Telehealth and Public Health Emergencies and Disaster Medical Responses

1
Telehealth and Public Health Emergencies and
Disaster Medical Responses
February 6, 2009
Lara Lamprecht
2
Report to Congress

• Fulfillment of PHS Act Section 319D (f) as
  amended by Pandemic and All Hazards Preparedness
  Act (PAHPA) (December 2006)
• Scope limited to Telehealth initiatives that
  could be utilized to optimize Emergency Support
  Function 8 efforts in service to the public
  during public health emergencies (PHE) or
  disaster medical responses (DMR)

3
Process to Create Report

• ASPR policy process mechanisms to obtain the
  proper utility of and format for a national
  Telehealth inventory
• ASPR-led multi-agency Telehealth Working Group
• Created a working definition of Telehealth
• Input garnered from internal and external
  entities
• Department of Health and Human Services (HHS)
  Enterprise Governance Board
• National Biodefense Science Board (NBSB)
• Institute of Medicine (via Dispensing Medical
  Countermeasures for Public Health workshop)

4
Working Definition for Telehealth

• Electronic information, infrastructure
  considerations, clinical, administrative
  applications and communication technology applied
  to improving health and maximizing patient
  outcomes with specific application to public
  health emergencies and disaster medical responses

5
Content of Report

• Working definition for Telehealth
• Inventory of existing Telehealth initiatives
  applicable to PHE or DMR
• Integration of Telehealth into NDMS practice
• Recommendations for improved interagency
  practices and cooperation
• Establishment and improvement of payment or
  reimbursement for telemedicine resources
• Preparation and integration of the electronic
  medical record
• Public-private collaboration to leverage existing
  networks
• Information technology and telephonic
  connectivity to enhance the applications to mass
  casualty event, or PHE and DMR

6
Working Group Identified Challenges

• Integration of existing Telehealth and ehealth
  resources and programs
• Expansion of communication technology
• Establishment of uniform information standards
• Implementation of Telehealth and ehealth
  throughout the public and private sectors at
  local, state and national levels
• Estimation of the type and amount of resources
  which will be required
• Determination of the role the Federal Government
  should play in integrating existing Telehealth
  and ehealth resources and programs

7
Recommendations

• Apply existing clinical and technical practices,
  networks and technological capabilities for
  information transfer, and rapidly insert
  intellectual and clinical consultation into
  remote and compromised environments during a
  response
• Use existing and uniform accounting and
  electronic asset and reimbursement strategies for
  Telehealth materials and services to
• Improve situational awareness
• Enhance overall incident management
• Accurately represent the event to facilitate
  crisis decision-making
• Inform event review and lessons learned by
  providing data for objective evaluation to
  determine reliable best practices (for swifter
  recovery and improved patient outcomes)
• Properly apply Telehealth tools to capture
  potentially the arc of a patients encounter
  with the system, course of care, and final
  disposition

8
Recommendations

• NBSB recommendation that a Task Force
• Address Working Group identified challenges and
  advise on a national strategy for Telehealth and
  ehealth application to PHE and DMR
• Consider the proper matching of PHE response and
  disaster medicine tactics with twenty-first
  century technology
• IOM recommendation that a Forum be held to
  address
• Health Informatics (ehealth, Telehealth, IT
  considerations) In Public Health Emergencies and
  Disaster Medical Response 21st Century Response
• Three specific topics
• EMR compatibility NDMS, public healthcare,
  private healthcare
• Innovative Response Consultation,
  Countermeasures, Tracking, Compensation,
  Confidentiality
• Interoperability ESFs 5, 6, 8, 9, etc.

9
Next Steps

• Development of a national strategy to incorporate
  Telehealth applications into PHE and DMR
  including
• Credentialing
• Portability
• Information exchange regarding adverse actions
• Waiving of licensing requirements
• Internal Working Group
• External input on strategic considerations
• NBSB Task Force
• Materials generated by IOM and other independent,
  objective entities
• EGB

10
(No Transcript)