Telehealth Applications in a Community Health Center

1. Telehealth Applications in a Community Health Center Patrick McShane Director – Special Programs Beaufort Jasper Hampton Comprehensive Health Services, Inc.

2. Beaufort Jasper Hampton Comprehensive Health Services Inc. BJHCHS • Beaufort Jasper Hampton Comprehensive Health Services, Inc. (BJHCHS) is a section 330 Federally Qualified Health Center (FQHC), • Patient Centered Medical Home model. • Predominantly serve rural areas of Beaufort, Jasper and Hampton Counties. • Hampton and Jasper counties are designated as Medically Underserved Areas (MUAs).

3. Beaufort Jasper Hampton Comprehensive Health Services Inc. • Providing care for 18,000 patients/year • More than 81,000 patient visits per year • Most are uninsured or underinsured • Additionally care includes: Pediatric; OB/GYN Services; Home Health Care; Nutritional Services; School Based Health Care; Migrant Farm Workers; BJHCHS Healthcare Mission

4. Beaufort Jasper Hampton Comprehensive Health Services Inc. • 1996 BJHCHS and the Medical University of South Carolina received a grant through the Office of Naval Research for Telemedicine • Purpose - address prostate health disparity in BJHCHS’ underserved population • Nurse Practitioner to conduct prostate biopsies in Port Royal • With real time guidance by a senior faculty Urologist at MUSC Early Telemedicine - BJHCHS and MUSC

5. Beaufort Jasper Hampton Comprehensive Health Services Inc. Early Technology – Community Engagement • Innovativetechnology supported by IBM, Telemedicine & Advanced Technology Research Center (TATRC), and Walter Reed MedicalCenter Telemedicine. • Real time encounters were not common place in 1990s. • The technology was Developed and NP was trained and approved for practice by MUSC Department of Urology • Local healthcare politics brought the program to an early conclusion in the community

6. 7TH Nationally Prostate Cancer Public Health\Research Initiative South Carolina Men Ages 20-79 Institute for Cancer Prevention (Designated NCI Cancer Center) Beaufort-Jasper-Hampton Comprehensive Health Services, Inc. (Section 330 Community Health Center) St. Helena Center Port Royal Center Ridgeland Center Hardeeville Center Sheldon Center Chelsea Center Hampton Center Estill Center

7. Beaufort Jasper Hampton Comprehensive Health Services Inc. Research – The Disparity of Prostate Cancer • 2000 - The Institute for Cancer Prevention (IFCP) in New York partnered with BJHCHS - research to identify bio-indicators for prostate cancer • Distance technology enabled full participation with researchers in NY • Conducted community screenings • Provided patient and provider education programs todetect early prostate cancer in African American Men

8. Beaufort Jasper Hampton Comprehensive Health Services Inc. Utilization of Distance Technology • Video conferencing capability in a variety of setting: • Participation in Practice Based Research Programs (PBRN) • Engage in Educational programs from CDC, NIH, CMS, HRSA, HHS, MUSC, and others • Outreach to rural sites • Telehealth technology fostered adoption of other technologies by staff • Contributed to early entry of Electronic Health Record system – we are now implementing our second generation EHR system

9. Beaufort Jasper Hampton Comprehensive Health Services Inc. Distance Video Conferencing now everyday event • Telehealth in some rural communities remains a challenge because of service providers • Recent Telehealth grant application to support 5 School Based Health Care and 5 Medical Centers 2014 Applications

10. Beaufort Jasper Hampton Comprehensive Health Services Inc. • Our recent application outlined programs that would reach the most rural communities served by BJHCHS: • Expand capacity of School Based Healthcare Program • Extend the capability of limited resources in support of Patient Centered Medical Home program • Extend availability of limited resources to distant rural communities with nutrition services, behavioral health, provider outreach, specialty consultations, and others. Telehealth can supports our mission now

11. Beaufort Jasper Hampton Comprehensive Health Services Inc. • We are currently applying for funding to: • Include both provider and patient educations programs for diabetes, hypertension, and weight management • Provide community outreach programs to several venues simultaneously • Enable a dialogue with MUSC and other research institutions • Provide the capability for providers at BJHCHS to reach out to specialists Telehealth Support of Current Mission

12. Beaufort Jasper Hampton Comprehensive Health Services Inc. • MUSC’s Department of Telemedicine –guided us to additional resources at MUSC and in South Carolina • South Carolina AHEC - supports provider and staff CME education • Palmetto Care Connections – understanding of rural community and connectivity challenges • Polycom, Inc.provides technical guidance and grant experience • South Carolina Office USDA – quick and thorough • Support from community leaders Telehealth Guidance

13. Beaufort Jasper Hampton Comprehensive Health Services Inc. Summary • BJHCHS views Telehealth as an additional tool to support our existing mission • Telehealth can connect to distant locations efficiently enabling a wide range of potential solutions for patient care • Enables specialized staff (I.E. Dieticians, Pharmacists, etc.) to access more patients in distant centers without the burden of travel • Providers and staff can access CME without the burden of travel • Providers can have ability to reach out to specialists • PCMH can be expanded and implemented more efficiently

14. Beaufort Jasper Hampton Comprehensive Health Services Inc. Lessons Learned • Cost of connectivity used to be a major restriction to Telehealth – now available at reasonable rates • Funding opportunities are more readily available • Community leaders need to share in the vision of the application • Community Coordinators and Community Health Workers can contribute significantly in support of mission of Telehealth • Telehealth needs a champion beyond the traditional IT department • PCMH can be expanded and implemented more efficiently