Brian J Grady, M'D' Director TeleMental Health Department of Psychiatry School of Medicine Universit

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Brian J Grady, M.D.Director TeleMental
HealthDepartment of PsychiatrySchool of
MedicineUniversity of Maryland

• TeleMental Health

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Todays Topics

• TMH Overview
• University Projects
• TMH Policy
• Future Directions

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TeleMental HealthOverview

• Beginnings Late 1950s
• Interactive Television 1960s to 1990s
• Affordable VideoConferencing late 1990s to mid
  2000s
• Evidence Based TMH mid 2000s to present

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The Merger
Technology
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The Merger
Technology
Clinical Needs
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The Merger
Technology
Telemental Health
Clinical Needs
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The Merger
Technology
Access
Clinical Needs
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UMB TMH Projects

• Maryland Youth Practice Improvement Committee
  Consortium of Psychiatry Department UMB,
  Psychiatry Department JHU, Mental Hygiene
  Administration, Regional Institutes for Children
  and Adolescents, State CA Inpatient Units
• School Based Mental Health Projects
• Baltimore, Western High School (04/05)
• Prince George Co, Suitland HS Kettering MS
• Health Resources and Services Administration
  Grant - Consortium of Mid-Shore MH CSA, Mental
  Hygiene Administration, Garrett Co Core Service
  Agency, St. Marys Co Core Service Agency,
  Psychiatry Department UMB

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Required Resources

• Clinical Champion Distant Site
• Site Champion Originating Site
• Administrative Support
• Technical Support
• Financial Support

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Financing

• Grants
• Health Services Resources Administration
• Department of Agriculture
• Maryland Community Health Resources Commission
• Fee for Services
• Medicare
• Maryland Public Mental Health System
• Third Party Reimbursements
• Contractual Agreements

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TMH Policy

• Regulations
• Board of Physicians
• Medicare
• Balanced Budget Act (BBA) of 1997
• Benefits Improvement and Protection Act of 2000
  (BIPA)
• Medicaid
• Draft Regulations

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Medicare Originating Sites(additional Medicaid
proposed)

• Physicians or practitioner office
• Hospital
• Critical Access Hospital
• Rural health clinic
• Federally qualified health center
• (Elementary, middle, high, or technical school
  with a supported nursing, counseling or medical
  office. A college or university student health
  or counseling office)
• (County Health, Human and/or Social Service
  offices or clinics and other county offices
  appropriate for private clinical evaluations and
  services)

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Qualified Geographical Areas

• Medicare
• Health Practice Shortage Areas (HPSAs)
• Non-Metropolitan Statistical Area (MSA) counties
• Entities that are Federal telemedicine
  demonstration projects

• Medicaid
• Garrett
• Allegany
• Worcester
• Somerset
• Wicomico
• Dorchester
• Caroline
• (proposed)
• Talbot
• Queen Annes
• Kent

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Technical Requirements

• 1. Minimum ISDN or IP bandwidth using H.264 video
  protocol gt 256 kbps
• 2. Monitor minimum, non-anamorphic, net display
  size of 16" diagonally
• 3. Minimum resolution of 1 Common Intermediate
  Format/Source Input Format
• 4. Switched Network or Encryption

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Future Directions

• Vision TeleMental Health Center of Excellence
• Clinical Champion
• Coordinator Resource
• Technical Resource
• Education, training research

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Comments, Questions