The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. © 2016 Society for Healthcare Strategy & Market Development

Telehealth as a RuralBusiness Development Strategy

Michael Adcock, FACHEAdministrator, Center for Telehealth

University of Mississippi Medical Center

Jeff CowartBusiness Development, Marketing & Public Affairs

University Health System, Louisiana

Three Key Take-Aways

1. The market and community need for telemedicine is here

2. Rural focus is good for patients and good for business

3. Drawing on models like UMMC can accelerate the process

Business Imperatives

84% Survey of healthcare executives who say telemedicine is important (2014 Foley & Lardner LLP)

80% Number of employers predicted to offer telemedicine to employees by 2018 (Towers Watson 2015)

7M Patients using telemedicine by 2018 (IHS Technology 2014)

Business Imperatives

76% Patients who care more about access versus human interaction with providers (Trendwatch 2015)

67% Telemedicine patients who say it improves satisfaction (Software Advice 2015)

30 States that require private insurers to cover telehealth the same as in-person services (ATA)

Business Imperatives51% Decrease in readmissions for heart failure (US Veterans Adm)

44% Reduction in readmissions over 30 days vs patients not enrolled in telemedicine program (Geisinger Health Plan)

11% Cost savings attributed to telemedicine (Geisinger Health Plan)

$6B Amount U.S. employers would save providing telemedicine to employees (Towers Watson 2015)

Rural Business Imperatives20% Americans live in rural areas without easy

access to primary or specialty care (TrendWatch 2015)

48 Rural hospitals closed since 2010 (NRHA)

283 Rural hospitals in danger of closing 2016 (NRHA)

66% Rural hospitals without telehealth (RUPRI 2013)

Adoption of telemedicine is significantly higher at

hospitals in more rural areas as compared to

urban areas.Center for Connected Health Policy

Michael Adcock, FACHEAdministratorCenter for Telehealth

What is Telehealth?

Telehealth lets doctors examine and treat patients remotely, in real time, using online streaming video technology and other interactive tools.

PATIENT & LOCAL CLINICIAN

USING UMMC’S ONLINE TELEHEALTH TOOLS UMMC SPECIALISTS

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Why is telehealth important?

Currently, 53 of Mississippi’s 82 counties are more than a 40-minute drive from specialty care.

Provides specialty care

that is convenient for patients

UMMC CENTER FOR TELEHEALTH

Offers vital support for

primary care physicians

Helps decrease the cost of care and improve

patient outcomes

Supports population health in

underserved areas

Provides interactive distance

educationfor providers to improve

qualityof care

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UMMC Telehealth Timeline

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Diagnostic test interpretationAdult and Pediatric Cardiology1990s

First videoconferencing of telemedicineEmergency Medicine 2003

TelePsychiatry underway2008

Full-time staff assigned to Telehealth 2011

Center for Telehealth formed24/7 Telehealth Call Center2013

Telehealth Scope of ServicesTelemedicine: Live (Audio-Video) Interaction

• Scheduled and unscheduled• Specialty consults, Primary Care, Employee & Student Health,• Prison Health

Remote Patient Monitoring• Chronic disease management

• Multiple disease states• Cost reduction/avoidance

• Readmissions• Medication management

• Post Acute monitoringStore & Forward & Diagnostic Tests Interpretation

• Cardiology, Radiology, Neurology, Audiology• Dermatology, Pathology, Ophthalmology

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UMMC Center for Telehealth Offerings

UMMC Telehealth offers more than 35 typesof specialty care through local clinics, hospitals, and even the patient’s home.These specialties, often not available in rural communities, include:

Emergency Services

eICU

Remote patient monitoring for chronicdisease management

Urgent Care

Psychiatry and Psychology

Plus a wide range of additional adult,pediatric and ancillary services

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UMMC Telehealth by the numbers

800,000+ Patient encounters since 2003

200+ UMMC availablespecialists

35+ specialty

services and growing

200+ locations,with new locationsweekly

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UMMC Center for Telehealth in Mississippi

• Community Hospitals & Clinics

• Mental Health Clinics

• FQHC’s

• Schools & Colleges

• Mobile Health Vans

• Corporations

• Prisons

• Patient’s Homes

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TelEmergency

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• Access to Care• 15 rural MS hospitals• >500,000 patients treated

• Multidisciplinary Team• NP & Board Certified EM

physician• Cost Effective Staffing

• EXPENSE25% reduction in staffing costs

• Rural Communities Benefit• 20% admissions locally

TelEmergency Outcomes Evaluation

New Site-Satisfaction Survey Community Hospital (Q1 2014)

100% physician satisfactionTotal patients seen with TelEmergency: 884

Total admission to that facility: 208Total transfers from that facility: 68

Total discharges: 608

Total admissions to this facility increased by 101 patients in Q1 of program

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Telehealth Strategy

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• Access

• Health and Wellness

• Education

• Training

• Collaboration

• Workforce Resource Optimization

Telehealth Strategy

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Consumer focused solution for competitive edge

Quality enhancement and risk mitigation

Resource optimization

Coordination of services

Strategic partnerships for growth

Population health

UMMC Center for Telehealth

• Build capacity in community

• Strengthen relationships• Optimize resources• Community revitalization

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Provide a turn-key solution for communities

Support community-based care

Delivery of Care

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UMMCSpecialist side of care

Rural HospitalPatient side of care

Clinical Quality

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Maintain same standard as in-person care

If the technology can not replicate the exam you would do in-person then the visit is not appropriate for telehealth. Do not

cut corners.

Study clinical outcomes and compare to in-person outcomes

Future Areas of Focus

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Population Health Management

Patient Engagement

Data Sharing/Access

Outcomes Analysis Provider Adoption

MISSISSIPPI DIABETES TELEHEALTH NETWORK

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MS Diabetes Telehealth Network

Background and Significance

• 2010: MS has highest % of adults diagnosed with diabetes• 2011: seven of the leading causes of death in MS were chronic-

disease related• 2012: diabetic medical expenses in MS totaled $2.74 billion

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MS Diabetes Telehealth Network

Purpose:• To improve clinical outcomes

and care coordination for chronic disease management

• Increase access to care• Bring healthcare resources

into the patient’s home

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Remote Patient Monitoring (RPM)

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The delivery of home health services using telecommunications to enhance the delivery of home health care including:

Daily Health Sessions

Personalized Interventions

Targeted Education

Health Coach

Behavior Modification

Patient Empowerment

MS Diabetes Telehealth Network

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HbA1c

1.7%

Medication Compliance

96%

Health Session Compliance

83%

Retinopathy Found

9 cases

Weight Loss

71 pounds

Miles Saved

9,454.11

No Hospitalizations or ER visits for DMPreliminary results on first 100 patients

Empowering Patients with Technology

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“Education is not a building…it is learning and I’ve learned so much!”

“This program works. I have learned more in this program than I did when I was in a hospital.”

“I never thought to look into my shoes”

“I have learned more in the few months of being in this program than I have in 17 years of having diabetes”

RPM in Mississippi

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SB 2646 (2014)- SAF; RPMSENATE BILL NO. 2646

(As Sent to Governor)

AN ACT TO CREATE NEW SECTION 83-9-353, MISSISSIPPI CODE OF 1 1972, TO REQUIRE HEALTH INSURANCE AND EMPLOYEE BENEFIT PLANS IN 2 THIS STATE TO PROVIDE COVERAGE AND REIMBURSEMENT FOR 3 "STORE-AND-FORWARD TELEMEDICINE SERVICES" AND "REMOTE PATIENT 4 MONITORING SERVICES" TO THE SAME EXTENT THAT THE SERVICES WOULD BE 5 COVERED AND REIMBURSED IF THEY WERE PROVIDED THROUGH IN-PERSON 6 CONSULTATION; TO DEFINE "STORE-AND-FORWARD TELEMEDICINE" AND 7 "REMOTE PATIENT MONITORING"; TO AMEND SECTION 83-9-351, 8 MISSISSIPPI CODE OF 1972, TO INCLUDE EMPLOYEE BENEFIT PLANS IN THE 9 REQUIREMENT FOR INSURANCE REIMBURSEMENT FOR TELEMEDICINE SERVICES; 10 AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI

http://billstatus.ls.state.ms.us/documents/2014/pdf/SB/2600-2699/SB2646SG.pdf

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UMMC’s RPM Plan• Monitoring for patients across

multiple chronic diseases• Significant cost savings• Extend outside of Mississippi’s

borders• Continue innovative approach

to bringing healthcare resources into the patient’s home

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Changing the Game

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Our team is dedicated to helping healthcare organizations deliver better care and access to more patients at a lower cost, while providing resources and clinical expertise. Addressing

today’s quality, cost and access challenges.

Center Of Excellence

Ensuring the ‘right’

technology

Marketing & Public Relations

Driving cultural change via RPM

Big swing strategies

• 100k+ Telehealth Visits a year

• Focus on patient experience

• 218 Sites of Services

• 35 Medical Specialties

• Care-Innovation• AT&T• GE• C-Spire• Standardization• Collaboration

• UMMC - Academic Center

• D.C. -Policymakers

• MS Governor

• Create culture of accountability and operational excellence

• Create a standardization philosophy for services and equipment

• Collaborations with key partners

• RPM collaborations• Healthcare access

for all• Rural expansion –

Belzoni• Fostering financial

growth• Branding and

Expanding UMMC Nationally

Thank you

Michael Adcock, FACHEAdministrator, Center for Telehealth

University of Mississippi Medical Centermadcock@umc.edu@ummctelehealth

601.815.2048

Jeff CowartUniversity Health System

jeff.cowart@uhsystem.com225.615.6070

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