June 4, 2007Version 4.0

Agenda

• Welcome and Introductions• Background • Current Setup• TeleConsult Program

– Overview– Emergent vs. Elective workflows– Roles and responsibilities– Schedules

• TeleConsult Web portal• Next Steps• Q & A

Welcome & Introductions

Harborview Team

Administrative– Cindy Hecker, R.N. – April Delgado, R.N.– Joe Marotta– Annie Feyereisen, R.N.– Chris Martin, R.N.– Peter Ghavami– George Cua– Shirley DeVera– Cara Towle

Physicians

– Richard Ellenbogen, M.D.– Laligam Sekhar, M.D.– Wendy Cohen, M.D.– David Tirschwell, M.D.– Randall Chesnut, M.D.– Marcelo Vilela, M.D.– Kyra Becker, M.D.

Background & History

2000: First generation PACS installed at Harborview

2004: Harborview totally filmless

2005: To PRESENT:

– Identified need to transmit digital radiology images from referring hospitals. (Trauma was our primary focus.)

– Determined need to establish a hospital to hospital connection that met all the security and privacy requirements.

– Created Virtual Private Network (VPN).

– Created HIPAA compliant agreement for digital information sharing between hospitals.

– Presented the availability of the VPN connection at the Governor's Steering Committee on Trauma.

– Began connecting hospitals across the state to the network.

Current Setup

PACS TeleRadiologyGateway

(Mini PACS)

VPNConcentrator

Internet(MedWAN, GCI, PeaceHealth,

AT&T, Qwest, etc.)

Kadlec Medical

Harborview Medical Center

Currently connected to 51 hospitals

Lake ChelanHarrison Medical

Central Washington

TeleConsult Pilot Program (1)

• Pilot Objective:– Provide neurosurgery consult to regional hospitals

(initially with four hospitals in the region).

– Improve trauma patient transfer decisions using TeleConsult(patient at the right facility).

– Improve trauma patient transfer procedures via TeleConsult.

– Identify non-emergent neurosurgery cases that can benefit from TeleConsult.

• Participants– Central Washington Hospital (CWH)

– Lake Chelan Community Hospital (LCCH)

– Harrison Medical Center (Harrison)

– Kadlec Medical Center (KMC)

• Duration– Three to four months.

TeleConsult Pilot Program (2)

• Pilot Coordinators– Executive Sponsor: Cindy Hecker, R.N.

– Pilot Manager: Chris Martin, R.N.

– Transfer Center/Medcon: April Delgado, R.N.

– Clinical Manager: Annie Feyereisen, R.N.

– Technical Manager: Peter Ghavami

• Metrics & Measurements– Quantity of consults by hospital, date and type

– Response time from Medcon

– Response time from neurosurgeons

– Outcomes

• Weekly conference calls– Monitor progress

– Report and resolve any workflow issues

TeleConsult Pilot Program (3)

Milestone Date Participants

Orientation Monday, June 4 CWH, LCCH, Harrison, KMC

1st Pilot group Monday, June 11 CWH, LCCH,

Harrison, KMC

Weekly conference call

Every Monday until October

All participants

Schedule

TeleConsult WorkflowEmergentor ElectiveConsult?

Call HarborviewTransfer Center

Enter Consult Request Form

on Web site:www.ReachHarborview.org

Emergent (0-1hr) Elective (0-24hrs)

Neurosurgeon contactsreferring physician

Medcon calls back andconfirms

receipt of information

Send imagesto Harborview

Neurosurgeon will follow up(If required)

Send imagesto Harborview

www.ReachHarborview.org

Next Steps

• Register yourself and encourage your physicians to register at www.ReachHarborview.org.

• Tell physicians at your hospital about this program. Encourage them to use it.

• Use the online request form for nonemergent consult requests.

• Use the usual Transfer Center phone number for emergent requests,(888) 731-4791.

• Don’t forget to send the Radiology images (CT/MRI) to Harborview via PACS (see instruction sheet). Please refer to Harborview’s CT and MRI scanning protocols at www.ReachHarborview.org.

• Participate in weekly pilot meetings: Mondays, 3 p.m., phone number: (206) 315-1785, code: 50065#.

What can you do to make this a success?

Q & A

• Whom do I contact if I have a question?

– For Medcon/Transfer Center questions,

• contact: April Delgado, R.N., (206) 744-6247

– For neurosurgery questions,

• contact: Annie Feyereisen, R.N., (206) 744-9314

– For technical questions,

• contact: Peter Ghavami, (206) 731-2636

• Do I use the Web site for emergent cases?

– No. For emergent cases contact Harborview Transfer Center at(888) 731-4791.

• How do I get technical help?

– Contact your IT professional, or page Harborview PACS/IT professionals at: (206) 541-1653.

– Refer to the Web site for more IT contact information.

Q & A

• What if a response is taking longer than expected?

– Contact:

• Medcon: Elective consults - (800) 326-5300

• Harborview Transfer Center: Emergent consults – (888) 731-4791

• What feedback do we receive after requesting a consult?

– You’ll get a call from the neurosurgeon

– You’ll receive the attending’s notes via fax.

THANK YOU