CAMC Health Education and Research Institute Our Telehealth Experience

1. CAMC Health Education and Research InstituteOur Telehealth Experience Sharon Hall, MS, President Barbara McGee, RN, MSN, Education Specialist II CAMC Health Education and Research Institute

2. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Since the introduction of Telehealth at the CAMC Institute in the early ’90s, our objectives have remained the same: • Provide expert clinical consultation via telehealth technology to patients/clients in underserved and geographically isolated areas of West Virginia (avg. 400 consults per year for past 5 years) • Broadcast continuing educational opportunities for healthcare providers (avg. 35 live CME programs/month and 48 archived CME programs/month) • Provide community health education and web-based health information (WV Mini Medical School for the Public) • Provide a means for healthcare professionals to participate in professional organizations, community health forums and administrative video conferencing (WV Hospital Assoc, WVDHHR)

3. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical consultations have been provided in a wide variety of medical disciplines/specialties including: • Internal Medicine • Behavioral Medicine and Psychiatry • Cardiovascular Medicine • Maternal-Fetal Medicine • Pediatrics • Otolaryngology • Post operative surgical assessment

4. Top five consultation priorities in US Cardiology Rheumatology Dermatology Neurology Psychiatry Top five consultation priorities at CAMC Dermatology Behavioral Medicine - Adolescent and Geriatric Pediatric Pulmonology - Pediatric Asthma Clinic Neurology Endocrinology CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present)

5. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • CAMC Center for Telehealth has provided more than 5,000 clinical consultations with 12 WV rural health care facilities: • Rural Health Clinics • Critical Access Hospital • FQHC Clinics

6. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical Milestones: • 1994: 1st teledermatology consultation with Boone Memorial Hospital • 1996: 1st dual clinical consultation with a cardiologist and pulmonologist at CAMC with “their” patient at Braxton County Memorial Hospital • 1998: 1st “live” pediatric echocardiogram on a 3 month old infant from Roane General Hospital

7. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical Milestones (continued): • 2000: 1st Diabetes Education Program presented from CAMC to 3 rural health care facilities, simultaneously • 2002: Pilot Project “Home Monitoring of Congestive Heart Failure Patients: Its Impact on Re-hospitalization, Quality of Life and Cost”

8. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical Milestones (continued): • 2007: Perinatal Ultrasound/Telehealth Project developed • - WVU School of Medicine • - CAMC Health Education and Research Institute Center for Telehealth • - West Virginia Perinatal Partnership • - Greenbrier Valley Physicians, Inc

9. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical Milestones (continued): • Goal of the Perinatal Ultrasound/Telehealth Project • - To improve management of patients with high risk pregnancies by face to face, live interactive clinical consultations as well as “real-time” maternal-fetal ultrasound capabilities

10. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical Milestones (continued): • 2008: Perinatal Ultrasound/Telehealth Project • - Network development • - Equipment acquisition and installation • - Initial Perinatal Telehealth Demonstration between CAMC and Greenbrier Physicians, Inc.

11. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Clinical Milestones (continued): • A by-product of this network development has been the development of a Pediatric Asthma Clinic between Women and Children’s Hospital and the Robert C. Byrd Family Medicine Clinic in Lewisburg, WV • Dr. Robert Kaslovsky, WVU Department of Pediatrics is the consultant for this clinic

12. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) • Our anticipated outcome is to provide real time maternal-fetal consultations with using ultrasound and telehealth technology to improve care for high risk obstetrical patients in rural communities of West Virginia. • Other anticipated benefits would include • - Keeping the patient in her home community for specialty care • - Moving information not the patient • - Supporting the care of the primary care providers • - Keeping health care dollars at the local level for ancillary care • - (Laboratory testing, radiology and pharmacy needs)

13. WHAT’S IN THE FUTURE?? Telehealth Assessment – February 2008 - Areas of Interest • Emergency/Trauma • Stroke • Cardiology • Critical Care • Sepsis • Endocrine/Diabetes • Geriatric Services • Consultative Specialty Care

14. WHAT’S IN THE FUTURE?? Telehealth Assessment – February 2008 – Perceived Barriers • Reimbursement Methodology • Lack of Highest Quality Technology/Infrastructure • Lack of Capital for Equipment • Costs of Line Charges • Concern to Maintain Referral Systems • Lack of Understanding of Potential Capacity/Benefit

15. WHAT’S IN THE FUTURE?? Focus Now On Connectivity • Telehealth Alliance – Partnerships to Advance Telehealth Focus on Service Development • Appropriate Service Delivery • Standard of Care • Efficient and Cost Effective Focus on Barriers • Education and Development • Funding Sustainability • Reimbursement

16. WHAT’S IN THE FUTURE?? Goals – Improve Access • Confidence of Providers and Patients • Highest Quality of Care (Equal to On-site Care) • Gains Confidence of Providers and Patients

17. CAMC Health Education and Research Institute:Our Telehealth Experience (1994 to present) Questions?