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A New Way to Look at the Business of Healthcare Nancy Nahlik Missouri Baptist Medical Center BJC...
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![Page 1: A New Way to Look at the Business of Healthcare Nancy Nahlik Missouri Baptist Medical Center BJC HealthCare March, 2014.](https://reader035.fdocuments.in/reader035/viewer/2022081511/56649c9b5503460f94959885/html5/thumbnails/1.jpg)
Telehealth
A New Way to Look at the Business of Healthcare
Nancy NahlikMissouri Baptist Medical Center
BJC HealthCare
March, 2014
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BackgroundMissouri Baptist Medical Center is a Community Hospital in a large metropolitan market
What could we do to set ourselves apart?• Developed relationships with rural hospitals
• Educated Medical Staff on value of outreach
• Created a hospital philosophy dedicated to rural markets
• Started working on program development specifically for rural hospitals and patients• CME programs• Missouri Heart Network• Affiliation Agreements
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Then……..2002 – 82 specialty outreach clinics in…
13 rural markets by …..45 different physicians
2006 – Rural markets represented 31% of total MoBap “cases”
110 outreach clinics in … 17 markets by …. 63 different physicians
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And Now
2013 – Rural markets represented 28% of total MoBap “cases”
90 clinics in…15 markets by….50 different physicians
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Other Outreach Programs
– Access to Purchasing Contracts through BJC
– Heart Life Line Alliance (STEMI)
– ED to ED Transfer Program
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Why Telehealth?
• Economy
• Physician retirement
• Younger physicians looking for quality of life and work/life balance
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What is Telehealth?
Telehealth: The use of medical information exchanged from one site to another via electronic communications to improve a
patient’s clinical health status.
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Telehealth is…..
NOT SKYPE
NOT Texting pictures from phones
Telehealth must be:
- HIPAA compliant
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Who is Using Telehealth Across the Country & World?
Cleveland ClinicMayo Clinic
Johns HopkinsUniversity of Michigan
EmoryUniversity of Missouri
Missouri Baptist Medical Center
• many more
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How Are They Using Telehealth?
• ICU Coverage
• Hospitalist Services
• Stroke Coverage
• Consulting Services
• Surgical Assistance
• Physician “Office” Visits
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And….
• Pharmacy Support
• School Nurse programs
• In-home monitoring
• Long Term Care Assistance
• Chaplain Assistance – patient and family education
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What Does Telehealth Look Like?
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At the outlying site, it is this…
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And this
And this
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At MoBap, It Is This…
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Telehealth at Missouri Baptist Medical Center
• Mo Bap can beam into 4 rural robots
• Specialty physician visits
• ED transfers
• Working with a Long Term Care Company to put a robot in one of their skilled and rehab units
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Specialty Clinics
• Cardiology • Oncology• Pulmonology
• ENT – discussed, but not implemented
• Neurology – within 3 months
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Specialty Clinic
• Seeing 60 – 70 patients a month in two rural locations
• Both new patients and followups• Patient satisfaction is HIGH• Physician satisfaction is HIGH• MoBap satisfaction is HIGH
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Emergency Services
• Robots in 4 rural CAHs• Available 52 hours a week • In a 5-month period in 2013:– 86 encounters an average of 20 min. each– 64 were direct admits to a floor– 12 admitted to ICU– 4 were recommended for a higher level of care– 2 came to our ED – 1 discharged from rural hospital
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Emergency Services in 2014
• Averaging 4 calls a day
• 3 physicians providing service
• Will be starting 24 hour 7 day a week “Consulting Services” through the ED within the next 3 months
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Emergency Room Telehealth in Action–
• ER Physician in a rural ER determines that a patient needs to be transferred to MoBap. He calls Dr. Winer’s cell phone.
• Through Telehealth - on an IPAD - Dr. Winer is able to “beam into” the rural ER.
• Robot taken into the patients’ room.
• Dr. Winer introduces himself to the patient and through telehealth is able to confirm the condition of the patient – and reassure them about the transfer.
• Dr. Winer calls the MoBap ICU and arranges for a bed. The patient becomes a direct admit.
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What Does This Accomplish?
1. With “eyes on” – the MoBap physician can be reassured about the condition of the patient
2. MoBap can make recommendations on method of transportation – Ground vs. Air
3. Keeps patient from being in 2 EDs
4. Patient and family satisfaction
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Telehealth in Nursing Homes
• In the beginning phases
• Working with one group within Metropolitan Service Area
• Consults will NOT be billable
• Patients will have a record at MoBap whether the patient is admitted here or not
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Advantages to Nursing Home
• A resource for staff during “off hours” to help determine whether a resident needs to go to the Emergency Department.
• Reduces the number of residents sent to Emergency Departments
• Reduces hospital re-admissions• Makes nursing home a choice referral source for
discharges from MoBap, knowing that they are involved in keeping the resident out of the hospital
• Clinical training/education supporting our staff
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Advantages to Hospital• A reduction in non-Emergency visits to the
Emergency Department
• A potential increase in true Emergency Department admissions
• A reduction in re-admissions
• A collaborative partner on the clinical care of patients
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Why Telehealth?
• Efficient patient care• The technology is dependable• It is reimbursed by most insurance
plans• Strengthens rural providers• Provides a platform to grow
marketshare• Consistent with our Mission:
To improve the health of the people and communities we
serve
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Let’s look……