1. Telemedicine—The How, the Why, the Cost, Benefit
Nipa R. Shah, MD
University of Florida, College of Medicine, Jacksonville
Chair, Dept. of Community Health and Family Medicine

2. TELEMEDICINE VS TELEHEALTH
Telehealth: Encompasses all aspects of health that is administered using remote technology services
Telemedicine—Clinical services are provided utilizing this technology

3. Technology and Health Care

6. TAKE HOME MESSAGE—it’s simple and it’s not simple
There’s no difference in the health care provided, just the modality.
Yet, many laws, policies, procedures play a role.

7. WHO can practice, and WHERE?
Interstate Medical Licensure Compact
Currently at 18 states
Licensure in multiple states-an expedited process
Allows a physician to render care in the state where the patient resides.

8. BENEFITS Speedier diagnoses
Increased access to care, esp. underserved/rural populations
Reduced health care costs
Can relieve physician shortages

9. HOW? AMA has some free resources….STEPS FORWARD program
dopting-telemedicine

10. Florida Report on Telehealth Utilization and Accessibility
Highlighted findings contained within this initial report include:
• Utilization of telehealth is expanding in Florida and nationally, both in terms of the variety of applications and use cases as well as patient volume and demand.
• Nearly half (44.8%) of Florida hospitals responding to AHCA’s telehealth survey indicated that telehealth services are available through their facilities.

11. A state survey

12. Florida Report on Telehealth Utilization and Accessibility
Utilization of telehealth is expanding in Florida and nationally, both in terms of the variety of applications and use cases as well as patient volume and demand.
Nearly half (44.8%) of Florida hospitals responding to AHCA’s telehealth survey indicated that telehealth services are available through their facilities.

13. Florida Report on Telehealth Utilization and Accessibility
Benefits reported from health care facilities and professionals offering telehealth services include improved convenience for both patients and providers, improved efficiencies, and improved patient care outcomes.
Financial barriers are the most frequently reported obstacles among health care facilities and providers during both implementation and ongoing operations of telehealth programs.

14. Florida Report on Telehealth Utilization and Accessibility
Due to multiple and often conflicting definitions of telehealth at every level (Federal, State, and among private payers and policymakers), there is significant uncertainty …purposes of coverage and reimbursement.
There remain significant challenges with interoperability between providers across the state and nationally,

15. Florida Report on Telehealth Utilization and Accessibility
Few providers have achieved a financial Return on Investment (ROI) attributable to the implementation of telehealth services; although some examples do exist.
Many providers reported a lack of detailed knowledge about telehealth services, and indicated interest in gaining access to evidence-based best practices, educational resources, or training opportunities associated with telehealth.

17. UF Health Virtual Visits
22 (out of 35 Primary care clinics) in NE Florida and Southern Georgia
Payers:
Capitated plan with Florida Blue
Gatorcare
Medicaid
Self-pay ($49 introductory visit)

18. Steps Consent form-verbiage added (1 year) Training
Access/Call Center personnel
CSRs/MAs
Physicians/Providers

19. Steps Infrastructure How to schedule the appointment
IT software/hardware (microphone, headset, webcam)
Legal
EPIC EMR (changes with upgrades)
Political (legislature worried about overuse, lack of parity)

20. Steps Marketing (Employers, Payors, Patients) Financial
Competition, national/international
Parity
Payors
Contracting
Billing and Coding

21. Steps Task Force/Committee/Division Problem solving Dissemination
Psychiatry, Pathology, Surgery, Neurology, Neurosurgery, Anesthesiology, Pharmacy, Orthopedics, OMFS, Pediatrics, Ophthalmology
Future: Physical Therapy, Dermatology, OB-Gyn

22. UF Health Virtual Visit

23. Contact information
Nipa R. Shah, MD