afhcan & alaska telemedicine
DESCRIPTION
TRANSCRIPT
AFHCAN & Alaska TelemedicineCindy Roleff, MS, BSN, RN-BC
AFHCAN Lead Telehealth CoordinatorAlaska Native Tribal Health Consortium
Who is AFHCAN?What are our challenges?What solutions have we implemented?
What were the outcomes?What are the next steps to meet the remaining challenges?
Overview
Who is AFHCAN?
AFHCAN 1998-2006 AFHCAN started in
1998 as a federally funded 4-year project to provide telehealth solutions to 235 sites belonging to 39 autonomous health organizations in Alaska
4
FY 1999-2000 - needs assessments & development of h/w & s/w solutions Oct 2002 - all equipment deployedOct 2002 - 2006 – organizations worked with telecommunications companies to extend connectivity to all sitesFederal partners: VA, DOD, USCG, IHS
◦ AFHCAN Program Development Strategic development and/or expansion of telehealth
programs Designs clinical workflows Provides training & education
◦ AFHCAN Product Development Provides customer service Develops h/w and s/w solutions Evaluates new technology through a Telehealth
Technology Assessment Center Manages AFHCAN warehousing & inventory
Whole Telehealth SolutionDesign Manufacture Deploy Install Train Support
6
Challenges
Roads, weather, cable/satellite, language, culture, health services
571,951 sq. mi.710,231 residents
Developed regions < 1% of total land area
Solutions
10
Store & Forward vs. Real-TimeStore & Forward
• Asynchronous Interaction
• Documents & Images• Electronic Medical
Records• Patient Education
• Radiology• Dermatology• Pathology• Oncology• Ophthalmology• Dental
• Cardiology• ENT• GI• Pulmonary• Rheumatology
• Psychology/ Psychiatry• Neurology• Speech therapy• Physical therapy
Clinical specialties for telemedicine
• Face-to-Face Interaction
• Immediate Feedback
Remoteconsultation
Real-Time (VtC)
Primary Care Tool◦ Ear Disease◦ Heart Disease◦ Respiratory Illnesses◦ Trauma, Skin and Wounds◦ Dental Problems◦ General Care
Currently supported peripherals include:◦ Video Otoscope◦ Digital Camera◦ Scanner◦ Video Conferencing◦ ECG◦ Spirometer◦ Tympanometer◦ Audiometer◦ Dental Camera◦ Vital Signs Monitor◦ Stethoscope
Design Evolution
User-Designed Interfaces
12
Case originated…
…Case received
Accredited by the American Telemedicine Association
AFHCAN specific training targeted to federal partners and others with our systems…evolving to a much broader audience
Add new course about once/year based on need Wide range of courses and learning modalities
AFHCAN Training
Variety of training options:◦ Train the Trainer (5-day)◦ Super User (3-day)◦ Clinical Administrator (1 ½ -day)◦ Telehealth Technical Support (3-day)◦ AFHCAN orientation/training (1-day, ½ day, hourly)◦ Videoconferencing user training (1-hr. modules)◦ Continuing education courses through UA
Three e-learning options:◦ Videoconferencing (VTC)◦ Computer-based training (CBT)◦ Web-based training (WBT)
AFHCAN Training
1/1/2001 to 12/31/2011
Outcomes
2001-2011
18
Alaska customer base includes:◦ 300 sites, 44 organizations
Tribal, US Army & Air Force, Public Health Nursing, Community Health Centers, Alaska Psychiatric Institute, Private Physicians
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Case
s Cre
ated
Cases Created per Year
19
49%
27%
20%
9%
13%
0% 10% 20% 30% 40% 50% 60%
Digital Camera Images
Video Otoscope Images
Scanned Images
ECG Files
Electronic Forms
% Cases
% Cases Using Each Device
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Annual Travel Savings (by Case Role)
Primary Care Specialty Care
21
Next steps
Unique AK needs Unique opportunity based on currently non-
competing programs Initial partners Goal of statewide membership AK Collaborative for Telemedicine &
Telehealth (ACTT) NRTRC opportunities
Professional Society (ACTT)
Goals◦ Establish a collaborative, non-competitive professional
forum to share ideas, promote educational opportunities and best practices among telehealth providers statewide
◦ Create a website that provides information regarding statewide telehealth programs, educational opportunities and links to telehealth resources in Alaska and throughout the Northwest region
Professional Society (ACTT)
• AFHCAN & University of Alaska have partnered to offer three college courses – Course 1- Telehealth Fundamentals– Course 2 – Beyond the Basics of Telehealth– Course 3 – Telehealth Program Management
• Completion of Courses 1&2 result in certification as Telehealth Coordinator
• Completion Courses 1-3 result in certification as Telehealth Program Manager
University Partnership
Not AFHCAN specific courses, open to all Continuing education credit Transition to university credit option
◦ Occupational endorsement◦ Continued option to take for CE only at reduced price◦ Electives for a variety of degree programs
Housing of courses
University Partnership
Issues to consider◦ Definition of terms in telehealth◦ Affordability of courses◦ Accessibility of courses◦ Academic credit, occupational endorsement,
certification….what’s really needed?◦ Content challenges◦ Are practicums practical?
University Partnership
