Developing the Next Generation Roadmap for HIT & Telemedicine to a Healthy eTexas

1. Developing the Next Generation Roadmap for HIT & Telemedicine to a Healthy eTexas Sponsored by: Statewide Health Coordinating Council (SHCC) & Texas Public Health Association Technology Committee Presenter: Janie M. Gonzalez, SHCC Public Member Date: February 19, 2010

2. State of Texas Healthcare Costs • In the 1998 fiscal year, Texas spent 40% of the state’s budget on Health and Human Services (HSS) • The largest portion of the Texas state budget is allocated to HHS • HSS spending exceeds the state’s educational costs

3. Factors contributing to HSS Costs • Aging population • Obesity-related illnesses • Prison population • Disease threats • Emergency room costs • Health professional shortage

4. Bottom Line • Texas recognizes a need for aggressive governance and fresh solutions to healthcare issues that also address the rising costs of healthcare

5. State of Texas Action Plan • Government efforts in place to widen the use of Health Information Technology (HIT) • HIT and telemedicine have social and economical benefits • HIT converges the Internet with health networks • HIT broadens healthcare access and improves health outcomes

6. Statewide Health Coordinating Council (SHCC) • Examines ways Health Information Technology (HIT) and Telemedicine (TM) enhances the efficiency and quality of institutional healthcare • Improves the delivery of medical treatment and collaborative efforts among health professionals and support staff

7. SHCC Technology Committee • Composed of various members of Texas from diverse backgrounds • Representative of • Small and large employers • Hospitals • Health policy experts • Community leaders • Business leaders

8. SHCC Technology Committee Purpose of the Committee: • Reviews healthcare and technology data • Identifies and assesses the use of policies, tools and technology in Texas • Makes recommendation to policymakers

9. Telemedicine and Telehealth Programs in Action • Two-thirds of healthcare organizations use telehealth for clinical or non-clinical purposes, according to a 2009 Healthcare Intelligence Network Suvey (Donovan 2010)

10. Telemedicine Case Study • This video describes the computer charting and Telemedicine technology that is being used in the Los Angeles County Sheriff's Medical Services Unit. • Copy/Paste link to a Internet Browser to view Telemedicine Case Study on YouTube.com: http://www.youtube.com/watch?v=_I0_fut2H8U

11. Finds of the Technology Committee (1) • Investment in training for the use of Telemedicine is critical to its success of HIT • HIT is essential for establishing the ability to track Telemedicine utilization

12. Finds of the Technology Committee (2) • Texas telemedicine legislation currently addresses the participation of various health providers, including physicians, dentists, chiropractors, nurses, and other health professionals. • Telemedicine holds the potential for the greatest economical impact on the rising health costs during century in the State of Texas.

13. Recommendations (1) • Enhance the efficiency and quality of institutional healthcare thereby improving the delivery of medical treatment and collaborative efforts through the HIT. • Provide training incentives to healthcare providers, clinical trainees, and students in health-related fields’ reimbursement up to 50% of their training costs.

14. Recommendations (2) • Expand the market for telemedicine with a national licensure system to reduce health care costs, increase accessibility, and eliminate many of the legal and regulatory ambiguities that constrain the present system. • Provide healthcare providers with reimbursements for a wider range of covered medical services • Promote the use and development of new technologies to enhance health

15. Recommendations (3) • Enhance and strengthen public and private partnerships to include regional strategic mapping of staff and services between organizations improve recourse allocation, trim numerous costs, and avoid service duplication. • Identify reform regulatory barriers, and amend laws to accommodate expansion of telehealth modalities.

16. Conclusion (1) • There is a need and an interest in developing collaborations among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers • Critical components of TM/HIT include the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization

17. Conclusion (2) • Next generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity.

18. Conclusion (3) • To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service.

19. Acknowledgements SHCC Technology Committee: • Janie Martinez Gonzalez, Public Member • Stephen Palmer, Office of e-Health Coordination HHSC • Dr. Alex Vo, Executive Director of AT&T Telemedicine • Tom Valentine, HHSC • Don Henderson, DADS • Elizabeth Sjoberg, JD, THA