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University of Tennessee Health Science Center Telehealth Network

University of Tennessee Health Science Center Telehealth Network Definitions “Telemedicine” is the use of medical information exchanged from one site to another via electronic communications to support Medical diagnosis Ongoing patient care Remote patient monitoring

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University of Tennessee Health Science Center Telehealth Network

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  1. University of Tennessee Health Science Center Telehealth Network

  2. Definitions • “Telemedicine” is the use of medical information exchanged from one site to another via electronic communications to support • Medical diagnosis • Ongoing patient care • Remote patient monitoring • “Telehealth” encompasses a broader definition of remote healthcare that does not always involve clinical services • Health-related distance learning

  3. UTHSC Telehealth Program Goals . • Provide access to medical services to isolated populations by providing specialty care or second opinions – “to fill in gaps” • 2) Develop and implement programs to improve access to health education for families and clinicians.

  4. Components of the UTHSC Telehealth Network 4 Campuses (18 total sites) 14 Pharmacy sites (4 Memphis) 8 Rural hospitals/clinics 11 Youth Development Center sites (5 Nashville) 2 UTCI Clinics (1 Memphis) 3 Delta Diabetes Sites 6 Carey Counseling/Behavioral Health Sites 1 Department of Children Services Site 1 REAC/TS 1 Urban Health Clinic (Memphis) 3 Methodist / LeBonheur sites (Memphis) 3 Regional Medical Center sites (Memphis) 71 TOTAL Sites

  5. Partnerships • Academic-community hospital linkages • Rural clinics (UT Family Practice) • Tennessee Department of Health • Department of Children Services • UT Medical Group, Inc. • UT Cancer Institute • Methodist LeBonheur Health Systems • Child and Adolescent Psychiatric Associates, LLC

  6. Tennessee Data • 67/95 counties designated rural • 33 counties have 10 or fewer licensed physicians (some have none) • State has provided seed funding to connect 43 FQHCs • FCC supporting 43 FQHC’s and multiple other sites for three years • Governor’s E-Health Council • State telehealth programs: • Erlanger Health System • Mountain States Health Alliance • Tennessee Telehealth Network • Vanderbilt • UTHSC Telehealth Network

  7. Broadband Connectivity • T1 line • ISDN • Satellite

  8. Barriers to Access • Geographic • >20% of US population reside in rural areas • Burden of transportation to care generally borne by patients • Medicaid programs bear the burden of transportation costs • Multiple definitions of rural • Financial • The uninsured, underinsured (> 40 million uninsured) • Delayed access to services for uninsured • High cost of travel for locally unavailable specialty care

  9. Barriers to Access • Societal • Societal stigmatization • Cultural barriers • Language barriers • Maldistribution/shortage of providers • Predicted shortage of physicians 85,000-200,000 by 2020 • Urban predominance of specialty providers • Isolation of rural health providers • Need for continuing health professional education

  10. Benefits of Telehealth • Patients: • Timely access to locally unavailable services • Spared burden and cost of transportation • Avoid excess time off from job • Improvement in quality of care

  11. Benefits of Telehealth • Health professionals • Access to consultative services • Access to CME • Primary care oversight of patient care • Knowledge base/research • Rural communities • Enhanced healthcare/economic empowerment

  12. UTHSC Telehealth Programs • Youth Development Centers • Clinical Specialty Consults • Provider Education • Department of Children Services • Assessment / Case Review • Behavioral Health • Addressing Diabetes in Tennessee (ADT) • Project Diabetes – Tennessee Department of Health

  13. UTHSC Telehealth Programs • Pharmacy • Support Rural Residency Program • Rural Hospitals/Clinics • Clinical Specialty Consults • Provider Education • Delta Health Initiative • Case Review • Patient and Provider Education

  14. UTHSC Telehealth Programs • UT Cancer Institute • Post Oncology Follow Up • Genetic Counseling • REACTS • Nationwide Education from Oak Ridge

  15. UTHSC Telehealth Programs • Urban Clinics • Specialty Consult Services • Epilepsy Study • Provider Education • Methodist / Le Bonheur Children’s Medical Center • Regional Medical Center / Medplex • UTMG Wolf River Clinic

  16. Activity Report

  17. Available Specialists: • Neurology (adult & pediatric) • Pediatric Pulmonology • Post-Transplant Surgery • Urology • Behavioral Health (adult & pediatric) • Pediatric Cardiology • Dermatology • Endocrinology (adult) • Pediatric ENT

  18. Telehealth OutcomesEfficiencies • Patients seen per hour SpecialtyTelehealthTraditional Dermatology 4.8 2.8 Psychiatry 2.3 0.79 ENT pediatric 4.0 2.3 ENT adult 4.0 3.14 Neurology 3.7 2.2

  19. Telehealth OutcomesYouth Development Centers • Prior to Telehealth, only one-third of patients referred to a psychiatrist received a diagnosis. • After six months of telepsychiatry, 100% of patients received a recorded diagnosis. • Medication usage decreased from 1.9 to 1.4 medications per resident.

  20. Telehealth OutcomesYouth Development Centers • 11.3% Decrease in spending on pharmaceuticals per student per month • 38% decrease in spending clinical visits per month • 56% decrease in ER visits per month • Pharmaceuticals • 4 months pre-telehealth implementation - $135.22 • 4 months post-telehealth implementation - $119.96

  21. Telehealth Outcomes • Patient Wait Times • On Time 70% • 10 minute wait 20% • 15 minute wait 10% • As verified by nursing reports and patient satisfaction reports

  22. Telehealth – Patient Satisfaction • Did you feel comfortable with the Telehealth consult? • Yes 93% • No 6% • n/a 1% • Did you think the specialist gave you their attention as well as a regular office visit? • Much better 47% • Slightly better 13% • As good as 40% • Slightly worse 0% • Much worse 0%

  23. Telehealth – Patient Satisfaction • Do you think overall quality service was as good as a regular office visit? • Much better 47% • Slightly better 6% • As good as 40% • Slightly worse 6% • Much worse 0% • Did your telehealth consult save you time? • Yes 100% • No 0%

  24. Telehealth – Patient Satisfaction • Did your telehealth consult save you money? • Yes 100% • No 0% • Would you use telehealth again? • Yes 100%

  25. Telehealth: Better Care for Rural Patients • Average miles from Memphis – 100 • Average PCP consults prior to telehealth for the same acute complaint – 4.7 • Number of telehealth visits – 2.1 • % patients with new diagnosis and/or new medications after specialist referral - 60% • % of patients problem resolved after referral - 90%

  26. Future Direction • Expansion of Pediatric ECHO • TelEmergency to provide 24/7 coverage to rural hospitals • Psychiatry • Geriatric • Pediatric • Adult • State of TN Prison Healthcare

  27. Future Direction • TBI (Traumatic Brain Injury) treatment for returning veterans • University of Tennessee BEAT Diabetes Program: Better Education, Access and Treatment • UTHSC • UTK Extension • Tennessee Department of Health

  28. www.utmem.edu/telehealth Toy Strickland, MBA Interim Executive Director, Telehealth University of Tennessee Health Science Center (901) 448-8844 Office Phone (901) 448-4324 Office Fax twstrickland@utmem.edu

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