1. Telehealth in Wyoming Rex E. Gantenbein, Ph.D. Center for Rural Health Research and Education University of Wyoming

2. What is telehealth? “[T]he use of electronic information and communications technologies to provide and support health care delivery by connecting patients and health care providers who are separated by long distances” (Appalachian Regional Commission, 2006)

3. Telemedicine/Telehealth/Health Information Technology “Telemedicine” is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status (American Telemedicine Association) “Telehealth" is often used to encompass a broader definition of remote healthcare that does not always involve clinical services “Health IT” refers even more broadly to information services

4. Telehealth/Health IT

5. Telehealth services Patient care: consultation, supervision, home health, and interprofessional case conferences Education: new, upgraded, and continuing health education Informatics: digital resources (online medical libraries, information management systems)

6. Telehealth/Health IT technologies Videoconferencing Transmission of still images Remote monitoring of vital signs Continuing medical education Online medical libraries Nursing call centers Distributed data sharing

7. Applications of telehealth Remote patient consultations Specialist referral services Remote patient monitoring Home health care Distance education Consumer information

8. Issues and Obstacles Infrastructure and management Quality Access Reimbursement Licensing and privileging Cost Technical support

9. Implementing telehealth in Wyoming Wyoming Network for Telehealth (WyNETTE) – HRSA Rural Health Network Development Program – HRSA Office of Health Information Technology – FCC Rural Health Care Pilot Program

10. Previous WyNETTE projects Evidence-based practice Mental health Home monitoring

11. WyNETTE currently Goal: Create a statewide telehealth network under WyNETTE name – Dedicated high-speed connectivity for hospitals, community mental health clinics, and substance abuse centers – 40 sites participating so far – Current funding will create telecommunication infrastructure and an independent organization to manage the network

12. WyNETTE currently

13. Other telehealth initiatives in Wyoming Wyoming Telehealth Trauma Treatment Center – Partnership between CRHRE and UW Department of Psychology – PTSD-based counseling for victims of domestic or sexual abuse – Remote connections to safe houses in Gillette, Cheyenne, and Rock Springs 13

14. Other telehealth initiatives in Wyoming Avera Health eCare (Sioux Falls SD) – eEmergency (video) eEmergency – eICU eICU – ePharmacy ePharmacy – eStroke eStroke Avera is partnering with three WY hospitals (Douglas, Sundance, and Gillette) to provide services 14

15. Other telehealth initiatives in Wyoming Powell Valley Health – Tele-pharmacy link to Basin hospital Tele-pharmacy 15

16. Other telehealth initiatives in Wyoming Title 25 pilot – Sheridan Memorial Hospital – Pilot sites for remote evaluation Multidisciplinary Team project – Links to U. of Washington – Mental health evaluation for children 16

17. How could telehealth benefit EHDI? Medical “home” (team approach to care) – Access to specialty care (otology, therapy, etc.) Follow-up in rural communities – Remote screening – Additional testing at later ages Training for parents or other family members Training for local providers, teachers, social workers, school nurses 17

18. The future of health care: THIS … Or THIS?

19. Questions? 19 Rex Gantenbein Voice: 307.766.6544 Email: rex@uwyo.edurex@uwyo.edu