elizabeth a krupinski phd arizona telemedicine program n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Elizabeth A. Krupinski, PhD Arizona Telemedicine Program PowerPoint Presentation
Download Presentation
Elizabeth A. Krupinski, PhD Arizona Telemedicine Program

Loading in 2 Seconds...

play fullscreen
1 / 29

Elizabeth A. Krupinski, PhD Arizona Telemedicine Program - PowerPoint PPT Presentation


  • 585 Views
  • Uploaded on

Elizabeth A. Krupinski, PhD Arizona Telemedicine Program. Recipe for Success: Skill Sets Home TH Leadership Potential Equation. Pelligrino & Cobb 2005. Recipe for Success: Skill Sets Home TH 5-Factor Personality Model. Pelligrino & Cobb 2005. Recipe for Success: Skill Sets Home TH

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Elizabeth A. Krupinski, PhD Arizona Telemedicine Program' - Leo


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
elizabeth a krupinski phd arizona telemedicine program
Elizabeth A. Krupinski, PhD

Arizona Telemedicine Program

slide2

Recipe for Success: Skill Sets Home TH

    • Leadership Potential Equation
pelligrino cobb 2005
Pelligrino & Cobb 2005
  • Recipe for Success: Skill Sets Home TH
    • 5-Factor Personality Model
pelligrino cobb 20051
Pelligrino & Cobb 2005
  • Recipe for Success: Skill Sets Home TH
    • VA Skill Sets
slide5

Technical feasibility

  • Provider & patient acceptance/satisfaction
  • Cost effectiveness
  • Outcomes = equivalent or better than traditional
  • H.R. 6331. = 1/1/09, skilled nursing facilities, in-hospital dialysis centers & community mental health centers = originating sites for Medicare reimburse
successful telenursing
Successful Telenursing
  • COPD HH vs TN
    • Pare et al. 2006
    • 7.5 vs 4.2 home visits
      • 46.6 min vs 57.5 min
    • 40% vs 5% hospitalizations
      • 7.3 days vs 13.5 days
    • $2,779 vs $2,424 per patient over 6 mo
    • Attitudes overall positive
successful telenursing1
Successful Telenursing
  • Diabetes
    • Chumbler et al. 2005 with VA
    • Pre vs post TH enrolment
    • 50% reduction hospitalizations
    • 11% reduction ER use
    • 3.0 fewer bed days of care
    • Overall improvement QOL, pain reduction & social functioning
    • Other studies show HbA1C improvement
successful telenursing2
Successful Telenursing
  • Acute infections
  • Chronic respiratory failure
  • Lung transplant recipients
  • Stroke recovery
  • Asthma self-management
  • Cystic fibrosis
  • Chronic heart failure
  • Spinal cord injury
  • PTSD & TBI
  • Mental disabilities (schizophrenia, Alzheimer’s)
  • Pediatric, adult & geriatric populations
slide9

Cancer patients with ostomies being discharged earlier after surgery

  • Reduces time proficient in self-care
  • Increases need for education & support visits by nurses after discharge
  • Distance & time can be considerable
  • Shortage of nurses specializing in ostomy care
slide10

Achieving self-care is a process

  • Nurses guide patients from dependence to independence
  • Start with total care & conclude with education & support
  • Telemedicine can serve a role in this process at all stages
methods subjects
Methods - Subjects
  • 28 patients with ostomies resulting from treatment for cancer
    • 14 HH =11 urostomy, 3 colostomy
    • 14 TH/HH = 7 urostomy, 7 colostomy
    • LOS = 8.86 days HH; 8.36 days TH
    • 68% male, 32% female
    • Mean age = 66.5 yrs (sd = 9.68)
    • 89% Caucasian, 7% Hispanic, 4% AfAm
slide17

Surgery: t = 0.304, p = 0.7632

  • Discharge: t = 0.170, p = 0.8666
slide18

Ostomy surgery explained = 100%

  • Enterostromal nurse participated care = 96%
  • Family of support during surgery = 100%
  • Received United Ostomy Association visitor during hospital stay = 38%
  • Who helped adjust to surgery
    • Family = 36%
    • Ostomy nurse = 36%
    • Doctor or nurse = 22%
    • Other = 6%
slide22

*Set fee for HH visit

**30 min 0.04/min airtime = $1.20 + $17.70 salary

*** TH only vs HH t = 5.05 p = 0.0001

e icu efforts
E-ICU Efforts

Pereira et al. IMEDIR in Spain

ICU filled with info

Need to organize

e icu efforts1
E-ICU Efforts
  • Avera eICU (South Dakota; Pat Herr)
e icu efforts2
E-ICU Efforts
  • Avera eICU (South Dakota; Pat Herr)
e icu efforts3
E-ICU Efforts
  • Sutter Health eICU (CA; Teresa Rincon)
    • Onsite intensivist coverage 12 hrs/day = $43,810
    • RN resource for APACHE & se[sis data collection = $11,700
    • Licensing fees for risk adjusted data collection = $1800
    • Total costs per bed onsite = $57,310
    • Total costs per bed eICU = $42,000
slide27

Remote monitoring & wearable devices

  • Wellness & prevention devices
  • Call-centers & automatic monitoring
  • Smart homes
  • Business-based programs
  • All have TH Nursing component
  • Need to be evaluated further for impact & health outcomes
slide28

Telenursing occurs on a variety of levels & in many environments

  • Clear cost & outcome benefits have been demonstrated
  • Opening avenues for reimbursement & new care settings
  • Providers & patients will continue to benefit from telenursing expansion