TeleneurologyCare:WhyItWorksforRuralHospitals

NRHAWebinar

Duane Miller, MBA, FACHEMr. 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, MDDr. 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

AsdefinedbytheAmericanTelemedicineAssociation

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.

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.

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

“Telemedicineismosteffectivewhenappliedwherephysicianresourcesarescarceandpatientcareistimesensitive.Anditisprovidinghopetoruralhospitalsinanerawhenclosureisavery

realpossibilityunlessnewmodelsofcarearedeployed.”

—Dr.McCormick

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

PatientsAll ages receptive to it, not just younger patients. They appreciate having access to physicians when

they need it most.

AdministratorsAppreciate the cost savings, census increases, and viable answer to physician shortage.

PhysiciansAppreciate the work-life balance, 24/7 coverage, quick availability of specialists.

NPs & PAsBenefit from having physician support and expertise.

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 technology can transmit still images, such as photos and X-rays, for interpretation by the physician.

• The technology enables the physician to 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.

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—Eventhemostremotehospitalbecomesacenterforqualityneurologicalcare.

• CollaborativeCare—SupportNP/PAmanagementbyprovidingaccesstophysiciansoffsitewhocanguideandadvisestaff.

• Telenocturnists—Anefficient,highlyfunctionalalternativetonighttimecareinruralhospitals.

• Tele-ICU—OffsiteICUphysiciansprovideexpertcareatICUbedsides.

• Telepsychiatry—Meetthegrowingdemandforbehavioralcarenomatterwhereyouare.

• Others—EmergencyMedicine,Cardiology,ID,Rheumatology.

TE L EN EURO LOGY: A N ATURA L EVO LUT ION F OR TE L EM ED I C IN E

Every40seconds,someoneintheU.S.suffersastroke.

Strokesarethe4th leadingcauseofdeathintheU.S.

Strokesarethe#1causeofdisabilityintheU.S.

T I M E I S B R A I N

Best-in-classteleneurologist resultsareimpressive:

• Averageresponsetimeof3.5minutes.

• Averagediagnosisandtreatmenttimeof21.8minutes.

• 40%decreaseintimefromemergencydepartmentarrivaltoadmission.

• 1to1.2-daydecrease inhospitalAverageLengthofStay(ALOS)forstrokepatients.

• Door-to-driptime<60minutes

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

Teleneurologycancovertheentirespectrumofacuteneurologicemergencies.

• Examples includestatusepilepticus, coma,andintracranialhemorrhage.

• Consultationonallemergencyneurologicalproblems, includingutilizationoftPA.

• Additional consultationonICUpatientsregardingallaspectsofmedicalmanagement, includingreversal ofanticoagulants.

W E L L - Q U A L I F I E D P H Y S I C I A N S

Teleneurology physiciansareexperiencedinbothacuteneurologyandtelemedicine.

• Theypossessanadvancedunderstandingofworkingasapartofacohesiveteam.

• Theydemonstrateanopenandcompassionateapproachtocaringforpatients.

• Teammayincludeneurologistswithadditionalfellowshipsinstroke/vascularneurology.

G E T T I N G S T A R T E D

Implementation

• Start-upResourcesInclude:

• Siteoperationsetup- Technology integrationwithhospital- Protocolandprocessdevelopment- Nurseandmedicalstaffin-services

• Licensingandcredentialingexpenses

• Clinicalleadership consultations

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

“Wherevertheyare,ourphysicianscanrespondwithin15minutestoanypatientsufferingastrokeorseizureatINTEGRISBass,doadiagnosis,prescribeathrombolyticdrugorothermedication,and

determinethemostappropriateleveloftreatment.”

—HerbRogove,DO,FCCM,FACP,Eaglephysician leaderforthe

INTEGRISBassprogram

I N TEGR I S B A S S CA S E S TUDY: CHA L L EN GES

• Ruralhospital inEnid,OK,oftentransferredpatients toTulsaorOklahomaCity—both100milesaway—forspecialized care.

• Lookedforamoresophisticated, effectivesystemfortreatingstrokeandotheracuteneurologypatients on-site.

• Wantedtoensureanytwo-wayvideoconferencingtechnologywas“alwayson,”readilyavailablewhenneeded, notusedasERcoatrack.

I N T EG R I S B A S S C A S E S TUD Y : E AG L E T E L EN EUR OLOG Y S O LU T I ON

• Neurologists are“beamed into”INTEGRISBassviatwo-wayvideoconferencing.

• Keepspatients intheirhomecommunity.

• Facilityanticipates $200,000reduction inlocumsupportcostsannually.

• Expects additional revenuesgreaterthan$55,000annuallybyreducingtransfers.

• Gainsmorerobustopticsandinstrumentation thanprevioussystem.

I N TEGR I S B A S S CA S E S TUDY: I N TOUCH TE L EN EURO LOGY R OBOT

• InTouch Health partnerprovidestheremotepatientmonitoringtechnologyhardwareandnetwork.

• Remote neurologistcanconductneurologicalexam,andgetaclearpictureofpatient’scondition.

• InTouch systemis“alwayson,”sonotimewastedwaitingforboot-up.

S I GN I F I CA N T R EDUCT ION I N LO CUM SUPPOR T CO S TS

“Ibecameanadvocateoftelemedicineasaresultofareductionoflocumsupportcostsfor

neurologyandreduction inpatient transfers.”

—DuaneC.Miller,MBA,FACHE,VicePresidentandCFO,

INTEGRISBass

F UR THER D I F F ER EN T I ATES I N TEGR I S B A S S

“Patientsofallageslikethetelemedicineapproach, anditfurtherdifferentiates ourfacility

fromothersinnorthwestOklahoma.”

—DuaneC.Miller,MBA,FACHE,VicePresidentandCFO,

INTEGRISBass

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

• TypicalStrokeDRG:$8,500*

• TypicalStrokeDRGwithtPAadministration: $13,000*

C O M M U N I T Y R O I

• Bringbestacutestrokecareavailabletocommunityresidents

• SpecialtysupportforED,Hospitalist,andPrimaryCareProviders

• 21st centurymedicalcareandinnovation

• Allowsmostpatientsandpatients’familiestostayintheirhomecommunity

T I M E I S B R A I N

Arecapofthebenefits forcareofstrokepatients:

• Averageresponse timeof3.5minutes.

• Averagediagnosis andtreatment timeof21.8minutes.

• 40%decrease intime fromemergencydepartmentarrivaltoadmission.

• 1to1.2-daydecrease inhospital AverageLengthofStay(ALOS)forstrokepatients.

• Door-to-driptime <60minutes.

V A L U E

• AdeleTickets— $200

• iPhone 6s— $700

• HondaAccord— $31,000

• Walkingoutofahospitalafterastroke—

Priceless

QuestionsandComments?ThankYou!

www.EagleTelemedicine.com