Telemedicine Lessons from Walmart & Texas Prisons - Dr. Glenn Hammack 9 feb2017
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Transcript of Telemedicine Lessons from Walmart & Texas Prisons - Dr. Glenn Hammack 9 feb2017
Lessons from WalMart and Texas Prisons
Telemedicine from Obamacare to Trumpcare
Guest: Dr. Glenn Hammack President and CEO NuPhysicia [email protected] diy.nuphysicia.com www.medicineatwork.net
2 © 2013 NuPhysicia, Inc. All rights reserved.
About Dr. Glenn Hammack
Dr. Glenn Hammack is founding President and CEO of NuPhysicia Inc., the private-equity-funded company providing advanced remote health services to markets across the U.S. and around the world. NuPhysicia has two medical service products: Medicine At Work®, the telemedicine alternative for on-site employee health, and InPlace Medical®, the health care solution for offshore, remote locations, and harsh environments globally. Additionally, NuPhysicia provides telemedicine services consulting and equipment to top-tier national hospitals and health systems through their patented DMS® solution. He received his OD Optometry degree with honors in 1984 from the Michigan College of Optometry at Ferris State University. In 1999 he completed a MSHI Master of Science in Health Informatics from the University of Alabama at Birmingham with a Telemedicine internship at Massachusetts General Hospital. He has contributed to several textbooks, has dozens of publications and abstracts in peer-reviewed literature, and is a frequent speaker and lecturer nationally and internationally.
6 © 2013 NuPhysicia, Inc. All rights reserved.
Texas Telemedicine Program - Correctional Encounter Volume
Fiscal Year 2006 37,161 Anesthesiology 13 Dental 872 Dermatology 281 Diet / Nutrition - Education - Emergency Room 1,330 Internal MedicineAllergy 94 Asthma 4 Cardiology 1,789 Diabetes 4 Endocrinology 63 Gastroenterology 1,581 Geriatrics 1 Hematology 18 Hepatology 313 Infectious Diseases 4,437 Internal Medicine - General 375 Nephrology 74 Oncology - Pulmonology 95 Rheumatology 108 Subtotal - Internal Medicine 2,970 NeurologyEpilepsy - Neurology - General 722
Subtotal - Neurology 292 Obstetrics & GynecologyGenetics - OB-GYN - General 16 Subtotal - OB-GYN 6 Ophthalmology 1 Orthopaedics 2,858 Otolaryngology 302 Pediatrics - Pharmacy 569 Primary Care 6,043 Psychiatry 6,702 Radiology - Rehabilitation - Speech 6 SurgeryCT - Neurosurgery 106 Oral & Maxillofacial 28 Plastics 187 Surgery - General 751 Transplant - Urology 980 Vascular 101 Subtotal - Surgery 680 No Service Reported 6,337 TOTAL 37,161
Specialty
Specialty
8 © 2013 NuPhysicia, Inc. All rights reserved.
Wal-mart Program Background
§ In May of 2008 NuPhysicia was approached to replace nurse-practitioner-staffed retail medical clinics at Houston area Walmart Supercenters with physician served telemedicine clinics.
§ The program needed to provide live physician interactive visits to six (6) locations around Houston suburbs. Medical assistants and paramedics assist the patient, and live video and supplemental examination tools support the physician examinations.
§ An EMR system provides communication, documentation, and prescriptions. § The clinics take cash, check, or charge and do not file insurance. § The program does not use grants or federal program funds in any form.
10 © 2013 NuPhysicia, Inc. All rights reserved.
Opening Day
Medical Assistant and Paramedic ready to go
11 © 2013 NuPhysicia, Inc. All rights reserved.
Exam Room
Paramedic with EMR laptop ready to see patient
14 © 2013 NuPhysicia, Inc. All rights reserved.
Problems
ICD Descrption Count ICD Descrption Count 465.9 URI 233 110.0 Allopecia Areat 2 V70.0 Gen Phy Exam 190 250 DM 2,controlled 2 462 Acute Pharangit 118 386.30 Labyrinth 2
461.9 Acute Sinusitis 76 250.01 NIDDM 2 466.0 Acut Bronchitis 57 388.70 otalgia, unspec 2 401 Essential HTN 26 110.0 tinea capitus 2
372.0 Conjunct 18 708 urticarea 2 382.9 ASOM 17 789.0 Abdominal Pain 1 477.0 Allerg Rhinitis 15 919.0 abrasion 1 487.8 Flu 14 351.0 bell's palsy 1 V04.8 flu vaccine 10 949.0 Burn, unspecifi 1 380.1 Otitis Ext 10 726.33 Bursitis, elbow 1 782.1 rash, unspec 10 920 Contusion face 1 380.4 Cerum Imp 9 780.4 dizziness 1 790.6 Abnormal Lab 7 995.2 Drug Reaction 1 790.6 Hyperglycemia 7 530.81 Esopha Reflux 1 919.5 Insect Bite 6 V72.0 Exm Eyes/Vision 1 995.3 allergic reacti 5 379.91 Eye Pain 1 401.1 Benign Ess HTN 5 251.2 hypoglycemia 1 110.5 tinea corpus 5 272.0 Hyprchlstrlemia 1 684 Impetigo 3 785.6 Lymphaden 1
879.8 Laceration 3 723.1 Neck Pain 1 879.8 Punture wound 3 525.9 Pain, tooth 1 373.11 sty 3 110.3 Tinea Cruris 1
110.3 tinea curis 1 384.2 TM Perf 1 524.62 tmj 1
15 © 2013 NuPhysicia, Inc. All rights reserved.
Clinic Operations Performance
Pts per Day
Rev per Pt
0.0
20.0
40.0
60.0
80.0
100.0
Aug-08 Sep-08
Oct-08 Nov-08
Dec-08 Jan-09
5.8 8.9 20.6 18.4
11.4 8.6
$77.05
$92.98
$64.23 $66.24 $72.88
$88.65
Pts per Day
Rev per Pt
17 © 2013 NuPhysicia, Inc. All rights reserved.
Caring for Business
• Staffed on-site clinic for workplaces
• 3-day or 5-day per week services
• Paramedic on site • MD services by advanced
video tools • No startup costs • No long-term contracts
www.medicineatwork.net
18 © 2013 NuPhysicia, Inc. All rights reserved.
Scope of Services: 3 Key Areas
Convenience Care § Coughs, Cold Symptoms, Flu § Ear, Nose, And Throat Infections § Skin Conditions And Rashes § Muscle Aches and Pains § Bladder Infections § Red Eyes Including Pink Eye Wellbeing Support and Coaching Programs § Blood Pressure, Cholesterol, Blood Sugar
Monitoring § Stress Management § Nutrition Counseling § Weight Management § Activity Counseling Occupational Medical Support § DOT, Other Drug Screens § Non-evidentiary Breath EtOH Testing § Job Physicals, Pre-employment Physicals
www.medicineatwork.net
19 © 2013 NuPhysicia, Inc. All rights reserved.
Consulting for Hospitals and
Health Systems
NuPhysicia was formed in 2007 to
leverage the success of telemedicine
programs developed at the University of
Texas Medical Branch (UTMB) in
Galveston, Texas, which proved to create
dramatic clinical efficiencies while
improving patient outcomes over large
populations over long periods of time.
NuPhysicia brings this expertise plus
commercial successes in global
telemedicine services to assist hospitals
and health care organizations across the
US. Leading national health care
accompanying executive summary
presentation for a strategic telemedicine
program plan. NuPhysicia will work
closely with your leadership, for optimized
data gathering and information sharing
meetings. A core team from your hospital
will be required to help facilitate this
process and secure the needed
information via data requests and
interviews.
The NuPhysicia team will use the data
obtained, and ongoing consultations
with your stakeholders as needs arise to
finalize the strategic telemedicine plan
document for you.
NuPhysicia Training – Clinical
Examination and Workflow
When you work with NuPhysicia, you are
partnering with the most experienced
telemedicine professionals in the industry. In
addition to assisting others create successful
telemedicine programs, we run our own
telemedicine service businesses in global offshore
remote medicine and US-based workplaces.
As such, we know how to DO telemedicine, not
just sell equipment. This means that we provide
the best in clinical telemedicine training, both
Clinical Telemedicine
Training
organizations have turned to NuPhysicia
when facing the challenge of creating
successful, scaled strategic telemedicine
programs.
With NuPhysicia’s recognized expertise
and experience, clients avoid having to
“start from scratch” and thus, will avoid
the common pitfalls and setbacks in
program development. NuPhysicia
provides a trusted and accountable
partner for your telemedicine successes.
NuPhysicia will provide its expertise and
knowledge, and with the input of your
stakeholders, will create a leadership-
focused written document and
Telehealth and Telemedicine Consulting
how to use the equipment and the process of seeing
patients.
Working with NuPhysicia, your patient-side clinicians
are trained by active telemedicine clinicians and
your physicians are trained by active telemedicine
physicians. This is unique in the industry. Your
telemedicine team will learn from individuals whom
have seen hundreds, if not thousands of patients.
Learning is always best when clinicians train clinicians.
On-site or remote options are available, as are one-
on-one live sessions or train-your-trainer programs.
Telemedicine Process
Management (TPM™) Software
Today’s organizations implementing
large-scale telemedicine programs
need more than a scheduler. They
need a complete telemedicine
process management software solution
– NuPhysicia’s TPM™
TPM™ is part of the Digital Medical
Services® or DMS® system, a US-
patented (US 7,912,733 B2) intellectual
property of the University of Texas and
is exclusively licensed to NuPhysicia. It
interfaces to one or more existing
electronic medical records,
automating telemedicine case ready-
status and intelligent notification to the
medical care team. Active monitoring
sends alerts on key events in the care
process.
With our decades-plus experience in building and
operating successful telemedicine programs,
clients choose us to procure and prepare
components as assembled packages for their
needs. NuPhysicia’s unique Integration and
Preparation™ service takes these components
and completes customized assembly with
improved cabling, strain relief, and upgraded
elements to make the system ready for daily
clinical care. Instead of boxes of gadgets and
cables, you get a patient-ready clinical
telemedicine package. Partnerships NuPhysicia helps clients design the most functional, cost effective systems for their application from a broad range of partnered technology providers. Clients are not locked in to a single resource or company product range.
How Does TPM™ work?
• Telemedicine endpoints report real-time
activity via proprietary messaging formats.
• The client EHR connects to +dms® via
secure API or uses +dms® EMRLite™
embedded application.
• The Telemedicine Process Manager –
operated as SaaS via secure cloud,
provides:
1. Provider Demand Awareness and
Patient Flow – +dms® secure web
messenger and virtual waiting room
browser pages.
2. Real Time Activity Alerts – Email or SMS
text – patient ready, patient waiting
too long, too many patients waiting,
more.
3. Analytics and Reporting – +dms®
secure web reports portal, detailed
patient flow data and summary
statistics.
Telemedicine Equipment Packages
TPM™ Software