Adirondack-Champlain Telemedicine Information Network (ACTION)

Transcription

1 Adirondack-Champlain Telemedicine Information Network (ACTION) Submitted by the Fort Drum Regional Health Planning Organization (FDPO) Submitted January 23 rd, 2015 Contact Information: Denise Young Executive Director Fort Drum Regional Health Planning Organization 120 Washington Street, Suite 230 Watertown, NY Phone: TABLE OF CONTENTS Page 1 of 11

2 Overview ACTION Goals and Objectives Strategy for Aggregating Health Care Provider Needs Strategy for Leveraging Existing Technology How the Broadband Services will Improve or Provide Health Care Delivery Previous Experience in Developing and Managing Health IT Programs Project Management Plan Overview Page 2 of 11

3 The Adirondack-Champlain Telemedicine Information Network (ACTION) is a regional initiative designed and developed by the Fort Drum Regional Health Planning Organization (FDPO). This initiative involves the creation of a Telehealth/telemedicine network that will connect multiple healthcare facilities operating in Clinton, Essex, Franklin, Rensselaer, Saratoga, St. Lawrence, Warren and Washington Counties in New York, and Chittenden County in Vermont. There are two primary elements to this project: addition of new participating members to the current ACTION network over which the telemedicine services will be provided; and development of the telemedicine services. The FDPO will oversee the design and implementation of the new ACTION locations, working closely with the winning bidder of the RFP process, all of the healthcare facilities, and multiple community partners to ensure a system that will produce immediate cost savings and healthcare access via telemedicine consults and a cohesive communications system. A staff member of FDPO will help to execute network-wide protocols for telemedicine determined by the participant organizations so that cross-communication among all providers is streamlined, efficient, and standardized. Estimates for the network across Clinton, Essex, Franklin, Rensselaer, Saratoga, St. Lawrence, Warren and Washington counties in Northern New York and Chittenden County in Vermont indicate a population of more than 955,000 people. 1 Access to care is currently hampered by rurality and low income for much of the region s population. Further, the hospitals face significant provider shortages in key specialty areas, including cardiology and psychiatry. The eight hospitals participating in the Adirondack-Champlain Telemedicine Information Network are Adirondack Medical Center, Alice-Hyde Medical Center, CVPH, Elizabethtown Community Health Center, Fletcher Allen Health Care, Glens Falls Hospital, Inter-Lakes Health and Massena Memorial Hospital. These facilities and their surrounding communities stand to benefit the most from the implementation of this network. 1 Information provided by the U.S. Census Bureau: Page 3 of 11

4 ACTION Goals and Objectives The following table serves to align the National Goals as identified by the FCC with that of the local Adirondack- Champlain Telemedicine Information Network (ACTION): National Goals Connect Public and Non- Profit Healthcare Providers in Rural and Urban Areas Add new eligible and noneligible locations to the existing ACTION network Local Objectives Connect new locations to existing ACTION facilities comprised of 48 North Country facilities, representing: o 8 hospitals o 39 Clinics o 1 Tribal facilities o 7 counties Connect new locations to existion ACTION facilities comprised of 17 North Country facilities, representing: o 1 hospital o 15 Clinics o 1 Administrative facility Bring Telemedicine Capabilities to Rural Areas Where Need is Most Acute Allow Patient Access to Critically Needed Medical Specialties in a Variety of Practices Without Leaving Home Communities Link Network and Create Access to Regional, State and National Telemedicine and Information Exchange Activities Enhance the Healthcare Community's Ability to Provide a Coordinated Response in the Event of a National Crisis Provide services to rural regions that are all RUCA code 4 and above Provide telemedicine services in areas where it is either not available or underutilized Create a unified, regional focus on telemedicine Faster Care Increased access to services with a growing population need Increased access to services with high intensity and low volume Access to services only available in urban areas Create access to the Public Internet Create access to CPP ACTION Project Network Create access to the NYS SHIN-NY Network Create access to Telepsychiatry Services Create expanded opportunities for education and research Create network for mass casualty/disaster communications Strengthen relationships between, and among, facilities and providers Page 4 of 11

5 The following table identifies specific local goals and objectives of the ACTION network: ACTION Goals Improve Patient Care Outcomes Respond to Provider Shortages Stabilize the Local Health System ACTION Objectives Shorter turn around times More consistent care Decrease demand for patient travel using Video Teleconferencing for follow-up care Improved patient compliance using Home Telehealth appliances Provide coverage for specialties with severe provider shortages (e.g., psychiatry and cardiology) Maintain access to specialties with growing shortages due to aging MDs Ensure continuity of care for specialties with low volume Capitalize on the interest of MD champions at referring and consulting facilities Increase MD satisfaction and retention Increase ability to recruit primary care physicians Create economies of scale by spreading cost Increase collaboration for mutual benefit Expand relationships with hospitals in Syracuse and Utica Stabilize the local system as a whole Leverage individual resources and capacities Reduce unnecessary costs Improve patient care and respond to community need Expand Local Information Access and Data Exchange Implement a Cost-Neutral, Timely Solution Improve Individual Hospital Performance Improve information sharing to Fort Drum Increase connectivity to CPP ACTION network Create a disease registry that is accessible throughout the region via the NCTP network Improve HIE connectivity Connect as many facilities as possible at minimal cost Connect the facilities as part of a single project Lower cost of telecommunications Improve telecommunications reliability and throughput Offset capital costs through expanded patient care capability Improve CMI at rural facilities Lower overall cost per patient day at all facilities Increase patient and MD satisfaction Decreased bottlenecks Spread patient volume and improve efficiency Page 5 of 11

6 Strategy for Aggregating Health Care Provider Needs Adirondack-Champlain Telemedicine Information Network: HCF Network Plan Over 70% of the ACTION consortium participants are rural (hospitals, clinics and public health departments). Our strategies for aggregating their needs include the following: A. Conduct various ongoing outreach and network planning activities to maximize network growth, sustainability and cost efficiency for participating ACTION consortium HCP members. B. Structure contracts in ways that will facilitate network additions. C. Engage in new RFP development cycles when network additions or upgrades require new competitive bidding. D. Continue to work on increasing network participation by the ACTION members and thereby create significant volume to support eh aggregation of needs. E. Challenge vendors to reduce costs due to the volume of connections and services that the ACTION consortium bidding process offers. F. Continually review current connections to determine if new or updated equipment or designs might provide more efficient, cost-effective network connections. (i.e., Instead of providing public Internet service to every ACTION HCP member location, provide the public Internet service to the main hospital location and create a hub-and-spoke network connection between the hospital and its affiliate clinics. This would allow the affiliate clinic to access the public Internet by utilizing the hospitals connection to the public Internet.) G. Increase health information transfer as part of overall plan for data exchange H. Create network-wide virtual services, such as network-wide video teleconferencing (VTC), which are centrally located in the network and able to be accessed by all of the members. These types of virtual services allow the members to pool their resources to create a virtual service at a fraction of the cost of implementing the same service at each of their locations. I. Combine the participants of the ACTION network with the participants of the North Country Telemedicine Project (HCP 17236) network at some point in Page 6 of 11

7 Strategy for Leveraging Existing Technology Adirondack-Champlain Telemedicine Information Network: HCF Network Plan A. Pursue a multi-vendor contracting strategy by encouraging multiple service providers (SPs) in our area to work together as a single team. This reduces overall cost by reducing the amount of new construction required to support new and existing ACTION locations. B. Seek quotes to connect HCPs to existing network infrastructures in order to leverage and expand existing investments. C. Continue to focus on long term plans to create a larger footprint by combining the ACTION network with the North Country Telemedicine Network (NCTP) at some point in Combining the two networks will increase the buying power of all the members and continue to push SPs to reduce connectivity costs. D. Seek opportunities to reduce the total number of HCP connections through the use of hub-and-spoke connections where appropriate. Page 7 of 11

8 How the Broadband Services will Improve or Provide Health Care Delivery Improvements to health care will be accomplished via the following methods: A. Using the network to transport large Teleradiology images (CT, CAT scan, MRI, etc.) B. Using the network to store and transport clinical decision information through a population health management disease registry. Through the use of this tool, eligible providers are receiving real-time guidance on the population and risk of admission/readmission for chronic disease management through timely interventions. C. Using the network to enter, retrieve and share clinical information with the eligible health care providers to support a seamless process for patients to receive post-discharge primary care follow-up as well as other needed services to reduce their risk of future admissions/readmissions. D. Using the network to support video teleconferencing (VTC) services in support of Telepsychiatry, follow-up surgery appointments, continuing medical education (CME) and various other services that can utilize VTC technology. Patients no longer need to travel for long distances, in uncertain weather, to receive these types of services which also reduces their time spent away from home/work and lost wages. E. Using the network to connect to the Statewide Health Information Network of New York (SHIN-NY). F. The fiber, and/or equivalent, Ethernet service improves telemedicine services by reducing round-trip delay and jitter; it increases throughput and stability which improves response times for telemedicine services and applications running on the network. G. Continually reassess the needs of the community and develop plans to address and support those healthcare needs by utilizing telemedicine and telemedical education; foster a platform for the collection and exchange of information to promote health through coordinated, area-wide health services programs. Page 8 of 11

9 Previous Experience in Developing and Managing Health IT Programs Adirondack-Champlain Telemedicine Information Network: HCF Network Plan The creation of the FDPO was announced by Congressman John McHugh (R-NY) and the two primary local partners, Samaritan Medical Center and Carthage Area Hospital on October 12, Fort Drum relies on the local healthcare system for the medical needs of its soldiers and their families. The FDPO Board of Directors meets regularly to ensure that the needs of the current and expanding North Country/Fort Drum community are met. FDPO formalizes this relationship, brings in other key players in the healthcare system, and ensures collaboration among all parties. The Fort Drum Regional Health Planning Organization, Inc. is a not-for-profit corporation formed by New York Not-for-Profit Corporation Law. In accordance with Section 601(a) of the New York Not-for-Profit Law, the Corporation has no members. The property and business affairs of the Corporation are managed by a Board of Directors. This organizational structure is vital to the FDPO s ability to fulfill its mission and maintain broad representation for collaboration through the Board of Directors. The mission of the FDPO was developed to fulfill the tasks set before it and to reach the vision for North Country healthcare held by the leadership of the organization. 1. Vision Statement Transform our current healthcare delivery system into a healthcare delivery model that partners Medical Treatment Facilities with Community providers to augment the Medical Treatment Facilities primary care capability with specialty care and inpatient services. 2. Mission Statement Through collaborative efforts, plan and evaluate to ensure quality healthcare services are provided to meet the needs of the Military Mission by enhancing our response to the military community while building a strong North Country health care system. To accomplish this we will utilize available, and develop necessary resources working jointly and cooperatively. 3. Goals Identify the healthcare needs of the community surrounding and including Fort Drum, NY Develop a plan to address and support the healthcare needs of the community Foster the collection and exchange of information to promote health through coordinated, area-wide health services programs Further such purposes in coordination with federal, state, and county governments, the military and local healthcare providers, agencies and consumers and in accordance with the mission of the U.S. military Solicit funds to further the stated objectives FDPO is the lead entity for two Rural Health Care Pilot Programs and NYS HEAL Programs: 1. Adirondack-Champlain Telemedicine Information Network (ACTION) 2. North Country Telemedicine Project (NCTP) 3. HEAL Heal 21 Page 9 of 11

10 Project Management Plan A. Project Leadership The ACTION HCF Consortium project will be led by the FDPO. The Project Coordinator will be Denise K. Young and the Assistant Project Coordinator will be Robert P. Hunt. Robert Hunt is FDPO s Fiber Network Manager and has been hired by FDPO to manage the ACTION and NCTP projects. B. Management Structure The FDPO is a not-for-profit collaborative of northern New York hospitals and clinics, with a Board of Directors composed of the CEOs of those rural hospitals participating in the NCTP consortium. C. Work Plan and Schedule Task Number Activity Timeframe Task Assignment Task 1 Network construction (for new ACTION locations starts with contract sign date) Months 1-6 Robert Hunt () Task 2 Meeting with the tertiary site providers to educate on telemedicine and refine business associate agreements Months 2-6 Task 3 Identification of site representatives for clinical services and IT issues Months 2-6 Task 4 Roll out of the committees representing the North Country facilities, the tertiary facilities, and Selected Telecommunications Vendor Months 4-6 Task 5 Protocol development for consult rule-in/rule out, consultation imitation and follow-up process, information exchange and security, etc. Months 5-7 Task 6 Testing the network Months 7-8 Task 7 Training and piloting network access, and use of the equipment Months 7-8 Task 8 Roll out of initial clinical specialties: Telepsychiatry, Teleradiology, Home Health Monitoring, TBD Months 8-36 Task 9 Evaluation Months Page 10 of 11

11 D. Budget FDPO will develop a formal budget as part of the RFP process. The budget will be based on the evaluation of the vendor responses for the ACTION RFP. The ACTION RFP has been written to allow participating ACTION HCP members to select from a range of connection speeds so the actual cost of the leased services won t be known before completion of the contracting phase. Our budget will be based on the following considerations: ACTION consortia participants will be responsible for all unfunded costs (100% of the 35% HCF funded costs). FDPO will pay for 100% of the costs associated with HCF administrative duties and responsibilities. ACTION consortia participants will pay for 100% of the FDPO travel costs associated with performing the required HCF administrative duties and responsibilities. Page 11 of 11