Beth O'Connor, M. Ed. Virginia Rural Health Association at Yahoo:
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Beth O’Connor, M. Ed. Virginia Rural Health Association
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Transcript of Beth O'Connor, M. Ed. Virginia Rural Health Association at Yahoo:
Beth O’Connor, M. Ed.Virginia Rural Health Association
What is telehealth?Telehealth is the utilization of information
and telecommunications technologies to electronically distribute health care services and health care data between health care providers, or between health care providers and patients.
- Virginia Telehealth Network
What?Videoconferencing, transmission of still
images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth.
- American Telemedicine Association
What does it mean for rural?Access to specialists
Do without or local doc goes beyond training
Often only option for indigent/uninsuredReduces rural isolation for docsAccess to provider training & other resourcesPatient education
For example…Southwest Virginia Community Health
Systems (SVCHS)Clinics in Saltville, Tazewell, Meadowview,
Troutdale <10,000 combined population
University of Virginia Telemedicine provides access to specialists of...
CardiologyDermatologyDiabetesEmergency MedicineEndocrineENTGastroenterologyGeneticsGeriatricsGynecologyHematology Infectious DiseaseNephrologyNeurologyNeurosurgeryOphthalmologyOrthopedic
ObesityOncology/Tumor boardsPain management Pediatric cardiology Pediatric nephrologyPediatric oncologyPlastic surgeryPsychiatry Pulmonary medicine RadiologyRheumatologySurgeryTCVToxicology/Poison control UrologyWound care
Child TelepsychiatryChild Psychiatry is the most underserved
medical specialtyComplicated diagnostic and medication
issues can stress primary care providersLong commutes to treatment sites are
costly and lead to school absences
UVA Provides…Initial Child Psych Evaluations Medication Follow-Up Visits and Management24/7 On Call for Urgent Medication IssuesNecessary Administrative Support and Record
ManagementCare Supervised by 2 board certified Child
Psychiatrists4500 visits 2007 - 2009
Type of diagnosisADD/ADHDOppositional BehaviorPsychotic DisorderBipolar DisorderDepressionAnxietySubstance AbuseAnd more!
Does it work?As reliable as in-person for clinical
diagnosis and neurological examsAs effective as in-person treatment for
depression and serious mental illnessWould you prefer face to face?
54% = disagree
Did it save you money? 92% = agree
Major implementation issues
Reimbursement Start-up & Capital CostsLicensing of providersBroadband Access
Reimbursement - who pays?Rules vary from state to stateEffective 2011 - most insurance in
Virginia valid for telemedicine10 others: CA, CO, HI, KY, LA, ME, NH,
OK, OR, TXMedicare rules convoluted
Start-up & Capital Costs
Rural T-1 connection = $1,200/month (less fed assistance)
Broadband fiber = $400/monthEquipment = $22,000
Licensing of providers
Rules vary from state to stateNorth Carolina license not valid in Virginia17 states have telehealth provisions for out of
state providers (AL, HI, LA, MD, MN, MO, MS, MT, NV, NM, OH, OK, OR, TN, TX, WA, WV)
Discussion surrounding model of nurse compact
Broadband
No broadband = no telemedicine
