Telehealth Strategies
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- Benjamin Richards
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1 2013 Telehealth Strategies regional telehealth forum Premier Partner
2
3 Welcome! Your friends at gptrac are pleased to welcome you to the third Regional Telehealth Forum. This is a great opportunity to learn from each other about the kinds of telehealth services being provided in our six-state region. Encouraging peer-to-peer communication opens up the opportunity to develop contacts and connections that could encourage future collaboration and potential telehealth service expansion. Should you have any questions/comments about this event, or have any ideas for future forums, please let us know. Also, remember, gptrac is here to provide guidance and assistance. Don t hesitate to give us a call or send us a message. We can be reached at Thanks for coming! We look forward to visiting with you! Your Friends at gptrac As we move into the era of accountable care and away from fee-for-service, telehealth is becoming an increasingly important means of delivering high quality, lower cost health care. Stuart Speedie, PhD Executive Director, gptrac
4 Great Plains Telehealth Resource & Assistance Center (gptrac) Great Plains Telehealth Resource and Assistance Center (gptrac) helps healthcare providers develop, implement and expand their telehealth programs. We serve Minnesota, Iowa, Nebraska, North Dakota, South Dakota, and Wisconsin. Our mission is to improve access to quality healthcare services through technology. At gptrac, we have a four-part mission: build telehealth awareness, promote education, provide individualized consultation, and provide data specific to telehealth services in our region. We promote healthcare services that take advantage of modern telecommunications technologies such as interactive videoconferencing, secure Internet transactions, home health monitoring and mhealth. We work to advance telehealth program development by offering resources to healthcare providers and organizations interested in telehealth and telemedicine. We can also help health organizations navigate other challenging areas in telehealth, including legal concerns, regulatory issues, appropriate technology, the implementation process, and financial issues. gptrac is one of several regional telehealth resource centers receiving support from the Office for the Advancement of Telehealth part of the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services. Telehealth Resource Centers Telehealth Resource Centers (TRCs) are funded by the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) Office for the Advancement of Telehealth, which is part of the Office of Rural Health Policy. Nationally, there are a total of 14 TRCs which include 12 Regional Centers, all with different strengths and regional expertise, and 2 National Centers which focus on areas of technology assessment and telehealth policy. 8 Find more information at:
5 Forum Schedule
6 Session Descriptions: Monday Keynote Session 1, 9:30am Connecting with a Purpose Carl Taylor, VP - Fraser Institute for Health Research We are at a moment in time in which the tools at hand be they known by the names of telehealth, m-health, e-health or communication driven healthcare are mature, affordable, and deployable on broad scale. But the tools or rather the capabilities they create must be evaluated in regards to the uncertain landscape of healthcare, what I call contextual reality. As we meet together there is more about the future of healthcare here in the US that is unknown than known. But there are common elements of strategies that will bridge this uncertainty. Among them are that quality is truly going to be job #1. The second is the role of the primary Concurrent Sessions #1, 11:00am care provider will deepen. The third is hospitals either on their own or with physicians will seek continuous care relations with their patients including developing retail strategies. Hence from a telehealth perspective we must ask- what is our purpose and our place in these strategies. Where do we fit and how will we need to articulate our role and our outcomes in order to become an integral part of healthcares future. This talk will suggest answers to those questions and allow the listener to develop a market ready strategy to meet future challenges. Panel Presentation #1, 1:15pm 1A - Telehealth Costs, Business Models, and Savings Strategies Jonathan Neufeld, PhD Upper Midwest Telehealth Resource Center, Terre Haute, IN Current business drivers and new financial contingencies anticipated under health care reform are factors driving telehealth expansion. This session will provide illustrative examples of ways rural and urban health care organizations are using telehealth to pursue the triple aim of health care. Specific attention will be paid to anticipated developments in the health care market over the next decade. 1B - Secure Desktop Video Provides Direct Care to Fragile Nursing Home Residents Max Thacker University of Nebraska Medical Center, Omaha, NE New high definition desktop and mobile technology is proving to be a valuable resource for both rural providers and patients. This session will describe the technology that the University of Nebraska Medical Center has deployed and will review how this application is improving care to nursing home residents in rural locations. A demonstration of the technology will be part of this presentation. 1C - Managing Diabetes as a Population Health Need Across the Health Care Continuum Maureen Ideker, RN Essentia Health, Duluth, MN This presentation will tell the story of the Essentia- Telehealth Network, ACO business plans and chronic disease management in diabetes. The use of the MN Community Quality Measures as evidence based outcomes directly tied into telehealth will be explained. The interface of ACO s and Health Care Homes will be outlined using the context of diabetic care and telehealth. Home Telehealth Solutions Sherrie Peterson and Tami Haugen-Lund Evangelical Good Samaritan Society, Sioux Falls, SD LivingWell@Home The Evangelical Lutheran Good Samaritan Society received an $8.1 million grant to launch the LivingWell@Home program in June LivingWell@Home uses telehealth and sensor technologies plus data monitoring strategies to help seniors maintain their wellness and live as independently as possible. This presentation will highlight this program, focusing on the role of layering technology and human touch to tie together disparate data and enhance healthcare outcomes across a continuum. Tammy Theurer, RN, and Jolene Wentz, RN St. Alexius Home Care and Hospice, Bismarck, ND Telehealth Home Care Coordinated Disease Management Demonstration Effectively providing follow-up healthcare after hospitalization can be challenging, especially for individuals living in remote rural areas who are struggling to manage one or more chronic conditions. St. Alexius Medical Center s Home Care & Hospice teamed with Great Plains Telehealth Resource and Assistance Center to evaluate the potential of a new telehealth program in managing the health outcomes of these high risk individuals. Parameters for the study, along with the excellent patient outcomes will be shared.
7 Concurrent Sessions #2, 3:00pm 2A - Use of Innovation Centers to Pilot and Propagate Telehealth Initiatives Gerald Malagrino, Sr. Project Manager Mayo Clinic Center for Innovation - Rochester, MN The overall strategy of Mayo Clinic identifies innovation as a key attribute to its future success. The innovation center works to understand and pilot different modalities of care in order to diffuse successful initiatives at an enterprise level. Four modalities, each having unique value to future workflows, will be highlighted: asynchronous consultations, synchronous consultation, mobile interactions, and virtual world interactions. 2B - From Telehealth to mhealth - Lessons Learned from the Department of Defense Loretta Schlachta Fairchild, RN, PhD, FACHE, LTC (ret), US Army AN - Eagan, MN Dr. Schlachta-Fairchild served as Clinical Director of Telemedicine for the US Department of Defense Telemedicine Testbed providing clinical consultation and project management for multi-state telemedicine applications. This presentation will identify key military mhealth applications that can be successfully applied to civilian healthcare populations. 2C - Telehealth Progress in the Fairview Health System Jason Albrecht, MHA, CCLS - U of MN Amplatz Children s Hospital; Adam Anderson - Video Guidance; Robyn Bushinski, MA, NE, PHN, RN - U of MN Medical Center, Fairview; Alison Koehler, MHA, U of MN Medical Center, Fairview This panel will discuss the evolution of telehealth within the Fairview Health System. Key technology and operational considerations that have optimized an adult Tele ICU Hub at UMMC will be described. As a powerful tool at the point of care, multiple strategies to keep children/families connected with each other, their care team, school and community will be shared. Through this discussion, participants will learn the critical value of key internal and external partnerships that have empowered innovation and growth. Concurrent Sessions #3, 4:00pm 3A - Preparing Providers to Deliver Telehealth- Enabled Services Jarod Giger, PhD. MSW, LCSW, Professor of Social Work - University of South Dakota - Vermillion, SD; Carol Brandl and Kathy Karsting, RN, MPH- Bryan Health Medical Center This session will highlight how two different programs in our region have begun to utilize telehealth technology in the education of healthcare service providers: Using Skype to Prime Social Work Students for Mental Health Services Delivery via Telehealth - Clinically trained social workers play an important role in the mental health system. Dr. Giger will describe a pedagogical model for introducing social work students to the potential of telehealth by having them complete and present a 15 minute biopsychosocial mock-patient assessment using Skype videoconferencing technology. Telehealth Education for School Health: A Strategy to Improve Quality and Effectiveness of Practice - Bryan Health Medical Center leads the TESH project in Nebraska, an educational series for professional nurses in school and child health practice. Presenters will discuss the value of developing collaborative relationships between local public health, medical partners, and school health professionals to use telehealth in school and community health settings. 3B - Image & Video Capture on your Smartphone - Telehealth Mobility Scott Feinberg, Director of Innovation and R&D - UnitedHealth Group, Minneapolis, MN Can the smartphone become part of the clinical tool kit? In this session, you will hear about the journey to create a smartphone application from innovation to development and eventually to deployment as a new clinical tool. In addition, we will review results from pilots that use smartphone image and video capture capability to improve wound care treatment and expand services within behavioral health. 3C - Expanding Connectivity: The importance of broadband and FCC s Healthcare Connect Jeff Plunkett, Telecommunications Coordinator - SISU Medical Solutions, Duluth, MN; Paloma Costa, Outreach Director - USAC Rural Health Care Program, Washington, DC This session will describe two components which are supportive of the long-term success of telehealth services in this region: Broadband Success and Struggles in Minnesota Telehealth requires a fast and reliable broadband connection. Many rural healthcare providers struggle to gain access to the broadband needed to provide the best possible patient care. Mr. Plunkett will address how broadband supports healthcare and explore broadband successes and struggles in rural healthcare. Rural Health Care Program s Healthcare Connect Fund The Federal Communications Commission (FCC) has announced an order establishing a new Healthcare Connect Fund (HFC) as part of the current Rural Healthcare Program. The HCF will help expand access by connecting healthcare providers to broadband networks needed for delivery of telemedicine. Ms. Costa will discuss the new program, including funding opportunities, eligibility and program requirements, and access to training resources.
8 Session Descriptions: Tuesday Concurrent Sessions #4, 8:30am 4A - A Sustainable Telehealth Workflow Solution Lois Last, RN; J.B. Hinote, Network Administrator; Kevin Schon, Telehealth Manager - Greene County Medical Center, Jefferson, IA The Green County Medical Center telehealth team has developed a solution that both attracts new physicians to telehealth as well as retains existing telehealth providers that are seeking improved workflow. This presentation will share the GCMC solution and demonstrate how telehealth can be affordable for schools, senior living facilities and employers. Topics include: single entry point telehealth visits, data mining for accessing ROI, and telehealth integration with future technologies. 4B - Increasing the Visibility of Telehealth within the Community - Project Access: Epilepsy Linda Cook - Monroe-Meyer Institute, Omaha, NE Unmet healthcare needs of children in rural areas can benefit from specialist care delivered effectively through telehealth. This presentation discusses two projects developing programs to provide access to pediatric neurologists for children with epilepsy who reside in rural underserved areas. 4C - Transformative Telehealth as a Strategy for Chronic Disease Management: 10 services, 15 locations, 10 months. Dr. Linda Williams, Chief Medical Information Officer, Olmsted Medical Center; Christian Milaster, Telehealth Expert, Ingenium Telehealth - Olmstead Medical Center, Rochester, MN Most telehealth services start organically somewhere in the organization, typically driven by a passionate provider with access to funds. Olmsted Medical Center (OMC) took a different approach and set out to launch their exploration of telehealth as a modern healthcare delivery tool to manage chronic diseases in a planned, strategically-guided way. Starting with telepsychiatry in area nursing homes, OMC is in the process of launching 10 different healthcare services at 15 different locations. Guided by six strategic themes and an overarching guiding principle set forth by the CEO and President, the strategy now effectively guides the direction and the growth of OMC s telehealth service portfolio. Keynote Session 2, 10:00am The Times They Are A-Changing Rob Sprang, Director - Kentucky Telecare Telehealth is the result of the emergence of modern communication/information technology and the need to extend limited healthcare resources to meet a nearly unlimited demand. The most basic ideal behind telehealth technology is to get the right care to the right people at the right time in the right place. The modern era of telehealth began in the early to mid-1990 s when federal grant programs began to fund new initiatives. Interactive videoconference technology had begun to develop in higher education, allowing colleges and universities to reach potential students in non-traditional, off-campus locations. Early telehealth initiatives often began at academic medical centers who were familiar with videoconference technology from academic extension programs and now wanted to use that same technology to extend the reach of clinical faculty to patients who would not, or could not travel to the academic medical center. Since those early years, technology has evolved, legal and regulatory barriers have been addressed, and the concept of telehealth has become familiar to many more people, but the industry is on the brink of dramatic change and the Accountable Care Act is just one catalyst that could help telehealth achieve its true potential. Panel Presentation #2, 11:00am Mental Health Solutions Phil Hirsch, PhD, CCO, Health Link Now The Value of Telemental Health Integration in the Medical Home The Robert Graham Center for Policy Studies in Family Medicine and Primary Care notes that Efforts to provide everyone a medical home will require inclusion of mental health care if they are to succeed in improving care and reducing costs. But many medical groups struggle to integrate behavioral health services in the primary care setting. This presentation will provide an overview of how telehealth technology makes it possible for clinics and hospitals to overcome economic and geographic barriers to integration. Andrew Rosenzweig, MD, MPH, Forefront Telecare The Use of Telehealth in Reducing Antipsychotic Use in Rural Nursing Home Residents In this presentation Dr Rosenzweig will describe how videoconferencing technology enables high-quality psychiatric care in rural nursing homes, and explore the recent CMS initiatives regarding targeted reductions in antipsychotic use. He also will review cases and strategies illustrating the use of telehealth in equipping nursing facility staff to better work with residents with dementia related behavioral problems.
9 Thank you! Thank you to our exhibitors & partners: Altru Health System ( - Altru Health System is a community owned system. The mission, vision and governance structure guides us every day. Altru Telemedicine connects rural patients with providers in a variety of specialties. Telemedicine consults improve patient outcomes and expand services throughout the region as well as reduce travel time for patients and providers. The technology presents a secure and live, interactive video and audio connection between a patient at their home town hospital and a specialist at Altru Health System in Grand Forks. AVI Systems ( is a leader in global deployment of all types of video conferencing technology including telemedicine. As a national integrator, we can design, procure, integrate, support and service your organization for all your video and A/V requirements. Our Forum partner, GlobalMed ( com), is the worldwide leader in the development of integrated, standards-based telemedicine and telehealth platforms that comprise solutions for a broad range of global healthcare systems and environments. Avumedia ( is a technology integration services company focused on providing highly simplified access to broadband enabled multimedia telemedicine. The A-Vu system is easy to use, low cost and flexible using PCs, tablets, mobile carts or fixed endpoint configurations. Early development was funded by a federal grant awarded to the SEMN Beacon Community with the goal of dissemination to other providers. Cardiocom ( is an integrated clinical telehealth services leader. Cardiocom provides cost-effective telemonitoring solutions for complex chronic conditions including heart failure, diabetes, hypertension, COPD, asthma, CKD and ESRD. The Cardiocom Telehealth System complements the chronic care model by decreasing acute care hospitalizations, focusing home visits and increasing referrals. Cardiocom is the recipient of the Frost & Sullivan North American Remote Patient Monitoring Enabling Technology of the Year Award. Community Health Information Collaborative (CHIC) ( is a nonprofit collaborative of healthcare organizations that leverages information technology and collaborative relationships to help improve care and save money. CHIC is a state certified health information organization, which offers electronic exchange of clinical information through the HIE-Bridge network. Cybermation ( founded in 1996, is a national distributor and integrator of tele-wellness products and systems. With a holistic approach to senior care through the use of technology, Cybermation utilizes the GrandCare system as the hub of an ecosystem to monitor telehealth data and activities of daily living while also providing a socialization component to the total solution. GrandCare can be incorporated into a firm s technology infrastructure to achieve a high level of payback as well as quality across the continuum of care by a healthcare organization. Forefront Telecare ( Forefront TeleCare is a pioneer and national leader in Behavioral Telehealth linking behavioral specialists to rural, under-served healthcare facilities coast-to-coast including Skilled Nursing Facilities, Rural Health Clinics and Federally Qualified Health Centers. Forefront offers behavioral health practitioners and facilities a comprehensive and fully supported Telehealth system that includes web scheduling services and very high quality, secure, and worry-free audio/video connections between behavioral specialists and their patients. Hazelden ( provides proven-effective addiction treatment, recovery, and prevention books, videos, and curricula to individual consumers, treatment programs, schools, hospitals, mental health agencies, correctional Continued on following page.
10 Thank you! (Continued) facilities, churches, and human resources programs. Hazelden publications focus on helping people recognize, understand, and overcome addiction and co-occurring disorders. As a leading national expert on issues related to addiction, treatment, and recovery,hazelden works to build awareness and understanding among the general public and policymakers about the nature of addictive disease and the effectiveness of treatment. HealthPOINT ( is the federally- designated health information technology (HIT) resource and support center for all South Dakota healthcare providers. We provide technical assistance, guidance, and information on best practices to support and accelerate providers efforts to become meaningful users of certified EHR technology. Our services include Security Risk Analysis, Penetration Testing, Change Management, Disaster Recovery and Workforce Training. MSpace ( Supporting Partner. the Twin Cities premiere audio and video integration company, has created a unique telemedicine interface that allows health care providers to do Virtual House Calls without compromising their existing workflow while being able to see more patients in a day. This solution is easy to use while improving communication and eliminating any distance barriers allowing patients to see their physician or specialists without the hassle of driving to their healthcare location. With the help of MSpace, doctors still do make house calls! Polycom/AVI-SPL ( - Premier Partner. Healthcare organizations the world over are turning to Polycom video collaboration solutions and their partners like AVI SPL to improve care and reduce cost. Collaborative healthcare solutions from Polycom enable patient centered care, multi-disciplinary team support, reduction of unnecessary re-hospitalizations, and collaboration across the entire healthcare team independent of physical barriers. There are many reasons why eight of the top 10 hospitals and the top ten pharmaceutical companies worldwide are Polycom customers. Polycom is a proud partner of this event. Stop by and see how we can help. USAC ( The Universal Service Fund s Rural Health Care (RHC) Program has $400 million a year available to provide reduced rates for telecommunications services and broadband access for the provision of health care services in rural locations including HIT and remote access to medical care. Stop by our booth to hear about whether you are eligible and learn about the Healthcare Connect Fund (HCF), the newest component of the Rural Health Care Program. Video Guidance ( Supporting Partner. is a marketleading, independent provider of strategic visual communications, offering video conferencing, telepresence and audio visual technologies and services. Their mission is to help healthcare customers transform their organizations by providing advanced visual communications technology and managed applications, supported by exemplary service. From ROI analysis and network design, to application development, to user adoption and support, Video Guidance is a one-stop conferencing partner. Windstream (windstreambusiness.com) Supporting Partner. is a provider of advanced network communications, including cloud computing and managed services, to healthcare organizations and businesses nationwide. At Windstream, our technology solutions for healthcare organizations are designed to minimize costs while enhancing the patient experience. Windstream is focused on meeting the constantly evolving IT challenges of today s healthcare industry, offering a full range of cost-effective, technology-savvy resources, along with the experts who understand the challenges unique to healthcare.
11 The top 3 kinds of organizations that have contacted us: 1. Vendors 2. Health Systems 3. Hospitals The top 4 topics that people call us about: 1. General Telehealth Information 2. Technology 3. Reimbursement 4. Project Initiation The top ten telehealth services nationally: 1. Psychiatry/ Behavioral Health 2. Diabetes Care 3. Cardiology 4. Pediatrics 5. Dermatology (recent TTAC survey) 6. Neurology 7. Primary Care 8. Emergency Medicine / Trauma 9. Family Medicine 10. Infectious Disease The top 5 kinds of telehealth questions addressed at gptrac: 1. Clinical 2. Equipment 3. Long-Term Care 4. Home Care 5. Strategic Direction
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