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
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
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
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”
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 [email protected]@ummctelehealth
601.815.2048
Jeff CowartUniversity Health System
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