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Improving Access to Quality Health Care in Virginia through Information and Communication Technology: A Strategic Plan for Telehealth in the Commonwealth

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Title: Improving Access to Quality Health Care in Virginia through Information and Communication Technology: A Strategic Plan for Telehealth in the Commonwealth


1
Improving Access to Quality Health Care in
Virginia through Information and Communication
Technology A Strategic Plan for Telehealth in
the Commonwealth
  • November 18, 2005
  • VRHA Annual Fall Conference

2
What is Telehealth?
  • Telehealth is the use of electronic information
  • and telecommunications technologies
  • to support long-distance clinical health care,
  • patient and professional health-related
    education,
  • public health and health administration.

3
What Types of Technologies are Used in
Telehealth?
Low Tech
  • Telephone, fax
  • Computers, printers, scanners
  • Email and Internet
  • Store and forward of digital images
  • Real-time patient data exchange
  • Videoconferencing
  • Fully integrated networks

HighTech
4
  • The Institutes of Medicine report "Crossing the
    Quality Chasm" (Ross et al, 2001) stated that
    "information technology must play a central role
    in the redesign of the health care system."
  • It could be argued that nowhere is information
    technology potentially more critical in the
    redesign of healthcare than in rural areas.

5
Can Rural Telehealth Work?
California Program on Access to Care Study
Hypotheses
  • Rural health care entities often have difficulty
    maintaining market share
  • Perceptions of quality play a role in rural
    residents decisions to leave community for care
  • Telehealth has the potential to bring expertise
    to rural communities and increase the scope of
    locally available services which may improve
    perceptions of local care

6
Can Rural Telehealth Work?
California Program on Access to Care Study
Design
  • Marketing research firm conducted 500 random
  • phone surveys in 7 rural communities to assess
    perception and utilization of local health care
  • Telehealth was implemented in the 7 communities
  • Seventeen months later, marketing research firm
    randomly contacted 500 residents in the same
    communities to assess perception and utilization
    of local health care

7
Can Rural Telehealth Work?
California Program on Access to Care Study
Findings
  • Respondents with a lower perception of the
    quality of local health were more likely to
    travel outside the community, and this
    relationship was stronger for those with a higher
    income.
  • Rural residents familiar with local telehealth
    efforts had a significantly higher opinion of
    local healthcare quality.

8
Can Rural Telehealth Work?
California Program on Access to Care Study
Findings (continued)
  • The benefits of rural telehealth could include
  • Potential reduction in health care costs
  • Keeping patients local retains direct and
  • indirect health care
  • When patients leave the community for health
    care, their purchasing dollars go with them to
    the urban community

9
What are the Challenges of Rural Telehealth?
  • The development of rural telecommunications is
    not profitable to large telecommunications
    companies, so the infrastructure can be
    inadequate and/or costly
  • Rural areas frequently have difficulties keeping
    up with the rapid advances in technology
  • Rural areas often lack the technical manpower and
    expertise to troubleshoot and provide technical
    assistance and training in the use of new
    technologies

10
The Virginia Telehealth Network (VTN)
  • Began in November 2002 as an informal gathering
    of over 20 individuals representing 14 private
    and public agencies/organizations who were
    identified as key stakeholders involved in
    telehealth
  • Is now comprised of over 80 individuals
    representing 50 public and private
    agencies/organizations

11
Purpose of the VTN
  • to facilitate networking,
  • to explore opportunities for collaboration,
  • to improve the current telehealth infrastructure
    and
  • to improve the current utilization of telehealth.

12
Establishing the Baseline
  • During 2003 - 2004, the VTN Infrastructure Work
    Group (IWG) designed a site survey to capture
    information about
  • Current telehealth infrastructure and capacity
  • Future (next 36 months) plans for expansion
  • of telehealth activities

13
Snapshot of Telehealth Sites (December 2003)
U.V.A.
X hub
point of presence (POP)
Community Service Board
V.D.H.
Winchester
D.O.C.
Leesburg
Arlington
RAHEC
Falls Church
EVTN
Front Royal
Woodstock
Fairfax
VA Dept. of Mental Health (VDMHMRSAS)
Alexandria
(2)
VCU.
Manassas
VT/VCOM
Warrenton
Harrisonburg
Culpepper
Monterey
Colonial Beach
Fredericksburg
Dahlgren
(2)
(2)
Craigsville
Staunton
Montross
Mitchells
Olney
Warsaw
Charlottesville
Hot Springs
Accomac
St Stephens Church
Callao
Bowling Green
Troy
Clifton Forge
Heathsville
Ashland
(2)
Coving-
Aylett
Tappanahanock
Nassawadox
(4)
(3)
Glen Allen
Kilmarnock
Low Moor
Goochland
ton
Belle Haven
Dillwyn
Franktown
Saluda
Lexington
Vinton
(2)
Lancaster
(2)
Richmond
New Castle
Powhatan
Grundy
(11)
Hartfield
Chesterfield
Lynchburg
(3)
Blacksburg
Roanoke
Farmville
Cheriton
Charles City
X
Vansant
Madison Heights
(2)
Petersburg
X
Salem
Clintwood
(2)
Bastion
Williamsburg
Tazewell
Christianburg
Hayes
Pound
Pearsburg
Blackstone
Hampton
Cedar Bluffs
Bland
Dungannon
Newport News
Newport News
Wise
St. Paul
Radford
Burkeville
Wytheville
Big Stone Gap
(17)
Virginia Beach
Portsmouth
Catawba
Norfolk
Lebannon
Saltville
Jarratt
Pulaski
Blacksville
Boydton
(3)
2-H
Norton
Floyd
Martinsville
Marion
(2)
Abington
South Boston
Laurel Fork
Chesapeake
Hillsville
Suffolk
Pennington Gap
Gate City
Konnarock
Galax
Danville
Stuart
Bristol
14
HoweverNetworks are Isolated
15
Where To From Here?
Based on the findings of the site survey. The VTN
IWG developed a white paper that delineated the
strengths and weaknesses of the existing
telehealth infrastructures. In that white
paper was the recommendation for the development
of a statewide integrated telehealth network.
16
The Birth of a Vision
Hospitals
Home health patients
17
The Next Step
The Development of a Statewide Strategic
Telehealth Plan for the Governors Consideration
is In Progress .
18
The Strategic Planning Team
  • Michael Aisenberg Liberty Alliance/Verisign
  • Ed Bostick Rappahannock Area Health Education
    Center
  • Peter Buccellato Knowledge Providers Group
  • Rebecca Davis Virginia Rural Health
    Association
  • Steve Gillis Telehealth Solutions Group
  • David Heise Telehealth Solutions Group/MCI
  • Jay Sanders The Global Telemedicine Group

19
Guiding Principles
  • Consumer Choice
  • End-user Driven Policies
  • Any to Any Connectivity (Open Access)
  • Scalability (Bandwidth Tailored to Need)
  • Geographic Parity
  • Financially Self Sustaining
  • Rapid Adoption of Telehealth Applications

20
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23
Anticipated Benefits
  • Interoperability
  • Compatibility of equipment
  • Group purchasing
  • Technical assistance
  • Calendaring/scheduling

24
Outline
  • Executive Summary
  • Introduction/Background
  • Needs
  • Vision
  • Recommendations
  • Technical and Clinical Specs
  • Standards
  • Architectural Design
  • Business Case
  • Administration and Oversight

25
Review and Comment
  • Download this Powerpoint presentation and see the
    very rough first draft of the strategic plan on
    Tuesday November 22 at http//www.vdh.virginia.gov
    /primcare/center/vtn/info.asp
  • Send feedback to Ed Bostick at edat1218_at_yahoo.com

26
For More Info
  • Contact
  • Kathy H. Wibberly, Ph.D.
  • Virginia Dept. of Health
  • Office of Health Policy and Planning
  • 804-864-7429
  • Kathy.Wibberly_at_vdh.virginia.gov
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