Telehealth Show Me the Money

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TelehealthShow Me the Money
Capitol Hill Series

• Dena S. Puskin, Sc.D.
• U.S. Dept. of Health and Human Services
• Health Resources and Services Administration
• HIV/AIDS (HAB) Bureau

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OAT VISION
NO MATTER WHO YOU ARE OR WHERE YOU AREYOU GET
THE HEALTH CARE YOU NEED WHEN YOU NEED IT
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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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TELEVILLAGE

TELEHEALTH
Health Professional Education
K-12 Education
TELEMEDICINE
Consumer Health Services
Business
Administration
Libraries
Public Health
Justice
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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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Real-Time Telemedicine
Patient in rural ER gets benefit of local care
plus remote consultation with specialists.
Remote doctor examines a patients inner ear from
a remote location.
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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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Store-and-Forward

• Primary care provider takes a still image and
  sends it to a consulting physician who later
  reviews it
• No real time interaction between patient
  consultant
• Commonly used for dermatology, radiology

Clinician reviews scan which was forwarded for
consultation.
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Home Health

• Low-cost equipment that needs only a regular
  phone line
• Used to check vital signs, monitor medications,
  visualize patient, provide enhanced support

Patient and nurse interacting during a video
home visit.
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Disease Management
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Department of Defense (DoD) Smallpox Vaccination
Patient Monitoring
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Informatics
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Inland Northwest Telepharmacy System
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RESOURCES
SHOW ME THE MONEY
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MANY FEDERAL AGENCIES FUND TELEHEALTH PROGRAMS

• DOD
• VA
• NASA
• HRSA
• CMS
• CDC

• NLM
• NIH
• AHRQ
• RUS
• Commerce
• TOP
• ATP

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HRSA Telehealth Inventory Hidden Telehealth
System Telehealth activities which are not
labeled as telehealth programs or activities
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• Preliminary Findings from HRSA Telehealth
  Inventory

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• Type of Telehealth Activities Reported from HRSA
  Telehealth Inventory

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TELEMEDICINE PERFORMANCE MEASUREMENT SYSTEM

• Create a performance measurement tool using
  common quantifiable objectives across all OAT
  telemedicine grantees
• Provide assistance to grantees
• Overcome small numbers problem in telehealth
  evaluations

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Evaluation Key Questions

• Who
• What
• How
• When
• Where

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Process for Creating Measures

• Collaborative Process with Grantees
• Measures Based on Grantees Actual
  Experience
• Emphasis on Practical Experience

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I. Example Encounters by Setting (12 months)
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I. Example of Type of Encounter/Data Transfer
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I. Example Encounters by Type of Service
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I. Example Access
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II. Example Practitioners referring to TM
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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