1. Show-me ECHO E xtension for C ommunity H ealthcare O utcomes E. Rachel Mutrux Sr. Program Director, Missouri Telehealth Network June 26, 2014

2. Missouri Telehealth Network University of Missouri- School of Medicine Mission: to use telehealth to increase access & quality of healthcare & provide education & research What we do: o Connect providers & patients over telehealth o Provides Continuing Medical Education (CME) credits for providers in rural Missouri Telehealth Network. o Is a part of the HTRC – Resource Center for telehealth activities in the state and across the nation. o Sub-contractor for the Missouri REC- Missouri HIT Assistance Center working with primary care providers to get EHR and achieve Meaningful Use

3. MTN Staff 3 Mirna Becevic, Associate Director Deb Denham, Business Support Specialist II Dr. Karen Edison, Medical Director Candy Garb, Telehealth Coordinator Omer Malik, Telehealth Coordinator Intern Rachel Mutrux, Sr. Program Director Danny Myers, Project Development Specialist Mary Beth Schneider, Training Coordinator Wendy Vogel, Office Support Assistant IV Katie Vollmer, Telehealth Coordinator Paulina Vazquez Moldando, International Telehealth Fellow

4. MTN Experience Work with legislature Develop new telehealth clinics- work with providers Existing partnerships with health care stakeholders o Missouri Primary Care Association o Missouri Hospital Association o Federally Qualified Health Centers Technology Provide CME Training conferences Existing communication lines Research Missouri HIT Assistance Center- Missouri’s REC

5. Missouri Counties with MTN sites

6. 6 Hospitals Federally Qualified Health Care Centers Community Mental Health Centers Specialty Medical Clinics Rural Health Clinics Cancer Hospital Missouri Division of Youth Services locations Missouri Department of Corrections facilities Army Hospital Rehabilitation Hospitals School of Medicine Nursing Homes State Health Facilities School of Nursing School of Health Professions Urgent Care Clinic Student Health Center Classrooms Conference Rooms Types of Locations

7. Growth of MTN Clinical Telehealth Includes all MTN member site usage.7

8. Telehealth / Telemedicine Is NOT a new service. IS a new service delivery mechanism. Increases Access! Moves information- not people. Reduces travel costs and other barriers.

9. Why Telehealth Clinical Shortages Maldistribution of providers Rural / Urban underserved Aging population Travel time, cost & hardship Delayed Treatment Language barriers Clinical education programs Administrative meetings An economic development factor in rural areas

10. Limits of 1:1 Telehealth

11. ECHO layers onto existing MTN services… ECHO layers onto existing MTN services… ECHO Specialist outpatient care via video CME & Admin use of Telehealth

12. Unlimited Potential Patients treated by PCP in own Community PCP’s getting educated ECHO Teams 1:1

13. Missouri Project: o Wayne Cooper, retired state representative and physician o Diane Franklin, current state representative o Karen Edison, dermatologist, health policy expert, telehealth champion o Rachel Mutrux, Director, MTN

14. December MO Delegation to New Mexico January -ECHO visits MO -Educate legislative & executive branches & stakeholders March -Rep. Franklin introduces HB2154 -Funding inserted in appropriation bill -Show-me ECHO team testifies in support May -ECHO language in 2 House bills gets combined and ends up in 2 Senate bills, passed both houses -ECHO funding passes both houses June -ECHO planning continues -ECHO teams -Evaluation -Space Waiting for Governor’s signature on bills!

15. Diabetes Health Literacy Hepatitis Pain Management

16. CDC Application MO DHSS MPCA MO DOC

17. ECHO wish list for MO Chronic Pain Management Hepatitis C Mental Health/ Substance Abuse Autism Diabetes High Risk OB Infectious disease Complex Costly Common Chronic

18. Questions? Contact: E. Rachel Mutrux Sr. Program Director, Missouri Telehealth Network 2401 Lemone Industrial Blvd. Columbia, MO 65212 573-884-7958 mutruxe@health.missouri.edu