Sponsored by:

Statewide Health Coordinating Council (SHCC)

&

Texas Public Health Association

Technology Committee

Presenter:

Janie M. Gonzalez, SHCC Public Member

Date: February 19, 2010

Developing the Next Generation Roadmap for HIT & Telemedicine to a

Healthy eTexas

State of Texas Healthcare CostsIn the 1998 fiscal year, Texas spent 40% of

the state’s budget on Health and Human Services (HSS)

The largest portion of the Texas state budget is allocated to HHS

HSS spending exceeds the state’s educational costs

Factors contributing to HSS Costs

Aging populationObesity-related illnessesPrison populationDisease threatsEmergency room costsHealth professional shortage

Bottom LineTexas recognizes a need for

aggressive governance and fresh solutions to healthcare issues that also address the rising costs of healthcare

State of Texas Action PlanGovernment efforts in place to widen the

use of Health Information Technology (HIT)HIT and telemedicine have social and

economical benefitsHIT converges the Internet with health

networksHIT broadens healthcare access and

improves health outcomes

Statewide Health Coordinating Council (SHCC)

Examines ways Health Information Technology (HIT) and Telemedicine (TM) enhances the efficiency and quality of institutional healthcare

Improves the delivery of medical treatment and collaborative efforts among health professionals and support staff

SHCC Technology CommitteeComposed of various members of Texas

from diverse backgroundsRepresentative of

Small and large employersHospitalsHealth policy expertsCommunity leadersBusiness leaders

SHCC Technology CommitteePurpose of the Committee:

Reviews healthcare and technology data

Identifies and assesses the use of policies, tools and technology in Texas

Makes recommendation to policymakers

Telemedicine and Telehealth Programs in ActionTwo-thirds of healthcare organizations use

telehealth for clinical or non-clinical purposes, according to a 2009 Healthcare Intelligence Network Suvey (Donovan 2010)

Telemedicine Case Study This video describes the computer charting

and Telemedicine technology that is being used in the Los Angeles County Sheriff's Medical Services Unit.

Copy/Paste link to a Internet Browser to view Telemedicine Case Study on YouTube.com:

http://www.youtube.com/watch?v=_I0_fut2H8U

Finds of the Technology Committee (1) Investment in training for the use of

Telemedicine is critical to its success of HIT

HIT is essential for establishing the ability to track Telemedicine utilization

Finds of the Technology Committee (2)Texas telemedicine legislation currently

addresses the participation of various health providers, including physicians, dentists, chiropractors, nurses, and other health professionals.

Telemedicine holds the potential for the

greatest economical impact on the rising health costs during century in the State of Texas.

Recommendations (1)Enhance the efficiency and quality of

institutional healthcare thereby improving the delivery of medical treatment and collaborative efforts through the HIT.

Provide training incentives to healthcare

providers, clinical trainees, and students in health-related fields’ reimbursement up to 50% of their training costs.

Expand the market for telemedicine with a national licensure system to reduce health care costs, increase accessibility, and eliminate many of the legal and regulatory ambiguities that constrain the present system.

Provide healthcare providers with reimbursements for a wider range of covered medical services

Promote the use and development of new

technologies to enhance health

Recommendations (2)

Recommendations (3)Enhance and strengthen public and private

partnerships to include regional strategic mapping of staff and services between organizations improve recourse allocation, trim numerous costs, and avoid service duplication.

Identify reform regulatory barriers, and amend laws to accommodate expansion of telehealth modalities.

Conclusion (1)There is a need and an interest in developing

collaborations among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers

Critical components of TM/HIT include the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization

Conclusion (2)Next generation tools and technologies are

vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity.

Conclusion (3)To cover the full spectrum of dynamic and

evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service.

AcknowledgementsSHCC Technology Committee:

Janie Martinez Gonzalez, Public MemberStephen Palmer, Office of e-Health

Coordination HHSC Dr. Alex Vo, Executive Director of AT&T

TelemedicineTom Valentine, HHSCDon Henderson, DADSElizabeth Sjoberg, JD, THA