Program Coordinator, Emergency and Inpatient Telemedicine Services Brooke Yeager, MSc, RRT Program Coordinator, Emergency and Inpatient Telemedicine Services Medical university of South Carolina

What is Telemedicine? Telehealth Telemedicine Broad definition of health services provided across a distance through electronic medical information exchange Telemedicine The use of electronic communications to exchange medical information from one site to another to provide medical care to a patient.

Georgia TeleHealth Encounters Telehealth on the Rise Year Georgia TeleHealth Encounters 2006 8 2007 8,000+ 2008 9,900+ 2009 18,000+ 2011 40,000+ 2012 70,000+

Telehealth on the Rise Consumer Demands Fast, convenient tech Value-Based Care Changing payer system Politicians Agree! High-speed Broadband Connectivity 3% homes in 2000 70% homes in 2013 Source: http://venturebeat.com/2014/10/20/why-telemedicines-window-is-finally-opening/

Organization of services

MUSC Programs Operational School-Based Clinics (RTs and asthma management) Maternal-Fetal Medicine Neurology EEG Pediatric Emergency and Critical Care Pediatric GI Pediatric Burn ICU (and ICU Innovations) Psychiatry (Victim/Trauma Specialty) Outpatient Services (Nutrition, Sickle Cell, Pediatrics, Transplant follow-up, Surgical follow-up, etc.) In Development Sexual Assault Pediatric Heart Transplant Neonatology Cardiology Child Abuse Wound Care/Skilled Nursing

Barriers to Success

(Diminishing) Barriers Lack of reimbursement (improving) Parity Laws and Medicare Coverage Credentialing (by proxy) Connectivity (increasing) Cost of technology (decreasing) Fear of change/unknown (we have to change this)

Parity Laws

Credentialing Credentialing of individual providers at each outlying facility has traditionally been a big road block New CMS and Joint Commission standards allow for credentialing-by- proxy Referring facility agrees to accept credentialing decisions by the consulting facility Consulting facility must be Joint Commission accredited Consulting facility provides a list of physicians credentialed to provide the selected services Referring facility provides performance review information to assure quality of care These options should substantially reduce the time and resources required for credentialing procedures.

Evolution of Technology The speed of innovation is both a blessing and a curse. “State of the Art” three years ago may now be obsolete. Must avoid “New Toy Syndrome” Adaptability and flexibility of system is absolutely essential Standard communication platform Wireless capability Ability to integrate with or transition to handheld devices Constant feedback and process improvement

Telehealth Equipment

Telemedicine Units

Peripherals Other devices: spirometers, EKG, vitals monitors

Opportunities for Respiratory Therapists Outpatient monitoring (COPD, Asthma, and home vent patients) Physician offices (telespirometry) Education Management

Questions