Upload File

telehealth basics the msu health care experienceat msu, htc east lansing total costs with driving...

  • Home
  • Documents
  • Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by
28
Telehealth Basics & The MSU Health Care Experience

Upload: others

Post on 16-Oct-2020

3 views

Category:

Documents


0 download

Report

TRANSCRIPT

Page 1: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Telehealth Basics

&

The MSU Health Care Experience

Page 2: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

1. About MSU Health Care

2. Defining Telehealth

3. Types of Telehealth

4. Telehealth at MSU

5. Challenges

6. Care Team Approach

7. Deployment of Telehealth for Pandemic

Response

8. Future State

Page 3: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Telehealth/Telemedicine/E-Visits

Telemedicine - the practice of caring for patients

remotely when the provider and patient are not

physically present with each other.

Telehealth - use of audio/video streaming technology to

examine patients.

E-Visits – A communication between a patient and their

provider via the patient portal. (Patient Initiated)

Telephone Visits - In some cases, a full audio/visual

telehealth visit is not possible or efficient. Due to limits in technology access within their covered patient

population, some insurance providers (Medicaid, Medicaid HMO, BC/BS,

BCN, the list is expanding daily) have allowed for telehealth visit to count

even if no video is used, only phone audio.

Page 4: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

The Need for Telemedicine

First documented in late 1950’s when a

Nebraska psychiatrist provided mental health

services to prison inmates >150 miles away,

using close circuit TV

Augments services, improves access

Reduces travel time & costs

Alleviate Physician shortage

Increase physician utilization

Provide specialist access to rural

populations

Deliver Comprehensive care

4

Whitten. Appl Clin Inf 2010;1:132

Page 5: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Types of services provided by

Telemedicine

5

Primary and

specialist

referral

services

Remote

patient

monitoring

Consumer

medical

and health

information

Medical

education

Page 6: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Telemedicine components

• Computer with camera at provider and patients end

• Close by printer, FAX, telephone

• Optional: dual screen, headset, teledevices: otoscope, stethoscope

Equipment

• Internet based, secure, HIPAA compliant for patient confidentiality

• Password protected web-link

Video-conference platform

• Integration into electronic health records

• Streamlined workflow

Information Technology support

Page 7: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Asynchronous

"Store and Forward" Telemedicine

Image transfer(MRI, mammogram, CT Scans Ultrasound)

“Have camera, take a picture and transmit it”

Home tele-care for disease management: monitoring blood

pressure, blood sugar, weight

Page 8: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Synchronous

Real-Time Telemedicine

HIPAA secure videoconferencing: patient

and provider communicate in real-time

Assess patient using tele-devices

tele-stethoscope

otoscope

derma-scope

Requires larger bandwidth

HIPAA = Health Insurance Portability and Accountability Act. Privacy act to protect individuals health information

Page 9: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

MSU Experience

with Telemedicine

Page 10: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Telehealth Expansion

PRIMARY CARE

Family Medicine Internal MedicinePediatrics

ADULT SPECIALTY PEDIATRIC SPECIALTY

Allergy and ImmunologyCardiologyEndocrinology Hematology/OncologyInfectious DiseaseNeurologyOccupational MedicinePhysical Medicine and RehabilitationPodiatryPsychiatrySports MedicineSurgeryUrology

Allergy and ImmunologyHematology/OncologyInfectious DiseaseNeurologyPodiatryPulmonologyPsychiatrySports MedicineSurgeryUrology

MULTI-DISCIPLINARY CLINICS

Center for Bleeding and Clotting DisorderCystic Fibrosis ClinicMuscular Dystrophy Association (Adult and Pediatric)

Prior to the health system wide expansion of telehealth, virtual services were held in small pockets across the health system and

was limited to provider partners to provide the in-office exam.

Page 11: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Widespan Telehealth Implementation

Phase 1

•Current Patients Only

•Training, Evaluation, and Troubleshooting and process with Athena and HIPAA Compliant Zoom

Phase 2

•New Patients (New to provider or office)

•Televisits (Audio Only)

Phase 3

•Telehealth from Home

•Resident Access and Expectations

Phase 4

•Psych Workflow

•Interpreter

•New to system Patients

Phase 5

•Multi-disciplinary Clinic work-flow

•E-Visit, Phone Only

Phase 6•Ongoing monitoring and reporting

Page 12: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Team for Telemedicine

Physician

Nurse

Information Technology (IT) to enable care team.

Care team – Social Worker, Physical therapy, geneticist, dental hygienist

Page 13: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Telehealth Footprint Lower Michigan

Page 14: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

National Telehealth Footprint

Telehealth has allowed MSU Health Care providers to continue to provide care to students who have returned home.

Page 15: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by
https://app.powerbi.com/groups/d082f676-337d-45e3-bc74-41f9751fecfe/reports/530d8745-82f7-4fe3-bec2-b353d786fd47/ReportSection?pbi_source=PowerPoint
https://app.powerbi.com/groups/d082f676-337d-45e3-bc74-41f9751fecfe/reports/530d8745-82f7-4fe3-bec2-b353d786fd47/ReportSection?pbi_source=PowerPoint
Page 16: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Anticipated Challenges

Patients

• IT literacy higher than expected

• Fear of insurance coverage

• Lack of understanding around telemedicine and appropriateness of visit

• Lack of service awareness addressed through social campaigns

Providers/Staff• Resistance to adoption

decreased after training

sessions

• To schedule a

patient/convert a patient to

telehealth resource heavy

Page 17: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Why now?

With the smartphone and current pandemic,

people have connected in more ways than ever

before.

Page 18: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

The current/future of

healthcare is digital

Public HealthDisaster

PreparednessHealth

ProfessionalEducation

RegionalHealth

InformationSharing

Administration

Remotemonitoring

Research

ConsumerEducation

DigitalHealth

Telemedicine

Genomics

MedicalImaging

3Dprinting

Apps

HealthIT

EMR

mHealth

ArtificialIntelligence

Telemedicine(Billable)

Telehealth

Page 19: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Smartphone adoption

2012 ~45%

2015 ~65%

2020 >80%

Page 20: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Bandwidth

More accessibility than ever before

More bandwidth, more services

5G cellular, long range wireless help solve access

limitations in the near future

We should be ready!

20

Page 21: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Connected Devices

Page 22: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Comprehensive care and Hybrid care:telemedicine and physical outreach

Images provided by Dr. Roshni Kulkarni with permission.

Newborn

2 weeks1 month

11 months

5 months4 months

3 years

5 years

Page 23: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

2001Medicare program began paying for virtual care

Medicare Advantage was allowed to offer telehealth

from home

2020Blue Care Network announced

they would cover video visits from home

(plan May 1, 2020)

Insurance Influence on Adoption

Page 24: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Insurance Influence on Adoption

Effective Jan 1, 2016

Policy #1: Allow patients to

connect from home

Policy #2: Reimburse phone

calls

Policy #3: Allow direct to

consumer telehealth (e.g.,

AmWell)

Page 25: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Pandemic Growth of Telehealth

BCBSM (State) Medicare (National)

Medicare program

began paying for

virtual care

BCBSM began

reimbursing telehealth

from homeCOVID-19

2001 2016 2019 2020 March 2020

Page 26: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Why do we need to do virtual visits?

Travel

• Rural Communities

• Homeless Populations

• Financial Limitations

• Transportation Limitations

Continuity of Care

• Student

• Travel

• Movement limiting conditions (Agoraphobia, etc)

• Support

• Low Income

Privacy

• Stigma of psychiatry

ACCESS TO HEALTHCARE

Page 27: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Telemedicine (TM) clinics at MSU:

Cost Analysis

Types of patients seen N= 58 patient , VWD(21%, Hemophilia 12%,

Bleeding disorders 33%, Blood Disorders 22%, Oncology 12%)

Site Patient costs Marquette Gen Traverse City Portage UP

Patient seen

at MSU, HTC

East Lansing

Total costs

with driving $1143 $579 $1275

Total costs

with flying$1668 $1405 $1887

Patient seen locally by

TM at clinic

Total costs:

local clinic$73–$117 $47 $40

Page 28: Telehealth Basics The MSU Health Care Experienceat MSU, HTC East Lansing Total costs with driving $1143 $579 $1275 Total costs with flying $1668 $1405 $1887 Patient seen locally by

Future Needs

Streamlined EMR Integration

Patient Centric and Accessible

Campaign to Patients for Telehealth Promotion


MSU LRES CAPSTONE - Montana State Universitylandresources.montana.edu/docs/Final total capstone presentation.pdf · MSU LRES CAPSTONE Why We Need Wetlands: Prioritizing Water Resources

Total Costs of Ownership Calculations and Worksheets …€¦ · Present Value of Capital ... Total Costs of Ownership Calculations and Worksheets by Building 2. ... Total Costs of

Costs. Short-run costs Total cost Output (Q) 0 1 2 3 4 5 6 7 TFC (R) 12 Total costs for firm X

Benchmarking Total Physician Costs Webinar

Economic profit = total revenue - all economic costs Economic profit = total revenue - all economic costs Economic costs include accounting cost (explicit

WHEN TOTAL REVENUE EQUALS TOTAL COSTS Break – even Analysis

Keywords Fixed Costs, Variable Costs, Total Costs Do Now Cost...2018/11/19  · Fixed Costs, Variable Costs, Total Costs R064 –Exam Activity: Sunny Beach Supplies sells bucket and

STANDARD FORM OF AGREEMENT TA WFPpubdocs.worldbank.org/en/209771496857378519/WFP-WB... · Web viewXXX Evaluation Costs Sub-Total Direct Support Costs TOTAL Operational Costs Indirect

Appendix D Total Fuel Costs

Table of Contents - EUROPA - TRIMIS · Web view2006/08/21  · Country Infrastructure Costs Air pollution costs Noise costs Costs of global warming External costs of accidents Total

EXCEL HUSTLER - Home | MSU Librariesarchive.lib.msu.edu/tic/wetrt/page/1981sep61-70.pdf · EXCEL HUSTLER Total maneuverability and year-round performance cut operating costs. Turf

heyford.info · 2018-11-23 · Donations Total receipts Pavments Refurbishment costs Legal costs Printing costs Field costs Total payments Net of receipts/(payments) Cash funds last

in –from pipe dream to national standard - YTONG BiH · Optimizing Costs investment costs and costs of operation total /m² net floor area % investment costs € 1.320 net costs

Supply Forecast and Analysis (SFA) · • Project start date: FY07 • Project end date: FY18 • Percent complete: 70% Total Costs FY 10 –FY 12 FY 13 Costs FY 14 Costs Total Planned

The Total Landed Costs of Offshoringin 2013 - APICSmedia.apics.org/sites/AnnualConference2013/presentations/The Total... · The Total Landed Costs of Offshoringin 2013 Marilyn Gettinger,

Land Use Summary Leveraged IRR Total Development Costs … · 2020. 7. 9. · Industrial Use / Infrastructure Growth Open Space Cedars ... Total Buildout Total Costs Financing Structure

2015/6/281 管理會計 (95/11/05) (4) Management Accounting (Fall, NCKU) Relevant Total Costs = Purchasing Costs + Ordering Costs +Carrying Costs + Shortage Costs

Borough President and City Council Capital Funding ...€¦ · 7.2 Total Construction Costs..... $3,334,000 (C) $0 $0 (E) 9.0 TOTAL PROJECT COSTS..... $3,500,000 Scheduled Occupancy

Can Flares Contribute to the Total ... - Solar Physics at MSU

Management and Resource Development Initiative (MRDI) II_ Sep 201… · Total in BDT Costs (in SEK) Total in BDT Costs (in SEK) Total in BDT Costs (in SEK) Total in BDT Costs (in

Estimating 988 Total Costs - Crisis Now

Montana State University Billings - MSU Billings | MSU ... · Montana State University Billings - MSU Billings | MSU

Costs and Returns in Michigan Christmas Tree Production, 2006 · Costs and Returns in Michigan Christmas Tree Production, 2006 By Pascal Nzokou and Larry A. Leefers, MSU Forestry

Vineyard Establishment Costs · Total establishment costs/acre . Variable costs $15,394 . Fixed costs ($923/yr x 3 yrs) $ 2,769 . Int on cumulative costs $ 1,954

AAMP Training Materials Module 4.3: Marketing Margins & Marketing Costs T.S. Jayne (MSU) [email protected]

1 of 29 © 2014 Pearson Education, Inc. 8 Short-Run Costs and Output Decisions CHAPTER OUTLINE Costs in the Short Run Fixed Costs Variable Costs Total Costs

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY · Direct Extramural Costs $4,118,785 Direct Intramural Costs 80,000 EPA hidirect (38.57% of all costs) 1,619,471 Total Project Costs

DEVELOPMENT COSTS AND SCHEDULING · Summary of Total Costs Benson Municipal Airport Stage I (1991-1995) Stage rt (1996-2000) Stage HI (2001-2010) Total Development Costs $4,657,800

Unveiling Overtime’s Total Costs How OT May Be Harming ...apihealthcare.com/sites/default/files/Unveiling Overtimes Total... · Unveiling Overtime’s Total Costs How OT May Be

GENDEAF May 8th-10th, 20031 Total costs of the project € 535.200 Total contribution from the commission € 523.800 Advance payment received € 209.520 Costs

Land Use Summary Leveraged IRR Total Development Costs ... · Phase 2 2013 - 2015 Phase 3 2016 - 2019 Total Buildout Total Costs Financing Structure Equity Capital Account Summary

Ins and Outs of Indirect Costs Under the Super Circular ......Total Costs 0 0 0 1,222,222 2,126,667 846,667 254,444 25 NICR using Total Direct Salaries Base TOTAL Expenses Total Costs

Power of Potential - The Center of Anna Maria Island...2017/07/19  · FY 2017-2018 Total Income: $1,103,104 Total Direct Costs: $524,650 Total Indirect Costs: $490,527 Total Admin

8 Short-Run Costs and Output Decisions CHAPTER OUTLINE Costs in the Short Run Fixed Costs Variable Costs Total Costs Short-Run Costs: A Review Output Decisions:

IMPACT REPORT - gallery.mailchimp.com€¦ · Micro-MBA $25,000 11% Africa Initiative $20,000 Management $6,500 5% TOTAL TRAINING COSTS: $130,000 TOTAL TRAINING COSTS: $175,000 Fundraising