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University of Tennessee Health Science Center Telehealth Network

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University of Tennessee Health Science Center Telehealth Network Definitions “Telemedicine” is the use of medical information exchanged from one site to another via electronic communications to support Medical diagnosis Ongoing patient care Remote patient monitoring

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slide1

University of Tennessee

Health Science Center

Telehealth Network

definitions
Definitions
  • “Telemedicine” is the use of medical information exchanged from one site to another via electronic communications to support
        • Medical diagnosis
        • Ongoing patient care
        • Remote patient monitoring
    • “Telehealth” encompasses a broader definition of remote healthcare that does not always involve clinical services
        • Health-related distance learning
slide3

UTHSC Telehealth Program Goals

.

  • Provide access to medical services to isolated populations by providing specialty care or second opinions – “to fill in gaps”
  • 2) Develop and implement programs to improve access to health education for families and clinicians.
slide4

Components of the UTHSC Telehealth Network

4 Campuses (18 total sites)

14 Pharmacy sites (4 Memphis)

8 Rural hospitals/clinics

11 Youth Development Center sites (5 Nashville)

2 UTCI Clinics (1 Memphis)

3 Delta Diabetes Sites

6 Carey Counseling/Behavioral Health Sites

1 Department of Children Services Site

1 REAC/TS

1 Urban Health Clinic (Memphis)

3 Methodist / LeBonheur sites (Memphis)

3 Regional Medical Center sites (Memphis)

71 TOTAL Sites

partnerships
Partnerships
  • Academic-community hospital linkages
  • Rural clinics (UT Family Practice)
  • Tennessee Department of Health
  • Department of Children Services
  • UT Medical Group, Inc.
  • UT Cancer Institute
  • Methodist LeBonheur Health Systems
  • Child and Adolescent Psychiatric Associates, LLC
tennessee data
Tennessee Data
  • 67/95 counties designated rural
  • 33 counties have 10 or fewer licensed physicians (some have none)
  • State has provided seed funding to connect 43 FQHCs
  • FCC supporting 43 FQHC’s and multiple other sites for three years
  • Governor’s E-Health Council
  • State telehealth programs:
    • Erlanger Health System
    • Mountain States Health Alliance
    • Tennessee Telehealth Network
    • Vanderbilt
    • UTHSC Telehealth Network
broadband connectivity
Broadband Connectivity
  • T1 line
  • ISDN
  • Satellite
barriers to access
Barriers to Access
  • Geographic
    • >20% of US population reside in rural areas
    • Burden of transportation to care generally borne by patients
    • Medicaid programs bear the burden of transportation costs
    • Multiple definitions of rural
  • Financial
    • The uninsured, underinsured (> 40 million uninsured)
    • Delayed access to services for uninsured
    • High cost of travel for locally unavailable specialty care
barriers to access9
Barriers to Access
  • Societal
    • Societal stigmatization
    • Cultural barriers
    • Language barriers
  • Maldistribution/shortage of providers
    • Predicted shortage of physicians 85,000-200,000 by 2020
    • Urban predominance of specialty providers
    • Isolation of rural health providers
    • Need for continuing health professional education
benefits of telehealth
Benefits of Telehealth
  • Patients:
    • Timely access to locally unavailable services
    • Spared burden and cost of transportation
    • Avoid excess time off from job
    • Improvement in quality of care
benefits of telehealth11
Benefits of Telehealth
  • Health professionals
    • Access to consultative services
    • Access to CME
    • Primary care oversight of patient care
    • Knowledge base/research
  • Rural communities
    • Enhanced healthcare/economic empowerment
uthsc telehealth programs
UTHSC Telehealth Programs
  • Youth Development Centers
    • Clinical Specialty Consults
    • Provider Education
  • Department of Children Services
    • Assessment / Case Review
    • Behavioral Health
  • Addressing Diabetes in Tennessee (ADT)
    • Project Diabetes – Tennessee Department of Health
uthsc telehealth programs13
UTHSC Telehealth Programs
  • Pharmacy
    • Support Rural Residency Program
  • Rural Hospitals/Clinics
    • Clinical Specialty Consults
    • Provider Education
  • Delta Health Initiative
    • Case Review
    • Patient and Provider Education
uthsc telehealth programs14
UTHSC Telehealth Programs
  • UT Cancer Institute
    • Post Oncology Follow Up
    • Genetic Counseling
  • REACTS
    • Nationwide Education from Oak Ridge
uthsc telehealth programs15
UTHSC Telehealth Programs
  • Urban Clinics
    • Specialty Consult Services
    • Epilepsy Study
    • Provider Education
  • Methodist / Le Bonheur Children’s Medical

Center

  • Regional Medical Center / Medplex
  • UTMG Wolf River Clinic
available specialists
Available Specialists:
  • Neurology

(adult & pediatric)

  • Pediatric

Pulmonology

  • Post-Transplant

Surgery

  • Urology
  • Behavioral Health

(adult & pediatric)

  • Pediatric Cardiology
  • Dermatology
  • Endocrinology (adult)
  • Pediatric ENT
telehealth outcomes efficiencies
Telehealth OutcomesEfficiencies
  • Patients seen per hour

SpecialtyTelehealthTraditional

Dermatology 4.8 2.8

Psychiatry 2.3 0.79

ENT pediatric 4.0 2.3

ENT adult 4.0 3.14

Neurology 3.7 2.2

telehealth outcomes youth development centers
Telehealth OutcomesYouth Development Centers
  • Prior to Telehealth, only one-third of patients referred to a psychiatrist received a diagnosis.
  • After six months of telepsychiatry, 100% of patients received a recorded diagnosis.
  • Medication usage decreased from 1.9 to 1.4 medications per resident.
telehealth outcomes youth development centers20
Telehealth OutcomesYouth Development Centers
  • 11.3% Decrease in spending on pharmaceuticals per student per month
  • 38% decrease in spending clinical visits per month
  • 56% decrease in ER visits per month
  • Pharmaceuticals
    • 4 months pre-telehealth implementation - $135.22
    • 4 months post-telehealth implementation - $119.96
telehealth outcomes
Telehealth Outcomes
  • Patient Wait Times
    • On Time 70%
    • 10 minute wait 20%
    • 15 minute wait 10%
    • As verified by nursing reports and patient satisfaction reports
telehealth patient satisfaction
Telehealth – Patient Satisfaction
  • Did you feel comfortable with the Telehealth consult?
    • Yes 93%
    • No 6%
    • n/a 1%
  • Did you think the specialist gave you their attention as well as a regular office visit?
    • Much better 47%
    • Slightly better 13%
    • As good as 40%
    • Slightly worse 0%
    • Much worse 0%
telehealth patient satisfaction23
Telehealth – Patient Satisfaction
  • Do you think overall quality service was as good as a regular office visit?
    • Much better 47%
    • Slightly better 6%
    • As good as 40%
    • Slightly worse 6%
    • Much worse 0%
  • Did your telehealth consult save you time?
    • Yes 100%
    • No 0%
telehealth patient satisfaction24
Telehealth – Patient Satisfaction
  • Did your telehealth consult save you money?
    • Yes 100%
    • No 0%
  • Would you use telehealth again?
    • Yes 100%
telehealth better care for rural patients
Telehealth: Better Care for Rural Patients
  • Average miles from Memphis – 100
  • Average PCP consults prior to telehealth for the same acute complaint – 4.7
  • Number of telehealth visits – 2.1
  • % patients with new diagnosis and/or new medications after specialist referral - 60%
  • % of patients problem resolved

after referral - 90%

future direction
Future Direction
  • Expansion of Pediatric ECHO
  • TelEmergency to provide 24/7 coverage to rural hospitals
  • Psychiatry
    • Geriatric
    • Pediatric
    • Adult
  • State of TN Prison Healthcare
future direction27
Future Direction
  • TBI (Traumatic Brain Injury) treatment for returning veterans
  • University of Tennessee BEAT Diabetes Program: Better Education, Access and Treatment
    • UTHSC
    • UTK Extension
    • Tennessee Department of Health
slide28

www.utmem.edu/telehealth

Toy Strickland, MBA

Interim Executive Director, Telehealth

University of Tennessee Health Science Center

(901) 448-8844 Office Phone

(901) 448-4324 Office Fax

twstrickland@utmem.edu