Objectives The learner will Be able to articulate the current state - PowerPoint PPT Presentation

Telehealth in South Carolina : Collaboration, Care Models and the Continuum of Care Kathryn King Cristaldi, MD, MHS Associate Program Director, National Telehealth Center or Excellence James T. McElligott, MD, MSCR Executive Medical Director, Center for Telehealth

Objectives The learner will › Be able to articulate the current state of development of telehealth in South Carolina › Have an understanding of the most common forms of telehealth in use in the State › Be able to discuss the value of various applications of telehealth › Have an understanding of payment innovations that enable telehealth

Telehealth Overview

National Trends in Telehealth The global market is projected to reach over $9 billion

Telehealth in South Carolina

HRSA National Telehealth Center of Excellence ➢ One of two National Telehealth Centers of Excellence in the country ➢ Medical University of South Carolina ➢ University of Mississippi ➢ Funded in 2017 with three- year award

HRSA and the COE Health Resources and Services Administration HRSA Federal Office of Rural Health Policy FORP Office for Telehealth Rural Telehealth Office of Rural Advancement of Network Grant Research Center Health Policy Telehealth Program Univ. Iowa OAT TNPG ORHP Telehealth Telehealth Center Resource of Excellence Centers TRC COE https://www.hrsa.gov/ruralhealth/programo pportunities/fundingopportunities

Telehealth expertise required • “Successful telehealth program with breadth, depth, and high volume” • 77 unique services; > 140 sites; 27 SC counties • Care settings: 28 hospitals; 90 community clinics; 50 schools and alternate sites https://www.hrsa.gov/ruralhealth/programo pportunities/fundingopportunities

Service to underserved areas required • “Telehealth services to medically underserved areas with high prevalence of chronic disease” • 78% of services in completely or partially medically underserved regions https://www.hrsa.gov/ruralhealth/programo pportunities/fundingopportunities

COE Vision • Apply rigorous, team science to characterize telehealth best practices • Develop materials and programs to facilitate ‘next level’ telehealth

3- Year HRSA Cooperative Agreement • “National clearinghouse for telehealth research, resources, and technical assistance” • Living laboratory • Impact of telehealth on healthcare spending • Provider and patient engagement in telehealth • Open access network evaluation and dissemination

HRSA Telehealth MUSC Center of Excellence Center for Telehealth Ford McElligott Creating and Cristaldi Valenta Federal and Local Evaluating a Program Healthcare Primary Care Coordinator Spending Telehealth Kruis Menu Evaluation of Telehealth as Behavioral OAN Provider and Model for Health Focused Evaluation Patient Implementation Telehealth and Best Engagement of Best Programs Practice Practices Dissemination 1. Evaluation 2. Dissemination materials 3. Technical Assistance 4. Consultation

The Mission Improve the health of all South Carolinians through Telehealth (South Carolina Telehealth Alliance) Telehealth for efficient, effective care (Center for Telehealth)

School-Based Telehealth

Supporting Community Practices with Co- management in the Medical Home

Telehealth Overview Synchronous, cart-based and software enabled consultation

Telestroke

Telestroke

Telehealth Overview Synchronous, in-hospital 24/7 monitoring

Telehealth Overview Asynchronous and mHealth Remote Patient Monitoring

Department of Mental Health

Direct to Patient

Service Development Innovation Telehealth Service Strategy Telehealth • Ensures strategy is defined, maintained and then implemented Service Design Telehealth Service Design • Consistent approach to design and development Telehealth Service Transition Telehealth Service • Period of testing through go-live Strategy Telehealth Operations Telehealth Telehealth Service • Operations Supports responsive and stable services Transition Continual Quality Improvement • Aligns services to customers’ needs

Reimbursement Innovation “Classic” telehealth Restriction Relief Remote Patient Monitoring Virtual Check-Ins Multidisciplinary Care Team Payment Models › Behavioral Health Integration Services

Telehealth Industry Engagement Paradox Industry Payment Technology Manpower Models Healthcare Business Delivery Infrastructure Model

Innovations in Collaboration Examples: - School-based care - Mental health support for hospitals - Telestroke

Innovations in Care Models Examples: - Remote patient monitoring for diabetes - Tele-ICU - Tele-sitter for hospitalized patients - Direct-to-Consumer

Innovations in the Continuum of Care Embrace the Asynchronous!

Outsourced Staffing Models Interoperable Technology Outsourced Alternative Virtual Payment Manpower Models

Influencing Strategy Hospital Support Services Primary Care Business Support Health Services Value Institutional MUSC Facility Service Support Extension Services Priority Cost Health Avoidance Disparities

What’s to Come? “ In My Day …..”