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The Archway . . . to Telemedicine

The Archway . . . to Telemedicine. What is Telemedicine?. . . . the use of electronic information and communications technologies to provide and support health care when distance separates the participants . Institute of Medicine, 1996. Telemedicine . Background Applications

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The Archway . . . to Telemedicine

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  1. The Archway . . . to Telemedicine

  2. What is Telemedicine? . . . the use of electronic information and communications technologies to provide and support health care when distance separates the participants. Institute of Medicine, 1996

  3. Telemedicine • Background • Applications • Benefits and Challenges • Research • Conclusions • Recommendations

  4. Background The evidence suggest that the concept dates to 1924.

  5. Coldeway’s Quadrants

  6. Quadrants Defined • ST/SP • Same Time/Same Place • DT/SP • Different Time/Same Place • ST/DP • Same Time/Different Place • DT/DP • Different Time/Different Place

  7. Who… … is involved with telemedicine?

  8. Telemedicine Networks

  9. Telemedicine Applications • 1. Remote Consultation • 2. Remote Monitoring • 3. Remote Education • 4. Telementoring

  10. 1. Remote Consultation

  11. Video Clip #1

  12. 1.a Telepsychiatry

  13. 1.b. Telemedicine for Children with Disabilities

  14. 2. Remote Monitoring

  15. Video Clip #2

  16. 2.a Collaboration

  17. 2.b Access to Information

  18. 3. Remote Education

  19. Video Clip #3

  20. 4. Telementoring

  21. Video Clip #4

  22. When… …do we use telemedicine?

  23. When do we use telemedicine? • Maldistribution of health resources urban and/or rural • Capitated populations • Access • Distance/Time/Travel • Patients and Families • Outreach Physician • Isolation of Provider • National/International

  24. When do we ‘NOT’ use telemedicine?

  25. Telemedicine Benefits and Challenges “It is an amazing invention, but who would ever want to use one” Rutherford Hayes, 1882 on the using telephone for the first time

  26. Trends • Market place reform/managed care • Shifting site of care Hospital>Clinic>Home • Case Management/Team Care • Improved communications between provider and patient • Health care practices and affiliations • Digital convergence

  27. Benefits Patient Perspective • Access: Time, Travel, Expense • Health Provider Collaboration • Enhanced Communications • TV & Computer Applications common and non- threatening • Added attention may enhance confidence that all that can be done is being done

  28. BenefitsProvider Perspective • Communication/Collaboration with specialists • ER ‘front-line’ support • CME/Life Long Learning • Saves time, travel to outreach clinics

  29. Challenges • Lack of reimbursement • Licensing and Credentialing issues • Liability • Privacy • Infrastructure • End-user Issues

  30. Recommendations • Conduct a comprehensive telemedicine audit/assessment • Explore Financial Issues • Develop a short, mid and long range telemedicine plan • Build training initiatives • Systematic implementation of plan

  31. Audit and Assessment • Medical Services Data • Descriptive elements • Current Services • Current technologies • Service Opportunities/Needs • Miscellaneous Observations/Comments

  32. Financial Issues • Program Budgets • Finding Funds • Maximizing Investments • Measuring Intangibles

  33. The Plan • Clarifying Goals • Prioritizing Objectives • Policies and Procedures • Operational Issues • Personnel

  34. Training is essential!

  35. Video Clip #5 : A Typical Telemedicine System

  36. Mere Vehicles Telemedicine and information technologies are merevehicles that permit the delivery of health care services but which have no greater impact on health care than the truck that delivers our groceries has on our nutrition. It is the content of the vehicle that permits effective health care, not the vehicle.

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