Developing the Telehealth Workforce

MATRC 2013 SummitDavid Cattell Gordon

Director, Office of TelemedicineCo-Director, Healthy Appalachia Institute

Instructor, Public Health Sciences, Nursing

March 18, 2013

Purpose of Presentation• Are we at a tipping point?• What are the indicators?• What are the consequences?• What are the resources?• What training is needed?• What are the opportunities?• Where we are headed?

The Tipping Point in Telemedicine

The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold,

tips, and spreads like wildfire.

If you want to bring a fundamental change in people's belief and behavior...you need to create a community around them, where those new beliefs

can be practiced and expressed and nurtured.

It’s not just the network stupid, it’s the network.

Engage

• Moving to warp speed: Broadband speeds continue to trend faster across all provider segments; In Virginia, average speeds have doubled since 2010.

• Expanding the universe: Continued increase in broadband penetration; Communities & providers are starting to see broadband as a public health metric.

• Resistance is futile: The Commonwealth is now national leader in the use of telehealth - 54% utilization by health systems; EMRs & HIEs continues to grow (VA is 4th).

• Going where no one has gone before: CVS, home monitoring, EMS…

Policy, Practice and Reimbursement is paving the way

Technology is Exploding

Costs continue to decline Access continues to increase–mobile, 4G… Adoption of standards-based operations Greater movement to the desktop and hand-held Processes are becoming simpler

Demand is Growing

Patient EncountersTOTAL 30,120+

FY 2011 21.3% 4,563

Monthly Avg. 335

7 8 5 8 0 6 7 . 4 2

TOTAL VA MILES SAVED

Fiscal Year Progress

Specialty Services Are Increasing Examples of Innovative Thinking

Stroke NetworkVideo-colposcopy

Remote Home MonitoringALS & Huntington’s Clinic

High Risk OB ClinicStone Clinic

Diabetic RetinopathyCystic Fibrosis Clinic

Ostomy ClinicSurgical Clinic

Emergency Tele-psychiatryPediatric Inpatient

Research 40+

Partner Networks are Rapidly Expanding

Community Hospitals Health Systems Rural Clinics (FQHCs, Free Clinics) Virginia Department of Health Virginia Department of Corrections Community Service Boards School Health Nursing Facilities PACE Programs Home Telehealth

108

Commitments to Telehealth are Increasing

Federal Grant funding (HRSA, USDA,

Commerce) Medicare Reimbursement (rural) CMMI Rural healthcare support

mechanism (USF) Indian Health Service Veteran’s Telehealth Military Telehealth NIST FDA FCC Healthcare Connect

State of Virginia Virginia Health Reform Initiative Virginia Medicaid State Rural Health Plan Virginia Cancer Plan State Stroke Systems of Care Task

Force Virginia Telehealth Network Virginia Department of Health Joint Commission of Health Care Tobacco Indemnification

Commission Medical Schools Health Systems Medical Society of Virginia Mandated Coverage

Benefits of Telehealth Are Well-Established Patients

Timely access to locally unavailable services Spared burden and cost of transportation Improvement in quality of care

Health Professionals Access to collaborative consultative services and CME Spared burden and cost of time and travel Referral network

Rural Communities Enhanced healthcare/economic empowerment

Health Systems Increased accessibility and state-wide presence

Radically Changing Health Care Environment• Demands for Preventing Readmission• Focus on Accountable Care• Increased Outreach to Veterans• Success of Home Monitoring Pilots• Federal Support such as FCC Healthcare Connect• Increasing Medicaid Patients• Medical Homes

The Problem: Limited Telehealth Workforce• Limited training for health professionals• Example: no set curriculum at UVA• Limited number of training programs • Few advanced degree programs• See one, do one, teach one model• Use of physicians to work equipment

The consequences…..

Moving From Blue Screen to Full View HD

• Formation of the STAR Center• Establishment of the Certified Telehealth Technologist

Putting the right person in the right place with the right skills• Improved Capacity in Communities

• Standardized Training/Setting the Standard

Mission: To increase access to health care, improve health outcomes

The Southside Telehealth Training and Resource Center Partnerships

Goals The Star Center• Address shortages and access to care by training

a workforce proficient in employing technologies• Develop a telehealth simulation lab at NCI• Train 250 telehealth technologists by Fall 2013• Deploy capability throughout the Commonwealth

and MATRC region• Create a standardized curriculum and delivery

model• Evaluate outcomes of the training• Foster develop of regional telehealth networks,

remote patient monitoring

Training Topics

•Overview of Telemedicine•Impact on Community Health •Best Practices in Telemedicine•Tools of the Trade•Etiquette and Protocols•Home & Healthy: Remote Patient Monitoring•Technology Lab Experiences•Application to Community

Opportunities

• ED Techs• ED Nursing • CNAs• Home Health Workers• Clinic LPNs and RNS• Paramedics• Home Monitoring Center Staff• Inpatient Staff• Advance Practice Nurses• Community Health Workers• IT Professionals• Administrators

Applications• Telemedicine• Telestroke Programs• Patient Monitoring• Access to Specialty Services• Community Health• Emergency Departments• Population Health• Hospitals, Clinics• Accountable Care Organizations• Inpatient Units• Correctional Telemedicine• Schools• Nursing Homes• etc.

Benefits of a Trained Telehealth Workforce

Continues establishment of telehealth networks Lets physicians do what they do best Ensures standardized skills & training Allows for rapid incorporation of new technology Facilitates ease of integrate with health

information systems Responds rapidly to increased competition Integrates TMED into mainstream medicine Develops novel approaches Improves outcomes Advances remote patient monitoring

Questions & ContactsLeanna Blevins

New College Institute276-403-5602

www.newcollegeinstitute.org

Edie BowlesVirginia Telehealth Network

1-804-453-6286www.ehealthvirginia.org

Kathy WibberlyMid-Atlantic Telehealth Resource Center

1-855-MATRC4Uwww.matrc.org

David C. GordonUVA Office of Telemedicine

434-924-5470www.healthsystem.virginia.edu/telemedicine