1. U.S. Department of Health and Human Services Health Resources and Services Administration Invitational Workshop on Personal Devices Dena S. Puskin, Sc.D. Health Resources and Services Administration Tele-home Care: Expanding the Opportunity for Personal Medical Devices

2. U.S. Department of Health and Human Services Health Resources and Services Administration VISION NO MATTER WHO YOU ARE OR WHERE YOU ARE YOU GET THE HEALTH CARE YOU NEED WHEN YOU NEED IT

3. U.S. Department of Health and Human Services Health Resources and Services Administration Office for the Advancement of Telehealth (OAT) Responsibilities Administer telemedicine grants Evaluate telehealth programs Develop telehealth policy Joint Working Group on Telemedicine

4. U.S. Department of Health and Human Services Health Resources and Services Administration Awarded over $225 million in grants since 1989 FY2004: Approximately $31 million Competitive and congressionally- mandated projects FY2003: 110 programs, in 43 states and District of Columbia OAT APPROPRIATIONS

5. U.S. Department of Health and Human Services Health Resources and Services Administration What is Telemedicine? What is Telehealth?

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

7. U.S. Department of Health and Human Services Health Resources and Services Administration Telehealth can be thought of as a tool box of technologies applied to diverse health care needs in a wide range of health care settings.

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

9. 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.

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

11. Home Health Low-cost equipment that needs only a regular phone lineLow-cost equipment that needs only a regular phone line Used to check vital signs, monitor medications, visualize patient, provide enhanced supportUsed to check vital signs, monitor medications, visualize patient, provide enhanced support Patient and nurse interacting during a “video home visit.”

12. U.S. Department of Health and Human Services Health Resources and Services Administration

13. U.S. Department of Health and Human Services Health Resources and Services Administration Disease Management

14. U.S. Department of Health and Human Services Health Resources and Services Administration

15. 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 and imaging applications in low cost devices

16. Department of Defense (DoD) Smallpox Vaccination Patient Monitoring

18. Informatics U.S. Department of Health and Human Services Health Resources and Services Administration

19. U.S. Department of Health and Human Services Health Resources and Services Administration Informatics

20. I. Example: Encounters by Setting (12 months)

21. U.S. Department of Health and Human Services Health Resources and Services Administration Evaluation Key Questions Who What How When Where

22. U.S. Department of Health and Human Services Health Resources and Services Administration

23. U.S. Department of Health and Human Services Health Resources and Services Administration

24. U.S. Department of Health and Human Services Health Resources and Services Administration CONTACT US Dena Puskin, Sc.D. 5600 Fishers Lane Room 7C-22 Rockville, MD 20857 Phone: (301) 443-0447 Fax: (301) 443-1330 Fax E-Mail: dpuskin@hrsa.govdpuskin@hrsa.gov