Telehealth: Lessons Learned Leadership in Global Health Technology LIGHT Initiative 2nd Invitational

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Telehealth Lessons Learned Leadership in
Global Health Technology (LIGHT) Initiative2nd
Invitational Summit

• Dena S. Puskin, Sc.D.
• Health Resources and Services Administration
• HIV/AIDS Bureau
• Office for the Advancement of Telehealth
• October 20, 2004

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Telehealth can be thought of as a tool box of
technologies applied to diverse health care needs
in a wide range of health care settings.
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TELEVILLAGE

TELEHEALTH
Health Professional Education
K-12 Education
TELEMEDICINE
Consumer Health Services
Business
Administration
Libraries
Public Health
Justice
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Challenges to Cost Effective Care in US

• Access Persistent Geographic and Functionally
  Isolated Populations
• Quality of Care Medical Errors
• Aging Population Estimated 20 over 65 by 2030
• Provider Shortages

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HRSA Grant Program Objectives

• Improve Access
• Improve Quality of Services
• Reduce Medical Errors
• Work Force Development
• Foster Integrated Systems of Care
• Document Value Added of Telehealth Technologies

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• Type of Telehealth Activities Reported from HRSA
  Telehealth Inventory

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The Office for the Advancement Of Telehealth
(OAT) Grant Awards

• Awarded over 225 million in grants since 1989
• FY2004 Approximately 31 million
• Competitive and Congressionally-
• mandated projects
• FY2003 110 programs, in 43 states and District
  of Columbia

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Emerging Technology Applications

• Emphasis on low cost applications
• Applications that improve quality of care
• Integration of information systems within
  institutions and across health care
  institutions

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Disease Management
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Informatics
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Inland Northwest Telepharmacy System
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Positive Trends

• Better Off-The-Shelf Equipment
• Lower Cost Equipment
• Wireless Technology
• Expanding Bandwidth Telecommunications Access
  to the Home
• High Patient/Family Acceptance

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Key Challenges

• Reimbursement
• Licensure/Credentialing
• Clinical Acceptance
• Low Volume gt High Per Visit Cost
• Evaluation Small Numbers
• Institutional Acceptance
• Financial Sustainability

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Key Challenges Clinician Acceptance

• Many applications improve access, but not
  provider productivity
• Provider discomfort with technology
• Economic protectionism
• Organizational Barriers
• Just One More Thing

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Evaluation Key Questions

• Who
• What
• When
• Where
• How

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Key Is To Define Cost Savings/Quality Improvement

• Admission to Hospitals
• ER Visits
• Office Visits
• Improvement in Disease Specific Markers (Blood
  Pressure, Blood Glucose)
• Nurse Productivity

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I. Example Encounters by Setting (12 months)
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Lessons Learned

• Needs/Resource Assessment
• Clinical Acceptance Critical Role of Nurses
• Equipment KISS Principle
• Telecommunications Infrastructure
• Organizational Integration
• Documentation of Value-Added
• Financial Model/Business Plan

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Future

• Growth in demand for health care services
  inevitable
• Shortages of key care-giving personnel will
  continue
• Changes in technology will drive a shift in how
  we provide health care
• SHORT-TERM SAVINGS NOT THE ONLY LITMUS TEST

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Implications for Global HIV/AIDS Activities

• CAREWare Software
• John Milberg
• Global HIV/AIDS Program
• WHO Collaborative

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CONTACT US
Dena Puskin, Sc.D. 5600 Fishers Lane Room
7C-22 Rockville, MD 20857 Phone (301)
443-0447 Fax [phone] Fax E-Mail
dpuskin_at_hrsa.gov