1. Rex E. Gantenbein PhD, Senior Member IEEE Center for Rural Health Research and Education University of Wyoming

3. Issues in access to health care in rural regions Distance and isolation Geography and weather Shortage of providers Provider burnout Telehealth is one way to address these issues “Telecommunications technologies to support long- distance clinical health care, health-related education, public health, and health administration” Telemedicine refers specifically to clinical applications

4. Example: access to mental health care Wyoming has a severe shortage of mental health providers Primary care providers have significant responsibility for mental health diagnosis and treatment Few local options exist for referral or consultation Telehealth supports increased access Direct intervention by a distant specialist Consultation between primary and mental health care providers Education and training in diagnosis and care for mental health

5. Technical barriers to expanding telehealth Bandwidth Endpoint equipment Training and technical support Security and privacy The Wyoming Network for Telehealth (WyNETTE) Increased bandwidth for 37 sites (hospitals, clinics, and mental health centers) Videoconferencing units at all sites User manuals and online education Technical support staff

6. Wyoming Network for Telehealth (WyNETTE)

7. Funding for WyNETTE development Telecommunications: Federal Communications Commission Rural Health Care Pilot Project Videoconferencing: Wyoming Hospital Association, Wyoming Department of Health Management and education: Health Resources and Services Administration, US Department of Health and Human Services Network configuration ATM cloud aggregated at University of Wyoming Dual and single T-1 connections made to each site Existing copper wire utilized

8. Non-technical barriers to expanding telehealth Reimbursement Connections for specialty providers to the network Licensing and credentialing Resistance to new technology Sustainability Wyoming is addressing these barriers All major payers reimburse for telehealth care Inexpensive desktop video (NOT Skype!) Innovative “fast-track” licensing process for out-of-state providers Education

9. Questions or comments? Rex Gantenbein, Director Center for Rural Health Research and Education http://www.uwyo.edu/health rex@uwyo.edu