1. Copyright © 2003 by Pearson Education, Inc. All rights reserved. The Archway... to Telemedicine

2. Copyright © 2003 by Pearson Education, Inc. All rights reserved. What is Telemedicine?... the use of electronic information and communications technologies to provide and support health care when distance separates the participants. Institute of Medicine, 1996

3. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Telemedicine BackgroundBackground ApplicationsApplications Benefits and ChallengesBenefits and Challenges ResearchResearch ConclusionsConclusions RecommendationsRecommendations

4. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Background The evidence suggests that the concept dates to 1924.

5. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Coldeway’s Quadrants STSPDTSP STDPDTDP

6. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Quadrants Defined ST/SPST/SP –Same Time/Same Place DT/SPDT/SP –Different Time/Same Place ST/DPST/DP –Same Time/Different Place DT/DPDT/DP –Different Time/Different Place

7. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Who… … is involved with telemedicine?

8. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Telemedicine Networks

9. Copyright © 2003 by Pearson Education, Inc. All rights reserved.

14. Telemedicine Applications 1. Remote Consultation 2. Remote Monitoring 3. Remote Education 4. Telementoring

15. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 1. Remote Consultation

16. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Video Clip #1

17. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 1.a Telepsychiatry

18. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 1.b. Telemedicine for Children with Disabilities

19. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 2. Remote Monitoring

20. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Video Clip #2

21. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 2.a Collaboration

22. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 2.b Access to Information

23. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 3. Remote Education

24. Copyright © 2003 by Pearson Education, Inc. All rights reserved.

25. Video Clip #3

26. Copyright © 2003 by Pearson Education, Inc. All rights reserved. 4. Telementoring

27. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Video Clip #4

28. Copyright © 2003 by Pearson Education, Inc. All rights reserved. When… …do we use telemedicine?

29. Copyright © 2003 by Pearson Education, Inc. All rights reserved. When do we use telemedicine? Maldistribution of health resources urban and/or rural Capitated populations Access Distance/Time/Travel Patients and Families Outreach Physician Isolation of Provider National/International

30. Copyright © 2003 by Pearson Education, Inc. All rights reserved. When do we ‘NOT’ use telemedicine?

31. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Telemedicine Benefits and Challenges “It is an amazing invention, but who would ever want to use one?” Rutherford Hayes, 1882 on the using telephone for the first time

32. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Trends Marketplace reform/managed care Shifting site of care Hospital>Clinic>Home Case Management/Team Care Improved communications between provider and patient Health care practices and affiliations Digital convergence

33. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Benefits Patient Perspective Access: Time, Travel, Expense Health Provider Collaboration Enhanced Communications TV & Computer Applications common and non- threatening Added attention may enhance confidence that all that can be done is being done

34. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Benefits Provider Perspective Communication/Collaboration with specialists ER ‘front-line’ support CME/Lifelong Learning Saves time, travel to outreach clinics

35. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Challenges Lack of reimbursementLack of reimbursement Licensing and Credentialing issuesLicensing and Credentialing issues LiabilityLiability PrivacyPrivacy InfrastructureInfrastructure End-user IssuesEnd-user Issues

36. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Recommendations Conduct a comprehensive telemedicine audit/assessmentConduct a comprehensive telemedicine audit/assessment Explore financial issuesExplore financial issues Develop a short-, mid- and long-range telemedicine planDevelop a short-, mid- and long-range telemedicine plan Build training initiativesBuild training initiatives Systematic implementation of planSystematic implementation of plan

37. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Audit and Assessment Medical Services DataMedical Services Data –Descriptive elements –Current services –Current technologies Service Opportunities/NeedsService Opportunities/Needs Miscellaneous Observations/CommentsMiscellaneous Observations/Comments

38. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Financial Issues Program BudgetsProgram Budgets Finding FundsFinding Funds Maximizing InvestmentsMaximizing Investments Measuring IntangiblesMeasuring Intangibles

39. Copyright © 2003 by Pearson Education, Inc. All rights reserved. The Plan Clarifying GoalsClarifying Goals Prioritizing ObjectivesPrioritizing Objectives Policies and ProceduresPolicies and Procedures Operational IssuesOperational Issues PersonnelPersonnel

40. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Training is essential!

41. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Video Clip #5 : A Typical Telemedicine System

42. Copyright © 2003 by Pearson Education, Inc. All rights reserved. Mere Vehicles Telemedicine and information technologies are mere vehicles that permit the delivery of health care services but which have no greater impact on health care than the truck that delivers our groceries has on our nutrition. It is the content of the vehicle that permits effective health care, not the vehicle.