“trends and hot topics in telehealth” m.d. telemedicine

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“Trends and Hot Topics in Telehealth” Ronald S. Weinstein, M.D. Founding Director, Arizona Telemedicine Program The University of Arizona, Tucson PastPresident, American Telemedicine Association

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Page 1: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

“Trends and Hot Topics in Telehealth”

Ronald S. Weinstein, M.D.Founding Director, Arizona Telemedicine Program

The University of Arizona, Tucson

Past‐President, American Telemedicine Association

Page 2: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Arizona Telemedicine Network

Page 3: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Categories of Services in General Usage

•Gap Services

•Urgent Services

•Mandated Services

Page 4: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Teleradiology

Page 5: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Categories of Services in General Usage

•Gap Services

•Urgent Services

•Mandated Services

Page 6: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

US Department of Veterans Affairs

Michigan

Wisconsin

Illinois

Dunn et al, 1996-201820,000+ cases

Intraoperative frozen section service

Page 7: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Iron Mountain, MI, VA -- Milwaukee, WI VA- Telepathology “Implementation Team”

Bruce E. Dunn, M.D., Director

Page 8: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Telestroke

Page 9: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Photograph depicting the bedside National Institutes of Health Stroke Scale (NIHSS) assessment scenario.

Demaerschalk B M et al. Stroke 2012;43:3271-3277

Copyright © American Heart Association

Page 10: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

ResolutionMD mobile.

Demaerschalk B M et al. Stroke 2012;43:3098-3101

Page 11: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Conclusions

• Telestroke is cost‐effective (cost‐savings)• Telestroke by smartphone is possible

Demaerschalk B M et al. Stroke 2012;43:3271-3277

Page 12: “Trends and Hot Topics in Telehealth” M.D. Telemedicine
Page 13: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Categories of Services in General Usage

•Gap Services

•Urgent Services

•Mandated Services

Page 14: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Categories of Services in General Usage

•Gap Services•Urgent Services•Mandated Services

•Mobile Health•Direct‐to‐Consumer•Cloud computing applications

Page 15: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

http://patientengagementhit.com/features/how‐mhealth‐technology‐supports‐patient‐engagement‐strategies

Page 16: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

https://ihealthlabs.com/wireless‐scales/ihealth‐core/

Images intended as examples of technology and not as an endorsement of companies or products.

Page 17: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

“Care Beyond Walls and Wires is the best thing 

ever for me, and the best thing for my dad.”

Rita Yazzie

Case Study

Mobile Telehealth

Page 18: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Connected Health/Mobile Health

Page 19: “Trends and Hot Topics in Telehealth” M.D. Telemedicine
Page 20: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Federal Grants for Telehealth Research

PCORI Program (2010-2018)(Patient-Centered Outcomes Research Institute)

77 Telehealth Grants$350 Million Dollars

Intervention Grant Programs

Page 21: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Categories of Services in General Usage

•Gap Services•Urgent Services•Mandated Services

•Mobile health•Direct‐to‐Consumer•Cloud ComputingApplications

Page 22: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Tucson Daily StarJanuary 6, 2019

• GET GREAT CARE YOU NEED• Cold & flu symptoms• Allergies• Pink eye• Ear infections• Respiratory infection• Sinus problems• Skin problems• … and more

Page 23: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Flagstaff, AZTucson, AZ

Page 24: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Direct-to-Consumer Telehealth

https://www.youtube.com/watch?v=gnVmHZRSOnQ

United HealthCare Virtual Visits

Page 25: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

(Single Click on the link)

Direct-to-Consumer Telemedicine

https://www.youtube.com/watch?v=sBryMAxi5tE

American Well

Page 26: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

AmericanWell/Cleveland Clinic “The Clinic”

•The Cleveland Clinic and telehealth vendor American Well have launched a joint venture, The Clinic, to provide virtual access to medical specialists for patients worldwide with complex healthcare issues.

•The two organizations have not yet fleshed out the details of exactly what types of services Cleveland Clinic's physicians will offer to patients through the telehealth format, but they said a wide range of specialists will be involved, offering "insights, opinions, recommendations and assistance.“

•The joint venture extends the relationship between Cleveland Clinic and American Well, which have collaborated since 2014 to provide 24-hour access to virtual non-emergency care for many minor illnesses and injuries through Cleveland Clinic Express Care Online. The express care service, which is primarily staffed with Cleveland Clinic physicians, also provides access to some specialists for virtual visits.

Page 27: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Major Categories of Services in General Usage

•Gap Services•Urgent Services•Mandated Services

•Mobile health•Direct‐to‐Consumer•Cloud Computing Applications

Page 28: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Project ECHO Programs(Extension for Community Healthcare Outcomes)

Page 29: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Arizona TelemedicineProgram

Page 30: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

ECHO TeleRheumatology Clinic

Page 31: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Physicians in Bisbee, AZ Attending from a rural hospital conference room

Page 32: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

PCORI Programs(Patient-Centered Outcomes Research Institute)

EXAMPLE

“Ostomy Telehealth for Cancer Survivors: A Program of Collaborative Research”

Robert Krouse, M.D., FACS, Principal Investigator

Page 33: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Ostomy Surgery

Page 34: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Session/Content

• Session 1: Self‐management & immediate concerns

• Nutrition• Pouching System• Goals/Resources

• Session 2: Social well‐being and body image

• Social/Interpersonal relationship

• Sexuality/Intimacy

• Psychological Health

• Session 3: Caregiver/Support Person only

• Ostomy review

• Concerns regarding ostomates

• Caregiver/Support person well‐being

• Session 4: Healthy Lifestyle

• Interpersonal Relationships

• Travel Concerns

• Physical Activity

• Improving Attitudes

• Psychological Health

• Session 5: Booster session for ostomateand support person

• Content Review

• Available Resources

• Goal Progress

Page 35: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

In‐Person Model

Telehealth Model

• Nurse‐educators • “PCORI Peers”• “TeleHealth” Engineers

Page 36: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

© 2018, Arizona Telemedicine Program

Cloud Computing ‐‐ Staff Meeting

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Cloud Computing ‐‐ Staff Meeting for PCORI Grant

Page 38: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Next Generation Applications

• Surgicenter Networks

• Robotics/Automation/Artificial Intelligence

• Virtual Hospitals

Page 39: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

New Generation Applications

• Surgicenter Networks

• Robotics/Automation/Artificial Intelligence

• Virtual Hospitals

Page 40: “Trends and Hot Topics in Telehealth” M.D. Telemedicine
Page 41: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

“THE SINGULARITY”

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New Generation Applications

• Surgicenter Networks

• Robotics/Automation/Artificial Intelligence

• Virtual Hospitals

Page 43: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Mercy Virtual HospitalChesterville, MO ‐ 2017

© 2013, Arizona Telemedicine Program

Page 44: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Mercy Virtual

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Tucson

Page 47: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

“Grand Opening – HSIB Building – Room 567”November 1, 2019

Page 48: “Trends and Hot Topics in Telehealth” M.D. Telemedicine

Thank you!

Ronald S. Weinstein, M.D.

[email protected]