Jay Srini jsrinij@gmail.com 412 760 9593 2014 NRTRC TELEMEDICINE - PowerPoint PPT Presentation

Jay Srini jsrinij@gmail.com 412 760 9593

2014 NRTRC TELEMEDICINE CONFERENCE ”FACE TIME ME BEFORE YOU TAKE THOSE TWO ASPIRINS!! “Jay Srini MS MSBA FIMSS” “March 24 2014” DISCLOS OSURES Practice Ga Gap: p: Lack o of awareness o on n how t to pr provide spe pecialty care services t to und under-served po popu pulations i in n the r region. Desired ed O Outcome me: :  Providers will be able to apply knowledge acquired from the conference to better provide care using telemedicine to patients across the region.  Providers will be able to solve problems within their practice using telemedicine.  Providers will be able to identify the services available for their patients via telemedicine within their region.  Providers will be able to recognize the changes in telemedicine and how best to continue improving their practices during change. Di Disclosure o of relevant financial r relationships i in n the pa past 12 mont nths: I I have no no relevant financial relation onships w with c com omme mercial interests t that ma may y have a direct bearing on on the subject m matter of this is C CME activ ivit ity.

CONSESUS ON THE EASY STUFF The he term rm t telemedicine lit iterally means “ “healing at a a dis distance” through t the L Latin “medic dicus” and Gre Greek “ “tele.”. ”. Ac Acco cording ng to t o the A Americ ican Telemedi dicine A Assoc ociatio ion, “ “telemedic icine is is the use of of medic dical in infor ormation e exchange f from om on one s sit ite to o another v via ia electronic ic communications t to i improve a a patient’s c clinical h health status.” ” This is in includes “ “the use o of telecommunicat ations and i informat ation t technology gy to provide a access t to health assessment, dia diagnosis, in interventio ions, c con onsultatio ion, s supervisio ion a and information a across d distan ance. Telehea healt lth servic ices allow c con onsumers rs t to o access health edu ducatio ion a and support f for or self-management throu ough t the I Internet, v via ia t their ir h hom ome com omputers rs or or wire ireless de devic ices. Lets agree to the t term c connected h health h to combine face t to face , , virtual , , community based care t to p provide an ecosystem of care a and e education on w which h uses multiple modalities

THE DESTINATION

SEVERAL INITIATIVES HAVE BEEN LAUNCHED ME MEDICAL H HOME ME SHARED S D SAVINGS NGS BUNDL NDLED P D PAYMENT PAY Fo For P PERFO FORMANCE ACAs s … … BU BUT

SUPPLY /DEMAND ASYMMETRY Growth in in chronic ic illness wil ill l continue to spir iral al u upwar ard, 40 percent in increas ase in heart diseas ase an and a a 50 percen ent increa ease in cancer er and diabetes projec ected d for 2023. Baby by boomers are e just begi eginning g to en enter their h high gh-maintenan ance hea ealth care e yea ears of sixty-five ve-plus ( non debat atab able) VS phys ysicians an and nurse ses- (Cli linicians) are both in sh short sup supply. ( workforce s stat atistics d dat ata) a) Scope o of p practic ice r regulat ations are restrictiv ive f for non physic ician an clin inicians

SO HOW DO WE GET THERE MAJOR I IMPEDIMEN ENT: SHOR ORTAGE E OF CLINI NICAL EX EXPERTISE and C COS OST HAMPERING NG SCALABILITY OF PILOT S SOLUTIONS ONS.

CONCERNS The f first st g grou oup, " "The Al Alarmed," is s made up 1 16% of of the public. T They b believe heal ealth c chan ange e is an an urgent prob oblem but have no c o clear i idea of of h how t w to f o fix i x it. ( (Aging B Baby b boom omers) s) The se secon ond grou oup (30% 0%) is s "The C Con oncerned." T They b believe it is s you our n neighbors problem n no t o theirs.. They a are in control! l! ( (mille llenn nnial, l, c current ntly ly healthier b baby boome mers) The t third g grou oup, " "The C Cautious" s" ( (23%), a are peop ople on on the fence. (Enli lightene ned b baby b boome mers, qu quantified s self folks, s, ) ). The f fourth g h group, "T "The he D Disengaged" " (10 10%), d doe oesn sn't k know anything a and nd does no not w want nt t to kno now ( ( con onsumed b by life issu ssues or s or lack t thereof) The f fifth th g group, "T "The D Doubtf tful" ( " (12%), do o not b believe there i is s away t to o sol solve i it. ( the sk sky i is s falling and nd the cup i up is half lf f full ull)

AGENDA THE E CASE F E FOR R SHARED RED D DEC ECISION N MA MAKING NG SHARED ED D DEC ECISION MA N MAKING NG A AND ND HEA EALTH L LITER ERACY FRA RAMEW MEWORK RKS FOR R SHARED RED DEC ECISION N MA MAKING NG TEC ECHNO NOLOGIES ES A AND ND SOLUTIONS NS U USING NG C CONNEC NNECTED ED H HEA EALTH THE E FUTURE : RE : IMPO MPOSSIBLE B E BEC ECOMES MES EVI EVITABLE E

ONE SIZE FITS ALL – NOT A REALITY IN MEDICINE Patients: The recent advancements in technology have ushered in an era of patient empowerment. Previously, patients were largely reliant on doctors for any knowledge or information regarding their health; now, patients have the tools to track and monitor their health at home or on-the-go, allowing them to be active members of their own health team. http:/ ://www ww.m .managedcarem emag. g.com/ m/archives es/1304/1304.s .shareddecision.h .html http://www.linkedin.com/today/post/article/20140218152316-12941029-5-technological- breakthroughs-changing-the-future-of-doctor-patient-relationships

Only 10–15 percent of an individual’s health status is attributable to the health care services he or she receives. The rest is driven by behavior, genetics, and social determinants including living conditions, access to food, and education status. That means t that the t tril illi lions of dollar ars the U United S States spends on health care service ces con ontribute to o on only on one-tenth o of the natio ion’s health . An in individual al’s behavior is is by f far the sin ingle most im important contributor t to his is or her overal all h health. I It is also a a substan antial al d driv iver of heal alth care costs .

SHARED DECISION MAKING NOT A NEW PHENOMENON: In n a 200 2001 r 1 rep eport, Cr Cross ssin ing t the Qualit ity Ch Chasm sm, the he In Institute of of Me Medicine re recommended re redesigning he health c care re pr processes ac according t to 10 rules, man many o of wh whic ich e emph phasize sh shar ared de decis ision mak making. One ne rule le, f , for instance, u , underli rlines t the i impor ortance o of the pat patient as as the so source o of control, e envisioning a a heal alth c car are sy system t that at e encourag ages sh shar ared de d decis ision mak making an and d accommo mmodat dates p s patie ients' s' p preferences. s.

IN FACT WE HAVE RECONGNISED IT FOR MORE THAN 3 DECADES One ne of t the f e first i instances w wher ere t the e ter erm ‘ m ‘shared d dec ecision ma maki king’ w was u used ed w was in a repo eport en entitled t the e ‘Pres esident's C Comm mmission for The S e Study o of Ethical P Problems in Medicin ine an and B Bio iomedical al Research.[1] T This is work b buil ilt o on the in increasing in interest in in pa patient-centredness and nd a an n inc ncreasing e emphasis o on r n recogni nising p pati tient aut utono nomy i in n hea ealth care i e inter eractions s since t the e 1970s. Charle les des escribed a set of pr principles f for s shared d dec ecision ma maki king, s stating “t “that a at l lea east two pa participa pants, t the e clinician a and pa patient be i e involved; that b both pa parties share e information; that b both pa parties t take s steps eps t to build a a consensus about the pr e pref efer erred tr treatment; and nd th that a an n agreement i is r reached o on th n the tr treatment t to imp mpleme ement. t. ” ”Thes ese e princ nciples r rely o y on n an n eventua ual a arrival a at a t an n agreement b but ut th this fina nal p princ nciple i is no not t ful ully accepted b by others in the f e fiel eld. T . The vie iew that at it it is is ac acceptable to ag agree to d dis isagree is is al also regarded a as a an n acceptable o outc utcome of shared d decision making. ^ Charles C, Gafni A, Whelan T (March 1997). "Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango)". Soc Sci Med 44 44 (5): 681–92. doi:10.1016/S0277-9536(96)00221-3. PMID 9032835.

WHERE ARE WE NOW