CAMILLE INFANTE, COOJENNIFER CAVALLARO, M.D, CMIO

LYNETTE SEID, VP FACILITIESTONY NGO, VP ANCILLARY SERVICES

PROJECT PLAN FOR FEBRUARY 14, 2014

Lakeland Regional Health System

Project Proposal: Telemedicine

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WHO WE ARE

Est. in 1914, Lakeland Regional Health System (LRHS) is a community-based health care network with multi-hospitals including specialty departments in Centers of Excellence for Cardiology, Oncology, Women’s Health, Behavioral Health, Neuro-Sciences and Orthopedics.

Includes senior communities for independent and assisted living and long-term care, Employee Assistance Plan, home care, hospice, teaching/research environment, and holistic medicine.

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OUR CHALLENGE

LRHS leadership is challenged to provide Centers of Excellence services to remote clinics:• Long distance between remote clinics and the Centers of

Excellence • Long patient access wait time for specialty appointments• Physician resource inefficiencies due to extensive travel time• Less physician and patient interaction for regular follow-up

appointments/consultations• Low patient satisfaction scores

Lakeland Regional Health System’s lack of integration between the metropolitan hospitals and the remote clinics must be properly addressed to retain its goal of providing high quality patient care.

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THE SOLUTION

Implementation of telemedicine technology at Lakeland Regional Health System remote clinics

What this provide for LRHS and the community:• Increase physician accessibility/

productivity by allowing patients to interact with their physician via video conferencing

• Reduce patient access wait times by allowing more convenient times for patient follow-ups and consultation

• Improving patient satisfaction • Better serve the rural communities

by extending specialty care services to those who are in need of primary and secondary care

• Improve the overall efficiency and integration of the health care continuum between metropolitan and rural areas

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OUR VISION

Lakeland Regional Health System Goals :

Partnerships with patients and communities

Convenient appointments at local clinics with centers of excellence physicians

Physicians and nurses working as a teamPhysician-to-Physician consultations

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FEATURES

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SCOPE AND LIMITATIONS

In-Scope

• Telemedicine • Hardware• Cisco

HealthPresence© 2.5• Software• Centers of

Excellence• Specialties• Physician & Nurse• Training

Out-of-Scope

• Infrastructure Upgrade

• Emergency Services• Invasive Procedures• Specialties other

than those listed• Assisted Living and

Long-Term Facilities • Home

Health/Hospice

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ORGANIZATIONAL SCOPE

•12 Remote clinics

•Cardiology, Oncology, Neuro & Ortho

Phase I

•Behavioral Health, Dermatology

•Women’s Health

Phase II

•Assisted & Long-Term Care

•Home Health & Hospice

Phase III

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PROJECT SUCCESS FACTORS

• Immediate increased patient access to specialist care.

• Improved health outcomes.• 25% increase in physician productivity.• 75% decrease in appointment

cancellations and no-shows.• Increased patient satisfaction scores.

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PROJECT BUDGETDescription Amount

Capital Funds Telemedicine - 12 Telemedicine Stations (USB Ultrasound probe, PC based ECG monitor, Diagnostic Image camera, and Streaming Stethoscope)

120,000$

- Live interactive video equipment for the Centers for Excellence 40,000 - Cisco HealthPresence© 2.5 software 100,000 - Facility Expenses to Install Equipment 15,000 Subtotal 275,000$ Project Resources 125,375 Project Contingency (5%) 20,019 Total Capital Funds 420,394$

Operating Funds - Project Startup Expenses 20,000$ - Training Expenses 20,000 - Misc. Operating Expenses 25,000

Total Operating Funds 65,000$

Total Project Budget (Capital and Operating) 485,394$

Ongoing Support Costs - Software/hardware maintenance 26,000$

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PROJECT TIMELINE

Description Complete Date

Create project proposal and request funding February 14, 2014Project start June 1, 2014Create steering committee and define governance processes June 8, 2014Develop project plan June 15, 2014Define telemedicine business requirements June 30, 2014Define “as is” and “to be” business processes July 8, 2014Identify IT solutions – hardware, software and infrastructure July 8, 2014Negotiate pricing with vendor and purchase equipment July 15, 2014Redesign business processes July 15, 2014Develop and test solution August 15, 2014Develop training program and train users September 15, 2014Implement telemedicine technology (go live) October 1, 2014Post-Implementation support October 31, 2014Monitor and track results to ensure return on investment February 1, 2015

Assumption: Complementary IT Infrastructure project will be completed by June 1, 2014

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BUSINESS RISKS AND MITIGATIONS

Risk Risk Mitigation Strategy

Lack of acceptance of patients to use telemedicine

The project team will work with the project Physician Leader and identify ways to prepare patients for the new technology. Recommendations include Telemedicine preview day at each clinic to demonstrate the technology

Quality of network infrastructure and WiFi capabilities

The project team will closely monitor the progress of the complementary IT Infrastructure Project to ensure delivery of a strong network and WiFi capabilities

Privacy and Security concerns The project team has identified IT Security resources to join the project team

Continuity of care in EHR The project team will work with the clinics and specialty physicians to define the training necessary to provide continuity of care in the EHR

Credentialing of physicians The project team has identified ARL resources to ensure appropriate credentialing

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PROJECT ORGANIZATION

STEERING COMMITTEECamille Infante, COO *Tony Ngo, VP Ancillary ServicesClark Gable, CFOSusan Leonard, CTO

Jennifer Cavallaro, MD, CMIO **Lynette Seid, VP FacilitiesVivian Leigh, CIO

PROJECT TEAMLynette Seid, Lead Project ManagerRaj Sidana, IT AnalystRick Ricketts, Project Manager IChristine Stern, Training and DevIT Infrastructure (as needed)IT Communications (as needed)IT Security (as needed)IT Network (as needed)

Compliance

Billing

Internal Audit

Nursing

Accreditation, Regulatory

and Licensing

Regulatory Affairs

Training and Development

Appointment Call Center

Human Resources

* Business Sponsor** Business Owner

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TRAINING SCOPE

The training programs will cover clinical, operation, business, and technical aspects of the organization.

The training plans should include: basic knowledge on telemedicine instructions on how to use the new system information on how to learn about new policies and procedures

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TRAINING TOPICS

Project Managers

Strategic Planning

Telemedicine Technologies

Managing organizational

change

Legal and regulatory

considerations

Data collection and management

reporting

Office

AdminInforming patients about

telemedicine, confidentiality and

privacy

Working with remote clinicians

Patient exams

Operating telemedicine

equipment and scopes

Collecting program data

Clinical Providers

Clinical protocols

Privacy and Security

Performing telemedicine consultations

Using the telemedicine equipment

Regulatory Issues

Technical Staff

How to apply telemedicine technologies

Telecommunications fundamentals

Knowing equipment types

Equipment maintenance

Troubleshooting

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TRAINING APPROACH

Ongoing training for new staff and refresher courses will be given to

ensure skills are adequate.

The remaining stakeholders will be trained by the cross functional

team.

Cross Functional Team/Super Users

Project managers, representatives from each department of clinical providers, operations staff, administrations, and technical staff.

Vendors

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FOR YOUR CONSIDERATION

Request approval for telemedicine projectThe Telemedicine Project meets all LRHS

goals:• Partners with patients and communities• Convenient appointments at local clinics• Physicians and nurses working as a team• Physician-to-Physician consultations

Increases physician productivityProject budget: $485,394Project timeline: start 6/1/14 - go live

10/1/14Project sponsor: Camille Infante, COO

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Questions?

TELEMEDICINE PROJECT