Telehealth Applications in a Community Health Center

Telehealth Applications in a Community Health Center

Patrick McShaneDirector – Special Programs

Beaufort Jasper Hampton Comprehensive Health Services, Inc.

Beaufort Jasper Hampton Comprehensive Health Services Inc.

• Beaufort Jasper Hampton Comprehensive Health Services, Inc. (BJHCHS) is a section 330 Federally Qualified Health Center (FQHC),

• Patient Centered Medical Home model.

• Predominantly serve rural areas of Beaufort, Jasper and Hampton Counties.

• Hampton and Jasper counties are designated as Medically Underserved Areas (MUAs).

BJHCHS


• Providing care for 18,000 patients/year

• More than 81,000 patient visits per year

• Most are uninsured or underinsured

• Additionally care includes: Pediatric; OB/GYN Services; Home Health Care; Nutritional Services; School Based Health Care; Migrant Farm Workers;

BJHCHS Healthcare Mission


• 1996 BJHCHS and the Medical University of South Carolina received a grant through the Office of Naval Research for Telemedicine

• Purpose - address prostate health disparity in BJHCHS’ underserved population– Nurse Practitioner to conduct prostate biopsies in Port Royal

– With real time guidance by a senior faculty Urologist at MUSC

Early Telemedicine - BJHCHS and MUSC


• Innovative technology supported by IBM, Telemedicine & Advanced Technology Research Center (TATRC), and Walter Reed Medical Center Telemedicine.

• Real time encounters were not common place in 1990s.

• The technology was Developed and NP was trained and approved for practice by MUSC Department of Urology

• Local healthcare politics brought the program to an early conclusion in the community

Early Technology – Community Engagement

7TH NationallyProstate Cancer

Public Health\Research InitiativeSouth Carolina Men Ages 20-79

Beaufort-Jasper-Hampton Comprehensive Health Services, Inc.(Section 330 Community Health Center)

St. HelenaCenter

EstillCenter

Port RoyalCenter

ChelseaCenter

RidgelandCenter

HardeevilleCenter

HamptonCenter

SheldonCenter

Institute for Cancer Prevention(Designated NCI Cancer Center)


• 2000 - The Institute for Cancer Prevention (IFCP) in New York partnered with BJHCHS - research to identify bio-indicators for prostate cancer

• Distance technology enabled full participation with researchers in NY

• Conducted community screenings

• Provided patient and provider education programs to detect early prostate cancer in African American Men

Research – The Disparity of Prostate Cancer


• Video conferencing capability in a variety of setting:– Participation in Practice Based Research Programs (PBRN)– Engage in Educational programs from CDC, NIH, CMS,

HRSA, HHS, MUSC, and others– Outreach to rural sites – Telehealth technology fostered adoption of other

technologies by staff• Contributed to early entry of Electronic Health Record

system – we are now implementing our second generation EHR system

Utilization of Distance Technology


Distance Video Conferencing now everyday event

– Telehealth in some rural communities remains a challenge because of service providers

– Recent Telehealth grant application to support 5 School Based Health Care and 5 Medical Centers

2014 Applications


• Our recent application outlined programs that would reach the most rural communities served by BJHCHS:– Expand capacity of School Based Healthcare Program

– Extend the capability of limited resources in support of Patient Centered Medical Home program

– Extend availability of limited resources to distant rural communities with nutrition services, behavioral health, provider outreach, specialty consultations, and others.

Telehealth can supports our mission now


• We are currently applying for funding to: – Include both provider and patient educations programs for

diabetes, hypertension, and weight management

– Provide community outreach programs to several venues simultaneously

– Enable a dialogue with MUSC and other research institutions

– Provide the capability for providers at BJHCHS to reach out to specialists

Telehealth Support of Current Mission


• MUSC’s Department of Telemedicine –guided us to additional resources at MUSC and in South Carolina

• South Carolina AHEC - supports provider and staff CME education

• Palmetto Care Connections – understanding of rural community and connectivity challenges

• Polycom, Inc. provides technical guidance and grant experience

• South Carolina Office USDA – quick and thorough

• Support from community leaders

Telehealth Guidance


• BJHCHS views Telehealth as an additional tool to support our existing mission

• Telehealth can connect to distant locations efficiently enabling a wide range of potential solutions for patient care

• Enables specialized staff (I.E. Dieticians, Pharmacists, etc.) to access more patients in distant centers without the burden of travel

• Providers and staff can access CME without the burden of travel

• Providers can have ability to reach out to specialists

• PCMH can be expanded and implemented more efficiently

Summary


• Cost of connectivity used to be a major restriction to Telehealth – now available at reasonable rates

• Funding opportunities are more readily available

• Community leaders need to share in the vision of the application

• Community Coordinators and Community Health Workers can contribute significantly in support of mission of Telehealth

• Telehealth needs a champion beyond the traditional IT department

• PCMH can be expanded and implemented more efficiently

Lessons Learned

Documents

Telehealth Applications in a Community Health Center