1. Program Coordinator, Emergency and Inpatient Telemedicine Services
Brooke Yeager, MSc, RRT
Program Coordinator, Emergency and Inpatient Telemedicine Services
Medical university of South Carolina

2. What is Telemedicine? Telehealth Telemedicine
Broad definition of health services provided across a distance through electronic medical information exchange
Telemedicine
The use of electronic communications to exchange medical information from one site to another to provide medical care to a patient.

3. Georgia TeleHealth Encounters
Telehealth on the Rise
Year
Georgia TeleHealth Encounters
2006 8
2007
8,000+
2008
9,900+
2009
18,000+
2011
40,000+
2012
70,000+

4. Telehealth on the Rise Consumer Demands Fast, convenient tech
Value-Based Care
Changing payer system
Politicians Agree!
High-speed Broadband Connectivity
3% homes in 2000
70% homes in 2013
Source:

5. Organization of services

6. MUSC Programs Operational
School-Based Clinics (RTs and asthma management)
Maternal-Fetal Medicine
Neurology
EEG
Pediatric Emergency and Critical Care
Pediatric GI
Pediatric Burn
ICU (and ICU Innovations)
Psychiatry (Victim/Trauma Specialty)
Outpatient Services (Nutrition, Sickle Cell, Pediatrics, Transplant follow-up, Surgical follow-up, etc.)
In Development
Sexual Assault
Pediatric Heart Transplant
Neonatology
Cardiology
Child Abuse
Wound Care/Skilled Nursing

7. Barriers to Success

8. (Diminishing) Barriers
Lack of reimbursement (improving) Parity Laws and Medicare Coverage
Credentialing (by proxy)
Connectivity (increasing)
Cost of technology (decreasing)
Fear of change/unknown (we have to change this)

9. Parity Laws

10. Credentialing
Credentialing of individual providers at each outlying facility has traditionally been a big road block
New CMS and Joint Commission standards allow for credentialing-by- proxy
Referring facility agrees to accept credentialing decisions by the consulting facility
Consulting facility must be Joint Commission accredited
Consulting facility provides a list of physicians credentialed to provide the selected services
Referring facility provides performance review information to assure quality of care
These options should substantially reduce the time and resources required for credentialing procedures.

11. Evolution of Technology
The speed of innovation is both a blessing and a curse. “State of the Art” three years ago may now be obsolete. Must avoid “New Toy Syndrome” Adaptability and flexibility of system is absolutely essential Standard communication platform Wireless capability Ability to integrate with or transition to handheld devices Constant feedback and process improvement

12. Telehealth Equipment

14. Telemedicine Units

15. Peripherals
Other devices: spirometers, EKG, vitals monitors

16. Opportunities for Respiratory Therapists
Outpatient monitoring (COPD, Asthma, and home vent patients)
Physician offices (telespirometry)
Education
Management

17. Questions