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TeleMental Health

Brian J Grady, M.D . Director TeleMental Health Department of Psychiatry School of Medicine University of Maryland. TeleMental Health. Today’s Topics. TMH Overview University Projects TMH Policy Future Directions. TeleMental Health Overview. Beginnings Late 1950’s

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TeleMental Health

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  1. Brian J Grady, M.D.Director TeleMental HealthDepartment of PsychiatrySchool of MedicineUniversity of Maryland TeleMental Health

  2. Today’s Topics • TMH Overview • University Projects • TMH Policy • Future Directions

  3. TeleMental HealthOverview • Beginnings Late 1950’s • Interactive “Television” 1960’s to 1990’s • “Affordable” VideoConferencing late 1990’s to mid 2000’s • Evidence Based TMH mid 2000’s to present

  4. The Merger Technology

  5. The Merger Technology Clinical Needs

  6. The Merger Technology Telemental Health Clinical Needs

  7. The Merger Technology Access Clinical Needs

  8. UMB TMH Projects • Maryland Youth Practice Improvement Committee – Consortium of Psychiatry Department UMB, Psychiatry Department JHU, Mental Hygiene Administration, Regional Institutes for Children and Adolescents, State C&A Inpatient Units • School Based Mental Health Projects • Baltimore, Western High School (’04/’05) • Prince George Co, Suitland HS & Kettering MS • Health Resources and Services Administration Grant - Consortium of Mid-Shore MH CSA, Mental Hygiene Administration, Garrett Co Core Service Agency, St. Mary’s Co Core Service Agency, Psychiatry Department UMB

  9. Required Resources • Clinical Champion Distant Site • Site Champion Originating Site • Administrative Support • Technical Support • Financial Support

  10. Financing • Grants • Health Services Resources Administration • Department of Agriculture • Maryland Community Health Resources Commission • Fee for Services • Medicare • Maryland Public Mental Health System • Third Party Reimbursements • Contractual Agreements

  11. TMH Policy • Regulations • Board of Physicians • Medicare • Balanced Budget Act (BBA) of 1997 • Benefits Improvement and Protection Act of 2000 (BIPA) • Medicaid • Draft Regulations

  12. Medicare Originating Sites(additional Medicaid proposed) • Physicians or practitioner office • Hospital • Critical Access Hospital • Rural health clinic • Federally qualified health center • (Elementary, middle, high, or technical school with a supported nursing, counseling or medical office. A college or university student health or counseling office) • (County Health, Human and/or Social Service offices or clinics and other county offices appropriate for private clinical evaluations and services)

  13. Qualified Geographical Areas Medicare • Health Practice Shortage Areas (HPSAs) • Non-Metropolitan Statistical Area (MSA) counties • Entities that are Federal telemedicine demonstration projects Medicaid • Garrett • Allegany • Worcester • Somerset • Wicomico • Dorchester • Caroline (proposed) • Talbot • Queen Anne’s • Kent • St. Mary’s • Calvert • Charles

  14. Technical Requirements 1. Minimum ISDN or IP bandwidth using H.264 video protocol > 256 kbps 2. Monitor: minimum, non-anamorphic, net display size of 16" diagonally 3. Minimum resolution of 1 Common Intermediate Format/Source Input Format 4. Switched Network or Encryption

  15. Future Directions • Vision: TeleMental Health Center of Excellence • Clinical Champion • Coordinator Resource • Technical Resource • Education, training & research

  16. Comments, Questions

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