Session Four Telehealth Provider Training: Education and Simulation Good afternoon and good morning everyone and welcome to the atom Alliance Quality Innovation Network Learning and Action Network Telehealth Series Session Three: Overview of the South Carolina Telehealth Alliance: Outcomes and Lessons Learned with Dr. Jillian Harvey and Shawn Valenta with the Medical University of South Carolina. My name is ______ from _______and I will be your event moderator today. September 20, 2017

Agenda Housekeeping Opening Remarks Presentation Q&A Closing Remarks Our agenda today includes a few housekeeping items; an introduction to our co-sponsors and partners in quality, some opening remarks, the presentation; a question and answer session; and closing remarks

Housekeeping Items: Chat To ensure maximum sound quality, participant lines have been muted; however we welcome ALL questions and comments via the chat board on the right hand side of your screen To submit questions or comments: Use WebEx chat – send messages to the panelists or all participants using the chat feature drop down menu All phone lines have been muted to preserve the sounds quality during the presentation. now and during the presentation. We encourage your participation throughout in the chat feature. You can select to send your questions or comments to all participants, or certain individuals from the drop down menu. A few of us from from the atom Alliance will be monitoring the chat box for questions and any feedback that you would like to share and will respond either in the chat box or during the call. A link to download the slides from this presentation will be posted in chat.

Housekeeping Items: Q & A To ask panelists questions directly, and privately The panelist can then decide to answer the question privately (only the person that asked the question will see the response), or the panelist can answer publicly, and all participants will see the question and the answer. You may also use the Q & A function to direct questions to certain individuals privately throughout the presentation.

Housekeeping Items: Polling During today’s presentations you may be asked to participate in some polling questions. These questions will come up on the right side of your screen. When you do answer a polling question, be sure to hit the submit button so we can capture your answer. During today’s presentation, we are aiming for 100% participation in some interactive polling questions. Please don’t be afraid--all answers are anonymous. These questions will come up on the right side of your screen in the WebEx Polling feature area. Right after you have selected your final answer, please be sure to hit the submit button so we can capture your answer.

Today’s session has been co-sponsored through a partnership between the following Quality Innovation Network-Quality Improvement Organizations: Health Quality Innovators in MD & VA, Atlantic Quality Innovation Network in NY, DC & SC, Alliant Quality in GA and NC, and the atom Alliance in AL, IN, KY, MS & TN. We are bonded through the dedication to bring high-quality educational opportunities to our Learning and Action Networks in our states and throughout the country. If you’ll notice in chat today, we have subject matter experts from each of these QIN-QIOs—please locate your state’s QIN-QIO representative and feel free to ask them a question or just say hello! Our organizations and attendees on today’s session, represent a significant area of our country. We thank you for taking the time to join us today. We appreciate all you do to improve quality and achieve better outcomes in health and healthcare and at lower costs for the patients and communities we serve.

THIMA represents approximately 2,600 health information management professionals in TN and is a component state association of the American Health Information Management Association (AHIMA). Our mission is to advance the health information management profession through development, education, member representation, and life long learning to ensure quality health information. Our focus: Quality healthcare through quality information We would also like to thank the our partner in quality, the TN Health Information Management Association. Ms. Wanda Mc Knight is here in the chat room in case you have questions about THIMA or the continuing education CEU for AHIMA members.

Objectives During this session, attendees will: Identify three areas of telehealth education to support providers, trainees and communities Design education interventions that support and advance telehealth application development Engage in partnerships to extend existing educational services while addressing the specific needs of new learner populations Here are the objectives for today’s webinar: During this session attendees will: -Learn about the history and creation of the South Carolina Telehealth Alliance -Understand the key components of developing a state-wide telehealth strategy -Discuss the telehealth outcomes and program growth The South Carolina Telehealth Alliance is an unprecedented collaboration of academic medical centers, community hospitals and providers, existing telemedicine systems, government leaders and other entities that believe that all South Carolina residents should and can have access to quality health care, while effectively managing the cost of providing care.

Telehealth Provider Training: Education and Simulation At this time I would like to introduce our speakers today; Shawn Valenta is the Director of Telehealth at the Medical University of South Carolina (MUSC Health) in Charleston, South Carolina. With over 16 years of clinical and health care leadership experience, Shawn oversees the strategic initiatives and operations of the MUSC Center for Telehealth. In this position, he has managed the operations of telehealth services that range from the ICU to the home, including a 26-hospital telestroke network and one of the fastest growing school-based telehealth networks in the country. Shawn has developed and managed the budget for the $65.4 million dollars of state-invested telehealth funds for South Carolina and has successfully executed contracts for nearly 200 South Carolina sites receiving telehealth services. Shawn has also worked collaboratively in statewide strategic planning and furthering the health of South Carolinians with telehealth technology through the formation of the South Carolina Telehealth Alliance. Jillian Harvey is an Assistant Professor in Healthcare Leadership and Management at the Medical University of South Carolina. She received a Master of Public Health from Oregon State University and a PhD in Health Policy and Administration from the Pennsylvania State University. Her research experience includes program evaluation, healthcare quality improvement, and mixed methods research approaches. Her current research focuses on evaluating the development and implementation of telehealth programs and the impact on healthcare outcomes. Jillian Harvey, MPH, PhD Assistant Professor Director, Doctor of Health Administration Division Department of Healthcare Leadership and Management Medical University of South Carolina Ragan DuBose-Morris, PhD  Telehealth Education Manager for the Center for Telehealth Assistant Medical Professor University of South Carolina

Empowering Telehealth Networks through Education and Simulation

Telehealth Education Ragan DuBose-Morris, PhD Telehealth Education Manager MUSC Center for Telehealth Jillian Harvey, MPH, PhD Assistant Professor MUSC Dept. of Healthcare Leadership & Management Telehealth Education

Objectives Identify three areas of telehealth education to support providers, trainees and communities Design education interventions that support and advance telehealth application development Engage in partnerships to extend existing educational services while addressing the specific needs of new learner populations

MUSC Health Medical University of South Carolina Based in Charleston, SC Oldest medical college in the South (1824) South Carolina’s only comprehensive academic medical center Ranked SC’s #1 hospital (by U.S. News & World Report)

MUSC Health - Center for Telehealth Over a decade of experience with telehealth initiatives (MFM, telestroke, telepsych) In 2013 - funded by SC Legislature to: Create a statewide telehealth network Expand telehealth initiatives throughout SC

South Carolina Telehealth Alliance Strategies Technical Infrastructure (open-access telehealth network) Respond to underserved and rural Service Development Education and training Organizational structure Marketing (telehealth awareness) Sustainability (payer engagement)

The Role of Telehealth Education South Carolina Telehealth The Role of Telehealth Education

What is Telehealth Education? Telehealth education is the provision of training and educational services through: In-person; Distance; or Telehealth modalities Telehealth education is part of an ecosystem of clinical, research and administrative services Examples include: Continuing education for healthcare providers related to Telehealth applications, processes and equipment Trainee education related to the history and current provision of Telehealth services Community and patient education about how Telehealth services can be accessed locally Partner education about lessons learned from program and service development

Why is Telehealth Education Important? Education can be the great equalizer The demonstration of education about technology through technology serves as a gateway to de-mystify the process Telehealth education can be seen as a low stakes investment Telehealth is an evolving area of science and application Baseline and continuing education are required for future and current providers Educational programs give partners a chance to test drive relationships and conduct needs assessments Telehealth education is an iterative process that is involved in all aspects of program conceptualization, development, dissemination and quality improvement

How is Telehealth Education Provided? South Carolina Telehealth How is Telehealth Education Provided?

Telehealth Education Modalities In-Person Hands-On Demos Check-Offs Facility Tours Simulation Synchronous Videoconferences Case Presentations Simulations Asynchronous Online Modules Recorded Programs Mobile App Content

Equipment and Processes

Connectivity and Applications Broadband Connectivity Palmetto State Providers Network FCC-Funded Network - Launched in 2008 Hospitals, FQHCs, EMS Hubs, Provider Offices Web-Based Services WebEx Vidyo Learning Management Systems Mobile Apps Patient & Consumer Apps Support Platforms Hardware Carts/Codecs Web-Based Video Applications Mobile Apps PSPN Connectivity

What Does Telehealth Education Look Like in South Carolina? South Carolina Telehealth What Does Telehealth Education Look Like in South Carolina?

Our Ecosystem Undergraduate Students Health Professions Students Graduate Medical Education Residents Practicing Healthcare Providers Community Members: Patients & Caregivers

Practicing Providers Types of Educational Offerings: Privileging and credentialing Competency check-off Equipment Processes Best practices for tele-presenting and teleconsulting Continuing education specific to telehealth programming and evidenced-based practice Telehealth simulation education to extend medical decision-making training

Trainees: Types of Educational Offerings: Interprofessional education for health professions trainees Includes students from all six of MUSC colleges Telehealth Team of the Future focuses on changing systems of care Launched in 2014 – Transitioned to a year-round, online course Includes Experiential Component and Team Project Graduate Medical Education Based off Interprofessional curriculum Piloted with Internal Medicine (IM) Expanding to all IM three years and other residency programs Includes Experiential, Shadowing and Certification Components

Patients and Communities: Types of Educational Offerings: In-Person training before discharge with mobile/home monitoring equipment Diabetic Home Monitoring Chronic Heart Failure Management Weight Management Mobile App Education Smoking Cessation Pediatric Burn Video Conferencing Community Health Conferences Follow-Up Consultations

What Have Been the Translatable Outcomes in South Carolina? South Carolina Telehealth What Have Been the Translatable Outcomes in South Carolina?

Practicing Providers Levels & Modalities of Training: Education developed and disseminated using multiple modalities Meet learners where and how they want to learn Empower providers to incorporate telehealth processes into their workflow Levels of training based on providers’ needs Privileging & Credentialing Competency Check-Off Evidence-Based Practice Continuing Professional Development: Exposure to new modalities of education – tele simulation training Inclusion of new teams of learners – enhanced quality improvement models

Trainees: Health Professions Trainees Graduate Medical Education High-levels of IP course satisfaction and self-reported knowledge gain Additional degree programs utilizing elective course Students who entertain other career options in rural and underserved settings Graduate Medical Education Residents who want more – more opportunities for training and practice Extension of activities to three years with a formal “sign-off” Opportunities for residents to assist faculty with program development Fellows and Interns Research and Clinical Rotations Community Projects – Presidential Scholars

What They Said… “Through telehealth, I can function as an oral health expert and become a member of a larger team that has one common goal—to provide patient-centered care”. “I now realize that my role in any sort of provision of care is to utilize all possible aspects of technology in healthcare to ensure that the population and individuals receive phenomenal care”. “Utilizing interprofessional techniques similar to those seen in telehealth models reinforces my belief that additional perspectives and incorporation of different healthcare professionals will always provide better health outcomes”.

Patients and Communities: Patients Report: Reduction in clinical visits for dressing changes for pediatric burn patients Access to educational services for weight loss in their doctor’s offices Majority had not previously had access to any weight/wellness program Benefits for whole family through shared educational experience Ability of newly diagnosed diabetic patients to watch “prescribed” videos Reduces initial time for adjustment of diet Allows for more tailored follow-up with dietician Allows for community programs to be attended by larger and more diverse groups Ongoing programs on prostate cancer, care transitions, population health

What Are the Opportunities Going Forward? South Carolina Telehealth What Are the Opportunities Going Forward?

Optional Verses Required Telehealth Education Programs are Currently Optional In Many Settings: Good way of engaging community providers and extending relationships Initiating demos and training can help with program feasibility assessment and recruitment Can “walk before you run” – provide patient education and then level-up to consults Innovative way to work towards population health goals through team-based collaboration Telehealth Education Is Becoming Required for Practice: State/Federal Legislative Requirements Higher Education Accrediting Standards Joint Commission Standards

Strategic Opportunities and Collaboration Robust Telehealth Education Programs Enable: Leadership through Content Expertise Collaboration through “Low-Stakes” Program Development Establishment of Technology and Process to Support Distant Communication Can use low-cost and asynchronous applications Add functionality as programs evolve Shared Knowledge-Base of Continuing Education Provider-to-Provider Engagement New Populations of Patients and Research Participants Customized Initiatives Centered on Community Needs Early “Wins” that Lead to Sustainable Partnerships Clinical Research Administration Education

Connect with Us Ragan DuBose-Morris, PhD Telehealth Education Manager MUSC Center for Telehealth duboser@musc.edu Jillian Harvey, MPH, PhD Assistant Professor MUSC Department of Healthcare Leadership & Management harveyji@musc.edu http://www.muschealth.org/telehealth

Polling Question 1 What is the status of telehealth at your organization? And with that, let’s begin our first polling question of the day: Thank you for participating!

Polling Question 2 What type of services is your organization providing We are now ready for our second polling question of the day: Don’t forget to to hit the submit button right after you select your answer

Polling Question 3 What are the major concerns that your organizations has regarding telehealth? And for our third and final polling question today: Right after you have selected your final answer, please be sure to hit the submit button so we can capture your answer.

Questions?

We thank you again for taking the time to join us today We thank you again for taking the time to join us today. We appreciate all you do to improve quality and achieve better outcomes at lower costs for the patients and communities we serve. This presentation will be available for viewing on-demand an a couple of weeks. We will send you and email notification once it is ready. Please connect with your state’s QIN-QIO on social media so we can continue to share and grow this network and demonstrate the impact of the work we are all doing to improve the quality of health care. .

How are we doing? Please complete the survey that will come up as you exit the webinar – we value your feedback in developing future events! This material was prepared by atom Alliance, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO), coordinated by Qsource for Tennessee, Kentucky, Indiana, Mississippi and Alabama under a contract with the ENTERS FOR MEDICARE & MEDICAID SERVICES (CMS), a federal agency of the U.S. Department of Health and Human Services. Content does not necessarily reflect CMS policy. 16.ASD1.05.014

Final Session: (All Sessions begin at 1 p. m. CT) Oct Final Session: (All Sessions begin at 1 p.m. CT) Oct. 18 - Two Decades of Telehealth at Cherokee Health Systems All sessions have been recorded and are available on-demand at: www.atomalliance.org Please join us for the two remaining sessions in this Telehealth Information series. You can also check out our past presentations under the On-Demand Learning Resources section. Thank you and have a great day!