1. 1 The Archway... to Telemedicine

2. 2 What is Telemedicine?... the use of electronic information and communications technologies to provide and support health care when distance separates the participants. Institute of Medicine, 1996

3. 3 Telemedicine BackgroundBackground ApplicationsApplications Benefits and ChallengesBenefits and Challenges ResearchResearch ConclusionsConclusions RecommendationsRecommendations

4. 4 Background The evidence suggest that the concept dates to 1924.

5. 5 Coldeway’s Quadrants STSPDTSP STDPDTDP

6. 6 Quadrants Defined ST/SPST/SP –Same Time/Same Place DT/SPDT/SP –Different Time/Same Place ST/DPST/DP –Same Time/Different Place DT/DPDT/DP –Different Time/Different Place

7. 7 Who… … is involved with telemedicine?

8. 8 Telemedicine Networks

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13. 13

14. 14 Telemedicine Applications 1. Remote Consultation 2. Remote Monitoring 3. Remote Education 4. Telementoring

15. 15 1. Remote Consultation

16. 16 Video Clip #1

17. 17 1.a Telepsychiatry

18. 18 1.b. Telemedicine for Children with Disabilities

19. 19 2. Remote Monitoring

20. 20 Video Clip #2

21. 21 2.a Collaboration

22. 22 2.b Access to Information

23. 23 3. Remote Education

24. 24

25. 25 Video Clip #3

26. 26 4. Telementoring

27. 27 Video Clip #4

28. 28 When… …do we use telemedicine?

29. 29 When do we use telemedicine? Maldistribution of health resources urban and/or rural Capitated populations Access Distance/Time/Travel Patients and Families Outreach Physician Isolation of Provider National/International

30. 30 When do we ‘NOT’ use telemedicine?

31. 31 Telemedicine Benefits and Challenges “It is an amazing invention, but who would ever want to use one” Rutherford Hayes, 1882 on the using telephone for the first time

32. 32 Trends Market place reform/managed care Shifting site of care Hospital>Clinic>Home Case Management/Team Care Improved communications between provider and patient Health care practices and affiliations Digital convergence

33. 33 Benefits Patient Perspective Access: Time, Travel, Expense Health Provider Collaboration Enhanced Communications TV & Computer Applications common and non- threatening Added attention may enhance confidence that all that can be done is being done

34. 34 Benefits Provider Perspective Communication/Collaboration with specialists ER ‘front-line’ support CME/Life Long Learning Saves time, travel to outreach clinics

35. 35 Challenges Lack of reimbursementLack of reimbursement Licensing and Credentialing issuesLicensing and Credentialing issues LiabilityLiability PrivacyPrivacy InfrastructureInfrastructure End-user IssuesEnd-user Issues

36. 36 Recommendations Conduct a comprehensive telemedicine audit/assessmentConduct a comprehensive telemedicine audit/assessment Explore Financial IssuesExplore Financial Issues Develop a short, mid and long range telemedicine planDevelop a short, mid and long range telemedicine plan Build training initiativesBuild training initiatives Systematic implementation of planSystematic implementation of plan

37. 37 Audit and Assessment Medical Services DataMedical Services Data –Descriptive elements –Current Services –Current technologies Service Opportunities/NeedsService Opportunities/Needs Miscellaneous Observations/CommentsMiscellaneous Observations/Comments

38. 38 Financial Issues Program BudgetsProgram Budgets Finding FundsFinding Funds Maximizing InvestmentsMaximizing Investments Measuring IntangiblesMeasuring Intangibles

39. 39 The Plan Clarifying GoalsClarifying Goals Prioritizing ObjectivesPrioritizing Objectives Policies and ProceduresPolicies and Procedures Operational IssuesOperational Issues PersonnelPersonnel

40. 40 Training is essential!

41. 41 Video Clip #5 : A Typical Telemedicine System

42. 42 Mere Vehicles Telemedicine and information technologies are mere vehicles that permit the delivery of health care services but which have no greater impact on health care than the truck that delivers our groceries has on our nutrition. It is the content of the vehicle that permits effective health care, not the vehicle.