Telemedicine Lecture

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Second Intensive Balkan Telemedicine and e-Health
Seminar October 21-23, 2007Tirana, Albania
Charles R. Doarn, MBA Executive Director Center
for Surgical Innovation Deputy Director Advanced
Center for Telemedicine and Surgical
Innovation Associate Professor of Surgery and
Biomedical Engineering Department of
Surgery University of Cincinnati College of
Medicine
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• Need
• Leadership
• Ability
• Capability
• Financial
• Societal
• Technical
• Legal
• Cultural
• PROCESS!

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Challenges and Opportunities
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Stakeholders and Policy Makers

• Various branches of government
• Executive Branch
• Congress / Parliament
• Agencies
• Councils
• Departments / Ministries
• State / Provincial / Community
• Based on their need(s) and responsibilities

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Stakeholders and Policy Makers

• Educators
• Payors
• Patients
• Providers (all levels)
• Administrators
• You and Me

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Barriers

• Distance/Geography
• Financial
• Technical capabilities/ availability
• Technology
• Culture
• Language
• Policy

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Barriers

• Legislative
• Access
• Socioeconomic/political
• Willingness to Change
• Acceptance
• Education / Training

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Challenges

• No immediate access to definitive medical care
• Distance
• Limited communications (time and rate)
• Resources (volume, weight and power)
• Cultural diversity
• Autonomy
• Environmental and occupational hazards

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Challenges

• Outcomes research
• Technological standards
• Clinical standards
• Evidence-based Medicine
• Quality of service
• Limited bandwidth
• Security

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Issues

• Privacy
• Confidentiality of information
• Reimbursement
• Sustainability
• Credentialing
• Liability
• Return on investment (ROI)
• Acceptance

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Privacy, Confidentiality, and Security

• Impact of technology
• Protection under the law
• Hippocratic Oath??

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Payment Policies

• Government
• Fee for service
• Bundled payment methods
• Capitation payment
• Fears and concerns rising costs across the
  board
• Teleradiology and telepathology are reimbursed

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Legal

• Legislative
• Licensing
• Who, Where
• Reimbursement
• Clinical responsibility apportioned

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Systems Approach

• Needs and Requirements Assessment
• Interact with leadership
• Interact with care providers (all levels)
• Interact with vendors determine what is
  available
• Identify your funding source

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Systems Approach

• Identify a champion
• Identify and document a process
• Get everyone involved
• Keep it simple
• Identify your market
• Collect date outcomes - is it really working
  and is it beneficial?

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Unique Environments

• Remote
• Extreme
• Multilingual
• Multicultural
• International

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Charles R. Doarn, MBA Executive Director, Center
for Surgical Innovation Deputy Director, Advanced
Center for Telemedicine and Surgical Innovation
Associate Professor of Surgery and Biomedical
Engineering Editor-in-Chief, Telemedicine and
e-Health Department of Surgery University of
Cincinnati 231 Albert Sabin Way, ML
0558 Cincinnati, OH 45267-0558 Voice (513)
558-6148 Fax [phone] Cell (513)
403-960 E-mail charles.doarn_at_uc.edu Web
http//surgery.uc.edu/csi.html