care:
Why It Works for Rural Hospitals
NRHA Webinar

2. Duane Miller, MBA, FACHE
Mr. Miller is Vice President & CFO of INTEGRIS
Bass Baptist Health Center in Enid, OK. INTEGRIS
Bass includes 207 licensed beds throughout three
facilities. The hospital enjoys the distinction of
being the only nonprofit, faith-based Enid hospital,
and has served the Enid area longer than any other
general hospital.
Talbot “Mac” McCormick, MD
Dr. Mac is a board-certified internist. He began as
a hospitalist in 2003, and has since served in
various physician leadership roles. He practiced
internal medicine for 20 years, and received his
Medical Doctorate from Emory University.
I N T R O D U C T I O N S

3. As defined by the American Telemedicine Association
T E L E M E D I C I N E B A S I C S
• Telemedicine allows health care
professionals to evaluate, diagnose and
treat patients in remote locations using
telecommunications technology.
• Telemedicine includes a growing
variety of two-way remote presence
devices that enable physicians to
perform real-time consultations with
patients.

4. T E L E M E D I C I N E B E N E F I T S
Provision of care to patients in their home communities.
Around-the-clock access to specialty care.
Reduced unnecessary out-transfer of patients.
Increased admissions, patient volume and revenue.
Hands-on access to education and training for NPPs and other staff.

5. T H E P H Y S I C I A N ’ S P E R S P E C T I V E : D R . M C C O R M I C K
“Telemedicine is most effective when applied where physician
resources are scarce and patient care is time sensitive. And it is
providing hope to rural hospitals in an era when closure is a very
real possibility unless new models of care are deployed.”
—Dr. McCormick

6. A C C E P T A N C E O F T E L E M E D I C I N E I S G R O W I N G
Patients
All ages receptive to it, not just younger patients. They appreciate having access to physicians when
they need it most.
Administrators
Appreciate the cost savings, census increases, and viable answer to physician shortage.
Physicians
Appreciate the work-life balance, 24/7 coverage, quick availability of specialists.
NPs & PAs
Benefit from having physiciansupport and expertise.

7. H O W T E L E M E D I C I N E W O R K S
• A cart or robot on wheels with a two-way videoconferencing
monitor brings a patient face-to-face with the physician, who
is “beamed in” from a distant hospital or other remote
location.
• The technologycan transmit still images, such as photos and
X-rays, for interpretationby the physician.
• The technologyenables the physicianto monitor the patient
remotely.
• Eagle typically assigns its telemedicine physicians in “pods”
of 4-6 assigned to a particular specialty or geography.
• Our goal is to develop relationships with the onsite staff, and
ultimately for staff to consider us their colleagues.

8. S P E C I A L I Z A T I O N D E L I V E R S G R E A T E R B E N E F I T S
• Teleneurology—Even the most remote hospital becomes a
center for quality neurological care.
• Collaborative Care—Support NP/PA management by
providing access to physicians offsite who can guide and
advise staff.
• Telenocturnists—An efficient, highly functional alternative
to nighttime care in rural hospitals.
• Tele-ICU—Offsite ICU physicians provide expert care at ICU
bedsides.
• Telepsychiatry—Meet the growing demand for behavioral
care no matter where you are.
• Others—Emergency Medicine, Cardiology, ID,
Rheumatology.

9. TEL EN EUR O L O G Y: A N ATUR A L EVO L UTI O N F O R TEL EM ED I C I N E
Every 40 seconds, someone
in the U.S. suffers a stroke.
Strokes are the 4th leading
cause of death in the U.S.
Strokes are the #1 cause of
disability in the U.S.

10. T I M E I S B R A I N
Best-in-class teleneurologist results
are impressive:
• Average response time of 3.5 minutes.
• Average diagnosis and treatment time of 21.8 minutes.
• 40% decrease in time from emergency department arrival to
admission.
• 1 to 1.2-day decrease in hospital Average Length of Stay
(ALOS) for stroke patients.
• Door-to-drip time < 60 minutes

11. T E L E N E U R O L O G Y C A R E A C R O S S T H E S P E C T R U M
Teleneurology can cover the entire spectrum
of acute neurologic emergencies.
• Examples include status epilepticus, coma, and
intracranial hemorrhage.
• Consultation on all emergency neurological
problems, including utilization of tPA.
• Additional consultation on ICU patients regarding
all aspects of medical management, including
reversal of anticoagulants.

12. W E L L - Q U A L I F I E D P H Y S I C I A N S
Teleneurology physicians are experienced in
both acute neurology and telemedicine.
• They possess an advanced understanding of
working as a part of a cohesive team.
• They demonstrate an open and compassionate
approach to caring for patients.
• Team may include neurologists with additional
fellowships in stroke/vascular neurology.

13. G E T T I N G S T A R T E D
Implementation
• Start-up Resources Include:
• Site operation setup
- Technology integration with hospital
- Protocol and process development
- Nurse and medical staff in-services
• Licensing and credentialing expenses
• Clinical leadership consultations

14. C A R E I S F I R S T - R A T E A N D I M M E D I A T E
“Wherever they are, our physicians can respond within 15 minutes
to any patient suffering a stroke or seizure at INTEGRIS Bass, do a
diagnosis, prescribe a thrombolytic drug or other medication, and
determine the most appropriate level of treatment.”
—Herb Rogove, DO, FCCM, FACP,
Eagle physician leader for the
INTEGRIS Bass program

15. I N TEG R I S B A S S C A S E S TUDY: C H A L L EN G ES
• Rural hospital in Enid, OK, often transferred patients to Tulsa or Oklahoma City—both
100 miles away—for specialized care.
• Looked for a more sophisticated, effective system for treating stroke and other acute
neurology patients on-site.
• Wanted to ensure any two-way videoconferencing technology was “always on,” readily
available when needed, not used as ER coat rack.

16. I N T E G R I S B A S S C A S E S T U D Y: E A G L E T E L E N E U R OL OG Y S OL U T I ON
• Neurologists are “beamed into” INTEGRIS Bass via two-way videoconferencing.
• Keeps patients in their home community.
• Facility anticipates $200,000 reduction in locum support costs annually.
• Expects additional revenues greater than $55,000 annually by reducing transfers.
• Gains more robust optics and instrumentation than previous system.

17. I N TEG R I S B A S S C A S E S TUDY: I N TO UC H TEL EN EUR O L O G Y R O B O T
• InTouch Health partner provides the remote patient monitoring technology hardware
and network.
• Remote neurologist can conduct neurological exam, and get a clear picture of patient’s
condition.
• InTouch system is “always on,” so no time wasted waiting for boot-up.

18. S I G N I F I C A N T R ED UC TI O N I N L O C UM S UP P O R T C O S TS
“I became an advocate of telemedicine as a result
of a reduction of locum support costs for
neurology and reduction in patient transfers.”
—Duane C. Miller, MBA, FACHE,
Vice President and CFO,
INTEGRIS Bass

19. F UR TH ER D I F F ER EN TI ATES I N TEG R I S B A S S
“Patients of all ages like the telemedicine
approach, and it further differentiates our facility
from others in northwest Oklahoma.”
—Duane C. Miller, MBA, FACHE,
Vice President and CFO,
INTEGRIS Bass

20. F I N A N C I A L R O I F O R T H E H O S P I T A L
• Typical Stroke DRG: $8,500*
• Typical Stroke DRG with tPA
administration: $13,000*

21. C O M M U N I T Y R O I
• Bring best acute stroke care available to
community residents
• Specialty support for ED, Hospitalist, and
Primary Care Providers
• 21st century medical care and innovation
• Allows most patients and patients’
families to stay in their home community

22. T I M E I S B R A I N
A recap of the benefits for
care of stroke patients:
• Average response time of 3.5 minutes.
• Average diagnosis and treatment time of 21.8 minutes.
• 40% decrease in time from emergency department
arrival to admission.
• 1 to 1.2-day decrease in hospital Average Length of
Stay (ALOS) for stroke patients.
• Door-to-drip time < 60 minutes.

23. V A L U E
• Adele Tickets — $200
• iPhone 6s— $700
• Honda Accord — $31,000
• Walking out of a hospital after a stroke —
Priceless

24. Questions and Comments?
Thank You!
www.EagleTelemedicine.com