U.S. IV Newsletter Spring 2012 - TELUS Health

IV Experience, passion, results.Professional Services for Healthcare Transformation

Issue N°11Spring 2012

Real life Strategies for a Successful ICD-10 implementation

Health Information Management Principles

The State of Healthcare Information Exchange Today

Clinical Scheduling is the Key to a Successful Telehealth Network


IV US - Spring 2012 - Editorial

I learned a long time ago that “the facts are friendly”, and that as

leaders we ignored them at our peril. All too often we screen

out patterns as shown in the data in favor of our instincts or beliefs

in what cannot be changed.

In this issue of Intelligent Views, TELUS’ commentary on

healthcare transformation, we focus on the smart use of

information and analytics to improve health system design and

decision making.

While the demands of Meaningful Use reporting are presently driving much focus and

spending on IT, we have a unique opportunity to lay the foundation for an information

resource that can be used to enable systemic improvement in the future. Couple this

with clinical and healthcare operational insight and we have the ingredients for informed

decision making at both a population and health system level.

The care demands and financial pressures on the healthcare system create

insurmountable challenges unless we are prepared to look at things differently.

The articles in this issue provide insights gained by our consultants from a number of

differing perspectives. The articles include:

1. Health Information Management Principles – Using Data to Inform Decision Making

2. Real life Strategies for a Successful ICD-10 implementation – an Insider’s Perspective

3. The State of Healthcare Information Exchange Today: what’s possible given

21st century technology, healthcare reform and goodwill amongst competitors?

4. Clinical Scheduling is the Key to a Successful Telehealth Network

More healthcare transformation commentary can be found at www.telushealth.com.

We welcome your feedback about this newsletter.

Dave Wattling

Vice-President, Transformation Services

TELUS Health Solutions

Dave Wattling


Real life Strategies for a

Successful ICD-10 implementation

– an Insider’s Perspective

Cindy Grant

The mandatory implementation of the new ICD-10 classification system in

October 2013 will have a major impact on all healthcare organizations throughout

the United States. The transition from ICD-9 to ICD-10 is not simply a task for

the health information management department, but rather an organization-wide

initiative that impacts nearly every department in a hospital. It is critical that

healthcare organizations conduct an internal assessment to understand the

impact and required changes necessary to prepare for ICD-10.

The following case study demonstrates our approach, key findings

and recommendations for an ICD-10 Assessment and Advisory

Services project conducted in the fall of 2011.

Introduction TELUS Health Solutions was engaged by the Health Information

Management (HI) Department at Hackensack University Medical

Center (HUMC) to conduct an ICD-10 Assessment and Advisory

Services project for the organization. Five key areas of assessment

were included in the scope of this engagement:

1. Assessment of HIM (coder) Training Plan and Development

of Education/Training plan for Physicians and other

organizational staff

2. Clinical Documentation Assessments and Recommendations

3. HIM Departmental and Overall Organizational Readiness,

including the development of a Communication and Change

Management Plan

4. Revenue Cycle Readiness and Assessment of Revenue Impact

5. Report / Output Analysis

HUMC is a non-profit, teaching and research hospital located in

Bergen County New Jersey and is the largest provider of inpatient

and outpatient services in New Jersey with over 750 beds and over

450,000 discharges/visits annually (all types). HUMC is ranked in

the top 10% of hospitals nationwide by HealthGrades and is on the

Leapfrog Top Hospitals List. They provide a wide range of tertiary

programs and services, including state of the art women’s and

children’s specialty centers, a cancer centre, heart and vascular

centre and many more innovative and award winning programs.

HUMC used the Epic Hospital Information System for clinical/patient

care use and is currently upgrading its financial and administrative

systems to Epic. The HI department uses the 3M systems for coding

and other departmental functions and processes. Their health record

is fully electronic and is used by more than 1500 physicians and

other clinicians throughout the organization. The HI department

functions in a nearly paperless environment.

This article provides an overview of the key strategies and tactics

identified and implemented for four key areas of ICD-10 planning

at HUMC:

Planning for HIM Training

Physician and Staff Education

Clinical Documentation Assessment

Organizational Interdependencies

Some of the practical and everyday implications and challenges of

managing and executing these strategies within the context of a

comprehensive organizational ICD-10 project plan are discussed.

1) Planning for HIM Training Effective education and training of HIM (coding) staff, and other staff

throughout the organization, who assign, manage and report using

an ICD code is critical to any effective implementation of ICD-10.

The transition from ICD-9 to ICD-10 is not an upgrade; ICD-10

represents a major change to the structure and logic of the coding

classification system and will require significant effort by the coding,

and other, staff to re-educate and re-learn coding concepts and

rules. In addition, it may be necessary to re-educate or upgrade

training in fundamental clinical topics such as anatomy and

physiology, medical terminology, clinical pharmacology and other

biomedical science areas.

Five key strategies identified for a successful education and training

plan at HUMC are:

Assessment of education requirements for A&P, medical

terminology, pathophysiology and pharmacology for the HI

(coder) group

Development of ICD-10 training curriculum, targeted to the current

proficiency and knowledge of HI coding staff

Development of a training budget, including availability of

grant programs

Identification of most appropriate schedule for training expert

coders vs. training core coding staff

Understand and leverage coding/abstracting vendor tools and

capabilities for preliminary education and training

HUMC was fortunate to receive a training program grant, offered by

a local university; those funds will be used to provide foundational

education in the areas of A&P, medical terminology, pathophysiology

and pharmacology and to send a core group of sixteen (16) coders

to early ICD-10 training. During 2012 and early 2013, this core group

will be utilized to identify and implement the required improvements

in the areas of workflow re-design and clinical documentation, both

within the HI department and with key stakeholders and programs

throughout the organization.

There is an established Clinical Documentation Improvement

program in place at HUMC, staffed by a core group of nurses and

physicians who concurrently assess inpatient health records to

ensure optimal clinical documentation. This group works closely

with the HI coding and data analytics staff to ensure consistency

of ICD code and DRG assignment. ICD-10 training was identified

as essential for this CDI group; strategies are in place to ensure

consistency of training and education between the both the CDI

and HI departments.

In addition to internally or externally provided education and training

programs, it would be an oversight if organizations did not take

advantage of enhanced functionality provided by their system

vendors as part of their education strategies for ICD-10. Through

the 3M system, the HUMC coders are familiarizing themselves with

the new ICD-10 codes and logics for assignment, as part of the

functionality that is now available in the latest release of the software.

2) Physician and Staff EducationIn addition to effective and comprehensive training for HIM and other

coding staff, an essential implementation strategy for any ICD-10

implementation is the training of physicians and other clinical and

administrative groups throughout the organization on the new ICD-10

classification system.

It will be very important to ensure that these groups are fully aware

of and recognize the greater granularity and clinical detail that is

required to adequately assign and use an ICD-10 diagnosis or

procedure code; in addition, the awareness of the impact on the

clinical documentation that they create and on data and information

reporting that is generated and used by the organization is critical.

The three key strategies identified by HUMC as essential for

physician and staff education are:

Identification of all the stakeholder groups that will require

training (physicians, Performance Improvement and Clinical

Documentation Improvement teams, Internal and external

reporting teams, management teams)

Assess level of training required for each group (general

awareness, impact awareness, intensive detailed education)

Determine mode of delivery of training (In person, classroom, job

shadowing, web based on demand training, CD training tailored

by specialty)

It is important that the tactic of “one size fits all” training not be

employed for these groups. The mode of training, and the type

of information delivered, for the senior management group will be

very different than physician or internal or external reporting teams.

A wide variety of delivery mechanisms should be utilized; the use

of in-person, classroom training should be minimized as much as

possible, with the exception of the HI coding groups who will require

more intensive and detailed education.


As part of the Assessment and Advisory engagement, a package

of training materials was provided to HUMC for use in physician and

other staff training. This was provided as a MS Powerpoint (.ppt) file,

including a series of slides that can be customized and tailored by

HUMC to fit their audience.

During discussions with HUMC physicians to assess their ICD-10

awareness and identify their requirements for training, it became

very apparent that the question of “what’s in it for me” must be

addressed in their training sessions. It will be extremely important

to demonstrate the linkage between accurate and complete

documentation and the ability to assign the most specific and

granular ICD-10 code, including implications if the most specific

code cannot be assigned. An effective method of demonstrating

these linkages would be to prepare specific examples of documen-

tation and code assignments, based on individual clinical services

and specialities, and present only those relevant services to forums

such as physician department meetings, speciality grand rounds

and other similar forums.

3) Clinical Documentation AssessmentBest practice for the HIM profession dictates that “if it isn’t documented,

you can’t code it”. The quality and extent of clinical documentation

that is available in an organization’s electronic health record will be

essential to accurately and completely identify, assign, use and

manage an ICD-10 code. Due to the greater level of detail and

specificity contained in the ICD-10 classification, it will be important

to review documentation practices against the new demands for

increased levels of detail to ensure that their documentation can

support more rigorous coding. And in addition, regardless of the ICD-10

initiative, this is an ideal opportunity to review current documentation

standards and practices to ensure that they meet and support:

clinical best practice according to professional and regulatory

standards,

enhanced reimbursement requirements, and

quality and performance measurement outcomes

Three key strategies identified by HUMC to ensure high quality

clinical documentation are:

Perform documentation audits mirroring actual coding practices

to Identify gaps in current documentation that would prevent the

complete and accurate assignment of ICD-10 codes

Collaborate with Clinical Documentation Improvement team to

address documentation deficiencies

Work with EHR / EMR development and/or operational teams to

streamline and improve clinical data capture and access

Examples of improvements to clinical data capture and access

could include improvements to drop down lists and other data

capture fields and the creation of structured queries and workflows

for physicians and clinicians to “drive” entry of most accurate clinical

information, both done within their Epic clinical information system.

The results of the documentation audit were essential in identifying

targeted services and programs for documentation improvement

strategies, i.e. identify those areas of highest volume, risk or case

mix profile. This strategy will allow the organization to focus on those

areas that will result in the most benefit and value, particularly in the

immediate ICD-10 transition period.

4) Organizational InterdependenciesAs with any broad organizational initiative, the implementation of

ICD-10 will not be accomplished in a vacuum. Given the wide use

and impact of ICD codes on diverse processes throughout an

organization, it is important to identify all key interdependencies and

ensure they are reflected in the ICD-10 project tasks and activities.

Examples of these interdependent initiatives at HUMC are:

Implementation of Epic systems

– Upgrades to on-line clinical documentation system

– Implementation of a new financial system (July ’12)

– Upgrade / implementation of new HI departmental systems

(Epic eScription and deficiency tracking (April 2012) and Coding

& Abstracting with automated physician queries (July 2012)

Overall application and integration (infrastructure) upgrades

and testing

Interdependencies in process workflows – streamline/reduce

duplicative and redundant data capture / analysis processes

– Clinical documentation improvement activities

– Performance improvement reporting

– External reporting for quality and outcomes

Representatives from the departmental, program and project

areas are included as members of the HUMC ICD-10 project

steering committee; the completion of tasks and activities within

these projects that may or will result in a direct or indirect impact on

the identification, creation, entry or reporting of an ICD code should

be coordinated with the ICD-10 project implementation teams to

ensure consistency and reduce duplication of effort.

Health Information Management

Principles – Using Data to Inform

Decision Making


Katie Mackle

Healthcare organizations are currently focused on implementing systems and

processes in order to meet regulatory requirements such as Meaningful Use and

ICD-10. It is important however to remember that the ultimate goal is not just to

implement a system, but to create an environment where information is readily

available to inform clinical and business decision making. The primary objective

of health information management efforts is to enable the use of real time

information to improve the quality and efficiency of the healthcare system.

The following health information management principles ensure

data is available and can be used to support the goals of the

healthcare system:

Data is collected in a standardized format In order for data to be analyzed it must be comparable. Data needs

to be collected through discrete data fields, rather than as free text.

Organizations need to develop a data dictionary that defines each

data element. The data elements then need to be used consistently

across all electronic health systems, allowing the organization to pull

together data from multiple information systems.

If data elements are not defined and standardized then it becomes

incredibly difficult to analyze and interpret data. For example, are

“reason for visit” and “chief complaint” the same? If an organization

has not standardized the way data is collected then these fields may

be used for different purposes in different information systems. As

a result, data compiled from both of these fields may provide

inaccurate information. Standardization during the system design

and build phases is critical to ensuring the data is useful.

Data sets contain identifiers that enable data to be linked and aggregatedHealthcare organizations that maintain multiple information systems

need to ensure they are able to link the data across systems. Most

large health systems have interface engines in place to integrate

systems, however there are many smaller hospitals that maintain

disparate systems. They use a single unique identifier for each patient

across all systems, including clinical, financial and administrative

systems, allowing data to be aggregated and analyzed.

A unique identifier is necessary to link data sets in a way that

allows understanding of cause and effect. As a result, longitudinal

relationship between intervention and outcome can be analyzed. For

example, information from a drug information system and laboratory

system can be aggregated to determine whether a blood clotting

drug therapy is effectively controlling patients’ INR levels.

Data sets are of a sufficient size to ensure the validity of future analysesIt is not enough to collect standardized data if the data set is so small

that it cannot be analyzed and interpreted. For example, a single

physician could consistently collect blood pressure values for all of

their patients, however if that physician only sees 500 patients in a

year then the data set is not of a sufficient size to allow for meaning-

ful interpretation. For example, you could not identify blood pressure

trends in female patients with congestive heart failure. However, if

every physician across a health system captures their patients’ blood

pressure values the data set could contain thousands of patients

and become large enough to analyze and trends for subpopulations

would be meaningful. Data standardization and the use of identifiers

support the creation of large data sets by enabling multiple data sets

to be brought together. The larger the data set the more robust the

analyses and the greater the opportunity to gain valuable insight from

the information.

Data is timely enough to give insights into current practice or health statusInformation is not actionable if it is outdated. It may be of interest

to know that 28% of a clinic’s diabetes population had their blood

sugar in control in 2010, however this information does not motivate

change. However, if the clinic knows that only 28% of diabetic

patients had controlled blood sugar in the past month then they can

act on this information. The clinic can proactively reach out of

uncontrolled patients to schedule follow up visits, counsel their

patients on diet and exercise to better control their sugar levels, and

adjust medications as appropriate. The clinic can then review their

data on a monthly basis to measure the impact of their actions and

learn how each intervention impacts the health of their patients. If

information is not timely it becomes a purely historical statistic, rather

than a tool to motivate and measure improvement efforts.

Data is collected at the point of care It is critical that data be collected in real time at the point of care.

Requiring physicians to manually capture data after a patient

encounter is inefficient and leads to incomplete data sets. Health

system leaders need to consider their future data requirements as

part of the electronic medical record (EMR) implementation process.

The system must be designed to facilitate quick data collection that

mirrors the clinician’s workflow. Clinicians then need to be trained to

capture the required data at the point of care.

Users understand how to gain insight from the data Data is useless if users, such as health system administrators and

clinicians, are not able to interpret the data and gain valuable insight.

The goal of data is to provide the information needed to motivate

change and improve the healthcare system. Data must be presented

in a manner that is understandable and conducive to action.

For example, data showing that a hospital ward’s average length of

stay (ALOS) is six days does not provide any meaningful information.

The user needs to understand the ALOS across comparable wards

within the hospital, as well as the industry standard ALOS for the

same type of ward. If the hospital determines the ward’s ALOS is

high then they need to drill into the data. The user will want to ask

questions such as:

Does the ALOS vary by admit or discharge day of the week

or month?

Is there a subset of specific patient diagnoses seen on the ward

that have a longer length of stay bringing up the overall average?

Is there a difference in length of stay by attending physician?

Is there a difference in length of stay for patients by diagnostic

procedure (e.g., patients requiring an MRI, EEG, cardiac

catheterization)?

How do patients typically come onto the ward? Is it a steady flow

(e.g., from the emergency department) or are there admission

spikes (e.g., based on surgery schedules)? Does the admission

flow onto the ward impact when patients are discharged?

Are patients typically discharged to their home or to another

facility? If they go to another facility then does the facility’s

admission policy (e.g., no admits on weekend) impact the ward’s

ability to discharge patients?

The user needs to understand not just that the ward’s ALOS is high

but why it is high. Without this information the ward may be unfairly

penalized for factors that are beyond its control. By understanding the

cause of the high ALOS the ward and entire healthcare organization

are empowered to take action to make the necessary changes.

For example, if the high ALOS is caused by wait times for specific

diagnostic services then the hospital can determine whether the

cost of additional diagnostic equipment and staffing offset the lost

revenue from a higher ALOS.

The State of Healthcare Information

Exchange Today: what’s possible given

21st century technology, healthcare reform

and goodwill amongst competitors?

Allison Larsen

U.S. healthcare is in a dynamic period as federal stimulus funding, consumer

interest in health information management, and related technology all reach

unprecedented levels of scrutiny, maturity and growth. This rapidly evolving

Health IT market adds further complexity and opportunity to new and ongoing

HIT projects. Concurrent with these market forces, Health Information Exchange

(HIE) has experienced a significant uptick in activity. KLAS’ annual report for 2011

noted 227 live HIEs, 160 private and 67 public. This report is striking in contrast

to the previous year’s KLAS report where only 89 live HIEs were measured.

Private HIEs are most often organized around a single entity and

are self-funded. Of particular interest are public HIEs, where

members are often disparately owned entities and are centered

on a geographic region. Funding is most often derived from

government entities or endowments with a focus on making the HIE

self-sustaining over time. Industry analysts note that such endeavors

rely on strong collaborative muscle in order to ensure that

stakeholder objectives are aligned, or at least balanced, such that

regional health care quality improves, cost is reduced and the

community is better-served overall. Early success in HIE has been

noted in a variety of jurisdictions, which has assisted the industry

in providing yet more funding in anticipation of a healthy return.

Improved quality of care and reduced costs (largely through

eradication of duplicate testing) have been reported in HIEs out

of Tennessee, Texas, New York, Vermont, Australia and Finland, as

evidenced by a recent literary review in the National Library of Medicine.

However, many challenges are noted by HIEs in various stages

of evolution. Most often reported are issues around funding,

governance, technical complexity and physician adoption. The

confluence of these issues, coupled with evolving government

standards (and incentives), explain why progress has been slow.

TELUS’ experience with the Carolina eHealth Alliance (CeHA) in

Charleston, South Carolina has recently yielded positive

improvements in healthcare in the area. The project went live last

year and is showing great promise in terms of delivering on the

goals of public HIE, as noted above.


Carolina eHealth AllianceCarolina eHealth Alliance (CeHA) is a collaboration of 11 hospitals,

owned by four organizations, which represent a mix of for-profit

and not-for-profit healthcare delivery, and is the largest live HIE in

the state. Members include Medical University of South Carolina,

Roper/St. Francis Healthcare, Trident Healthcare (HCA owned)

and East Cooper Regional Medical Center (Tenet owned).

Plans for growth include onboarding new members across

the region as they, and their funding, become available. CeHA

envisions the addition of all manner of other healthcare provider

organizations, including various outpatient clinics and even

federal healthcare entities.

CeHA chose to address Emergency Medicine improvements

as a first use-case, with a goal of improving quality of care and

reducing costs through the online sharing of patient records in their

11 emergency departments across the Charleston metropolitan

area. To date thousands of patient records have been aggregated

and made available for use in the HIE portal. Upon a patient’s

arrival in an area emergency room, pertinent data can be pulled

from area hospitals, electronically, and presented to caregivers, in

an integrated view, at the time of care. Such data includes labs,

radiology findings, discharge summaries, allergies and other such

data types.

Early experience is confirming that CeHA leadership was correct in

that improvements can be made by exchanging data in this setting.

In fact, in a four month time-slice across one ED, caregivers

overwhelmingly reported that patient care was improved and ED

length of stay was shortened. A forthcoming study will report much

deeper detail, as well as other key findings around reduction in

costs and improvement in care.

The alliance has been fortunate in gaining key stakeholder support

during its early stages, as well as establishing goals that benefit the

local community and enjoy national recognition in terms of priority

and importance in the overall healthcare arena. As the project

matures, benefits related to overall public health will begin to emerge

and move to the forefront, including: information exchange to public

health entities, improved regional disaster preparedness, shared

learning across hospitals and a greater maturity overall in the

effective use of clinical data exchange in South Carolina.

Lessons Learned, Experience from the FieldThough the CeHA founding hospitals all compete for market share in

the Charleston metropolitan area, a common theme of collaboration

and goodwill has dominated the project throughout. This is a key

strength in that many challenges conspire to provide an unending

list of items that need attention and or resolution. CeHA wisely

employed an independent program director, from the community,

with good relationships with all four organizations’ leadership teams.

This has ensured that senior leadership has remained engaged,

with a direct connection to the director in order to raise issues,

voice concerns and get status reports. The program director also

ensures that all other important stakeholder groups are connected

such that privacy, legal, clinical, technology and PR groups across

all entities are part of the conversation. Any additional time this

may take is outweighed by the reality that all four founding hospital

groups have equal voice in the current and future activities

surrounding the alliance.

Early guidance from HIMSS signaled to our industry that HIE would

require intensive work from the legal sector to ensure projects were

expertly guided throughout. CeHA’s experience has proven out the

early HIMSS counsel: organizational charters, data use agreements,

privacy and security initiatives and technology agreements all must

meet the needs of ‘the all’. While CeHA members utilized an ‘in kind’

model for legal services, as the project expands, future plans include

consideration for outsourcing legal services to keep up with the pace

of a thriving HIE.

Future PlansWith the early success of Emergency Department linkage behind

them, CeHA leaders are expanding usage of the HIE portal to all

employed physicians in their respective organizations, with an eye

towards expanding the benefit to patients and caregivers across all

healthcare settings. This includes large primary care groups whose

caregivers drive a large portion of the area’s healthcare equation.

In 2012 the project will also evolve from its current HL7 message

transaction based technology, to the new standards-based Continuity

of Care Document (CCD) exchange. This plan will ensure that patient

data exchange is more efficiently and effectively managed for current

members, as well as ensure that new members can experience a more

streamlined onboarding process in joining the alliance. With these

plans in place, CeHA is poised to deliver on its goal of improving the

quality of patient care across the region, concurrent with the ONC’s

vision for transforming healthcare with the strategic use of health IT.

Clinical Scheduling is

the Key to a Successful

Telehealth Network

Andrew Stroud

Healthcare services and how they are delivered and managed are currently

going through a major transformation. This transformation is being driven by

the challenges that healthcare systems around the world face, including:

Rising Costs - In the United States alone, healthcare costs rose

from $2.3 trillion in 2008 to $2.5 trillion in 2009. These costs are

expected to reach $4.5 trillion for 2019.1

Quality Care – Providing quality care is becoming increasingly

difficult.

Level of Demands – It is estimated that the number of people in

the world that are over 60 will increase from 600 million to 2 billion

between 2000 and 2050.2

Provider Shortages – Some experts estimate that the United

States will face a shortage of 124,000 physicians and 260,000

nurses by 2025.3

These challenges are forcing healthcare systems to change

and modify how services are delivered. One way health systems

are beginning to deal with these challenges is through alternative

forms of healthcare delivery; specifically, collaborative healthcare

through telemedicine.

Telemedicine uses technology to provide healthcare services across

geographies. Telemedicine services can be provided in real-time

or in an asynchronous fashion. The services can be provided by

providers at their hospital, office, homes or any location where

they can be connected to a network. While telemedicine gives

providers the flexibility to provide services from virtually anywhere,

it also gives patients the ability to receive services from various

locations including their home, GP’s office, the mall, the school or

even a local hospital.

Up to this point in time, telemedicine has not been very successful

within mainstream healthcare in the United States, or anywhere else

for that matter. This isn’t because telemedicine does not add value

or help patients. There are many reasons as to why telemedicine

has not been widely adopted. Historically, telemedicine has been

provided by academic institutions or other institutions that receive

grant monies to try out new technologies. The typical telemedicine

program in the past has received a pot of money through some


1 “National Health Expenditure Projections 2009-2019” U.S. Centers for Medicare and Medicaid Services, 2009, p1.

2 “What are the public health implications of global ageing?” World Health Organization (WHO), September 2006.

3 Nursing Shortage: “American Association of Colleges of Nursing (AACN) Nursing Shortage Fact Sheet,” September 2010, (original source) Peter I. Buerhaus et al., “The Recent Surge in Nurse Employment: Causes and Implications,” Health Affairs, Vol. 28, No. 4, July/August 2009, p w663. Physician Shortage: “The Complexities of Physician Supply and Demand: Projections through 2025,” Center for Workforce Studies, Association of American Medical Colleges, November 2008, p5.

type of grant and used most of the money to go out and buy video

conference equipment along with some new medical equipment.

In most cases, there is no money left to run the telemedicine

program and/or pay the physicians required to provide the services.

The result of these pilot projects is a telemedicine project/service

that has been set up for a limited period of time, with a few

patients seen and a few doctors exposed to a new means of

providing services. Unfortunately in too many cases, the result

is a hospital or healthcare system sitting on a lot of expensive

equipment that does not get used because the grant money

runs out.

Historically in most cases, telemedicine has not been able to

justify itself due to the inability to create scalable delivery models,

the high costs of equipment, provider licensure issues, and most

importantly the lack of reimbursement. Fortunately, the environment

has improved over the last several years. The cost of equipment is

coming down and the government has made millions and millions

of dollars available to create the network infrastructure required to

support telemedicine services. Governments have also started to

ease the licensure restrictions for providers as it relates to providing

telemedicine services. In addition, tools are now available that enable

organizations to create scalable telemedicine delivery and opera-

tional models. All of these factors, coupled with the challenges that

health systems face today, give telemedicine a very bright future here

in the United States and all over the world.

Recent projects have proven that telemedicine can enable health

systems to lower the costs, improve access and quality of care,

increase service capacity, and empower individuals to become more

proactive in their own health care.

Over the past several years TELUS Health Solutions has successfully

deployed the TELUS iScheduler platform, powered by Eceptionist.

iScheduler is a web based solution that provides health organiza-

tions the ability to create scalable business models around virtual

and asynchronous telemedicine services. The iScheduler platform

includes a telehealth module, a triage and referral module, a wait list

module and an extra enterprise scheduling module. This platform

enables organizations to better manage the delivery of collaborative

healthcare services across the healthcare economy.

iScheduler is used by organizations to manage the request and

referral of services into, within and out of facilities. iScheduler can be

used to schedule all of the resources required for collaborative care

including the sites, rooms, physicians, equipment, networks,

bridges and whatever else is required regardless of whether it is

a collaborative event between two facilities or fifty facilities. Finally,

iScheduler ensures that all of the people involved in the healthcare

process have the information that they need at the right time to

provide the required services regardless of whether they are at the

patient site or not. This is possible because iScheduler has been

designed to easily integrate with the existing third party systems that

are already installed at a particular client site.

In Canada, iScheduler is the only commercial product that meets

all of the clinical scheduling requirements related to managing and

providing telemedicine services set by the Canada’s health

information technology certification body, and iScheduler has been

deployed across British Columbia, Manitoba and Newfoundland.

These provincial telemedicine networks successfully created a scalable

platform to manage and expand the delivery of collaborative services.

In the United States, the iScheduler product is also being used as a

tool to facilitate large scale telemedicine services. Some examples of

clients in the United States using iScheduler include Louisiana State

University Health Sciences Center (LSU) and Johns Hopkins

Medicine International. In the case of LSU, iScheduler is used to

manage and facilitate services across LSU affiliates sites and clinics

across Louisiana, community clinics, prisons and jails.

iScheduler is a tool that health organizations can use to help beat the

challenges that health systems face today. iScheduler has proved

over the years that it can play an important role in helping healthcare

organizations transform how and what services are delivered.

For more information on iScheduler, please contact

[email protected].

Questions?

[email protected]

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U.S. IV Newsletter Spring 2012 - TELUS Health

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Transcript of U.S. IV Newsletter Spring 2012 - TELUS Health