1. Telehealth Show Me the Money
Connecting Communities for Better Health Learning Forum and Resource Exhibition
Heather Gerhart
Health Resources and Services Administration
HIV/AIDS Bureau

2. VISION
NO MATTER WHO YOU ARE OR WHERE YOU ARE YOU GET THE HEALTH CARE YOU NEED
WHEN YOU NEED IT

3. Awarded over $225 million in grants since 1989
OAT Grant Awards
Awarded over $225 million in grants since 1989
FY2004: Approximately $31 million
Competitive and congressionally-
mandated projects
FY2003: 110 programs, in states and District of Columbia

4. TELEVILLAGE TELEHEALTH Business Libraries Public Health Justice K-12
Professional
Education
K-12
Education
Consumer
Health
Services
TELEMEDICINE
Business
Administration
Libraries
Public
Health
Justice

5. Educational and Administrative Uses
U.S. Department of Health and Human Services
Health Resources and Services Administration
Educational and Administrative Uses
Continuing education
Patient education
Administrative meetings
Rural providers can receive continuing education without the need to travel.

6. Real-Time Telemedicine
Patient in rural ER gets benefit of local care plus remote consultation with specialists.
Remote doctor examines a patient’s inner ear from a remote location.

7. U.S. Department of Health and Human Services
Health Resources and Services Administration
Store-and-Forward
Primary care provider takes a still image and sends it to a consulting physician who later reviews it
No real time interaction between patient & consultant
Commonly used for dermatology, radiology
Clinician reviews scan which was forwarded for consultation.

8. Home Health Low-cost equipment that needs only a regular phone line
Used to check vital signs, monitor medications, visualize patient, provide enhanced support
Blood pressure, heart and lung sounds, range of motion, wound care
Patient and nurse interacting during a “video home visit.”

9. Emerging Technology Applications
U.S. Department of Health and Human Services
Health Resources and Services Administration
Emerging Technology
Applications
Emphasis on low cost applications
Applications that improve quality of
care
Integration of information systems within institutions and across health care institutions

10. Inland Northwest Telepharmacy System

11. RESOURCES
SHOW ME
THE
MONEY

13. MANY FEDERAL AGENCIES FUND TELEHEALTH PROGRAMS
U.S. Department of Health and Human Services
Health Resources and Services Administration
MANY FEDERAL AGENCIES FUND TELEHEALTH PROGRAMS
NLM
NIH
AHRQ
RUS
Commerce
TOP
ATP
DOD VA
NASA
HRSA
CMS
CDC

14. Don’t Be Limited To Grants Labeled Telemedicine or Telehealth
U.S. Department of Health and Human Services
Health Resources and Services Administration
Don’t Be Limited To Grants Labeled Telemedicine or Telehealth
AHEC Grants
Community Health Centers
Nursing Informatics Grants
Homeland Security/Disaster Preparedness
Rural Development/Hospital Flex Grants
Community Access Program
Rural Outreach Grants
NIH Categorical Grants

15. HRSA Telehealth Inventory
U.S. Department of Health and Human Services
Health Resources and Services Administration
HRSA Telehealth Inventory
“Hidden Telehealth System”
Telehealth activities which are not labeled as telehealth programs or activities

16. Preliminary Findings from HRSA Telehealth Inventory

17. Non-Grant Sources of Support
Third Party Payers
Medicare
Medicaid
Private Insurers
Workman’s Comp
Universal Service Program
Contracts
Prisons
Schools

18. Lessons Learned from Our Grantees
U.S. Department of Health and Human Services
Health Resources and Services Administration
Lessons Learned from Our Grantees
Planning Phase
Conduct a targeted needs/
resource assessment
Form a clear vision of what you want
Ensure that vision “jives” with ‘needs”
Involve the community in planning
Match technology to needs
Strategic Plan/business Model
> Develop institutional support
The most important lesson I want to share with you today is the need to understand what the market is for services. You need to know your market. And understand what the needs are and what the demand is for services. The targeted needs assessment will provide you with that information. -
And it is important to have organizational support. For without that your program is setting itself up for failure.

19. Lessons Learned (continued)
U.S. Department of Health and Human Services
Health Resources and Services Administration
Lessons Learned (continued)
Implementation
Champion(s)
Clinician acceptance
Staffing: Site Coordinators, Technical Personnel
Visits/encounters should resemble services as usual
Close contact with all sites - nurture the partnerships; especially physicians
Market, train, market, train!
Focus on Value Added
Identifying a Clinical Champion is critical to the success of the program. This person or persons will help with clinician acceptance and can be your spokesperson wherever they go.
Staffing is important -make sure staff have dedicated time to implement the program and put it in their job descriptions.
Market…...

20. Lessons Learned (continued)
U.S. Department of Health and Human Services
Health Resources and Services Administration
Lessons Learned (continued)
SUSTAINABILITY
Reimbursement
Licensure
Establish quality, results/outcome measures
Develop protocols
Training and Technical Assistance
Some important lessons on how to survive post Federal funding:
When an applicant applies for OAT dollars, they are aware that they will need to develop a strategic/financial plan the first year of operation. Given that requirement, we urge grantees to work with their third party payors to have them to cover the tm consult as if it were a face-to face.
Design multiple uses for the system-for instance Maine is contracting with the Correctional system, the dept of mental health and the dept of human services; many programs are using it for continuing education, or applying the technology to special settings.
Standardize the process as much as possible and provide training;

21. 10 Steps to Writing a Successful Grant Application
Know What Agency is asking for
Show how your project fits Agency goals
Know What you want to do and why and how you want to do it
Review instructions very carefully

22. 10 Steps to Writing a Successful Grant Application
Budget realistically
Write a clear budget narrative that justifies your budget, but is not endless
Do not oversell: Keep expectations reasonable

23. 10 Steps to Writing a Successful Grant Application
Understand and convey that you understand limitations in your project
Use simple and clear language and do not rely on appendices
If partnerships involved, demonstrate real commitment of partners (define contributions in terms of money, roles and responsibilities)

25. CONTACT US Heather Gerhart 5600 Fishers Lane Room 7C-22
Rockville, MD 20857
Phone: (301)
Fax: (301) Fax