Telehealth Challenges and Opportunities
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- Annabel Wilkinson
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1 Telehealth Challenges and Opportunities Internet2 Health Network Initiative Day Crystal City, VA April 24, 2008 Dena S. Puskin, Sc.D. U.S. Department of Health and Human Services Health Resources and Services Administration Office of Health Information Technology Office for the Advancement of Telehealth
2 Challenges to Effective Care in US Access: Persistent Geographic and Functionally Isolated Populations Aging Population: By 2030, 70 million Americans estimated to be over age 65 (20% of population) Provider Shortages: By 2020, RN nurse shortage estimated to reach 1 million
3 Challenges to Effective Care in US Boomer Impact by 2020: Account for more than 40% of all physician visits Boomer Impact by 2030: 14 million will have diabetes 26 million will have arthritis More than 21 million will be considered obese/care will cost Medicare 34% more than for others Knee replacements will increase 800% from today
4 Comparison of Adoption Rates - NACHC 2006 Survey Sources: Based on NACHC May 2006 Fact Sheet. National data from Woodwell DA and Cherry DK. National Ambulatory Medical Care Survey: 2002 Summary. Advance data from vital and health statistics: No Hyattsville, Maryland: National Center for Health Statistics Burt CW and Hing E. Use of Computerized Clinical Support Systems in Medical Settings, United States, Advance Data from vital and health statistics: No Hyattsville, Maryland: National Center for Health Statistics
5 HRSA HRSA is the primary Federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable. HRSA programs reach into every corner of America, providing direct health care services for 20 million people each year (about 1 in every 15 Americans). HRSA uses its $6.4 billion budget (FY 2007) to serve as America s health care safety net.
6 HRSA Primary Health Care
7 HRSA s HIT Goals
8 HRSA Administrator Associate Administrator Cheryl Austein Casnoff Division of HIT Policy Johanna Barraza Cannon Office for the Advancement of Telehealth Dena Puskin Division of State and Community Assistance Susan Lumsden
9 Vision for America NO MATTER WHO YOU ARE OR WHERE YOU ARE YOU GET THE HEALTH CARE YOU NEED WHEN YOU NEED IT
10 Telehealth vs. Telemedicine Telehealth Health Professions Education Administration Telemedicine Regional Health Inform. Sharing Consumer Education Evaluation Research Homeland Security Public Health
11 Some telemedicine facts Almost 50 different medical subspecialties have successfully used telemedicine. There are approximately 200 active telemedicine networks in the United States, excluding purely radiology networks. Of these, estimates are that about half are actively providing patient care services on a daily basis.
12 Key Challenges Reimbursement/Start-up Costs Re-engineering Practice/Clinical Acceptance Low Volume > High Per Visit Cost Evaluation: Measuring Costeffectiveness Financial Sustainability Infrastructure Licensure/Credentialing
13 Advancing HIT through Networks
14 OHIT/DSCA HIT Grants HIT Planning Grant: To support health center networks in planning for the adoption of electronic health records (EHRs) or other HIT innovations EHR Implementation Grants: To implement EHRs in CHC Networks
15 OHIT/DSCA Grant Programs High Impact Grants: Promotes the high impact implementation of an EHR in a short time frame HIT Innovation Grants: To implement health information technologies other than EHRs
16 OHIT/DSCA HIT Funding Summary FY 2007 HIT EHR High Impact EHR Total
17 Technical Assistance HRSA Health IT Community Portal HRSA established a Health IT Community Portal for HRSA grantees with the Agency for Health Care Research and Quality (AHRQ) to serve as a virtual community ot: Collaborate and share experiences Create a central hub for communication across geographically disparate sites that allows grantees to view important announcements, documents, tasks, events, and discussions related to their initiative. Provides access documents, tools and resources on issues related to planning for and implementing health IT in the community provider setting.
18 OHIT/OAT Grant Awards Awarded over $250 million in grants since 1989 Competitive and Congressionally- mandated projects FY2006/2007: 148 programs in 43 States and District of Columbia
19 Telehealth Programmatic Grants FY Telehealth Resource Center Grant Program 6 awards Telehealth Network Grant Program (including home health) 16 awards Licensure Portability Grant Program 2 awards
20 Telehealth Network Grants University of Arkansas for Medical Sciences, AR Northern Sierra Rural Health Network, CA Ware County Board of Health, GA The Queen's Medical Center, HI Public Hospital Cooperative SE Idaho Inc., ID Illinois Department of Human Services, IL University of Kansas Medical Center Research Institute, KS Eastern Maine Healthcare Systems, ME Tri-County Hospital, MN Citizen's Memorial Hospital District, MO St. Patrick Hospital & Health Foundation, MT Duke University, NC Children's Hospital Medical Center of Akron, OH Home Nursing Agency & Visiting Nurse Association, PA University of Washington, WA Marshfield Clinic Research Foundation, WI
21 FY 2006 Telehealth Resource Center Grantees/States Covered California Telemedicine and ehealth Center: California Northeast Telehealth Resource Center (Medical Center at Lubec): Maine, Vermont, New Hampshire, Massachusetts Midwest Alliance for Telehealth and Technologies Resources (Marquette Hospital) : Michigan, Kansas Northwest Regional Telehealth Resource Center (St. Vincent Foundation): Alaska, Hawaii, Idaho, Montana, Oregon, Utah, Washington State, Wyoming Great Plains Telehealth Resource and Assistance Center (Avera Rural Health Institute): North Dakota, South Dakota, Nebraska, Minnesota Center for Telehealth and E-Health Law: National Center
22 Licensure Portability Grants Federation of State Medical Boards National Council of State Boards of Nursing
23 Technical Assistance/ Information Grants Information
24 Home Computer of the Future 1954
25
26 CONTACT US Dena Puskin, Sc.D Fishers Lane Room 7C-22 Rockville, MD Phone: (301) Fax: (301) Fax
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