This document provides an overview of the resources and steps needed to plan and implement a telehealth program. It discusses the following: 1) The Great Plains Telehealth Resource Center (GPTRAC) which provides guidance, tools, and education to hospitals, clinics, and other organizations on telehealth. 2) The key aspects of planning a telehealth program including needs assessments, project management, technology, policies/procedures, training, and evaluation. 3) Where to find additional information and resources on these topics from organizations like the Telehealth Resource Centers, American Telemedicine Association, and Health Resources & Services Administration. 4) Contact information for the GPTRAC Outreach Director for those seeking

1. What You Need To Get Going …and… How To Find It!

2. Disclosure The Accreditation Council for Continuing Medical Education (ACCME) requires all speakers to make a verbal disclosure of all relevant financial relationships with any commercial interest and the nature of the financial interest pertaining to this lecture. None!

3. Why me? One of the TRCs Built and run telehealth programs Involved in telehealth since 1993 Dirt! (old as…)

4. Who is the GPTRAC? One of several federally-designated regional TRCs around the nation Established in 2006 Located at University of Minnesota/IHI Extensive telehealth program implementation experience 75+ years, combined

5. What do we do? Provide guidance Gather information Answer questions Share tools and resources Provide education Encourage collaboration Gather regional information

6. Who do we serve? Hospitals Clinics Providers Safety-net Organizations Schools Nursing Homes Etc.

7. Overview: General Planning Operations Training Technology Reimbursement Evaluation

8. What you need…

9. How to find it…

10. Just starting Definitions Information Articles

11. TRCs www.telehealthresourcecenter.org Telehealth Resource Centers

12. ATA http://www.americantelemed.org American Telemedicine Association

13. HRSA www.hrsa.gov/telehealth/default.htm Office for the Advancement of Telehealth

14. Publications Telemedicine and e-Health Journal of Telemedicine and Telecare

15. Planning Project Management Business Planning/ROI Needs/Readiness Assessments

16. Need a map

17. CTEC www.cteconline.org Telehealth Program Developer 7-step process

18. GPTRAC www.gptrac.org Planning Process Pilot Business Case Micro Planning Macro Planning Readiness Evaluate Expand Enhance Implementation Cycle

19. OAT/HRSA http://telehealth.muhealth.org/general%20information/TAD.html

20. Business Plans Business & Finance SIG – Member Groups – ATA

21. operations Organizational Structure Policies/Procedures Standards/Guidelines Forms Staffing Remote Partner Locations

22. Operations?

23. www.telehealthresourcecenter.org

25. Operations www.telehealthresourcecenters.org

26. Policies/Procedures

27. Policies/Procedures Example

28. ATA http://www.americantelemed.org American Telemedicine Association

29. Standards/Guidelines

30. Forms

31. Forms

32. Staffing

33. Remote Sites www.gptrac.org

34. training Learning Centers Clinical: Initial and On-going Distance Education

35. Learning Centers Methods: In-person Sessions On-Line Learning Focus on: Clinical Administrative Technology Etc.

36. UC-Davis Center for Health & Technology

37. UC-San Diego Telemedicine Learning Center

38. University of Arizona Telemedicine Training Center

39. Internal Training Not everyone can “go” for training Need to: Develop comfort and understanding Establish competency Assure service continuation

40. Nursing Training www.gptrac.org

41. Distance Education Receiving: Look around for opportunities Technology allows you to stretch! Options: The TRCs The Health Systems in your region Others Expect quality, and encourage it.

42. Resources:

43. Distance Education Providing: Teach your presenters Engage the remote locations Make accommodations to facilitate learning at the remote locations Teaching aides/hand-outs On-site resources

44. Distance Education www.gptrac.org

45. Example http://www.medicine.virginia.edu/education/more/telemedicine/projects/craig

46. technology Equipment Peripherals Network

47. Equipment Videoconferencing Remote Monitoring Peripherals

48. Videoconferencing Room Units Telepresence Desktop Web-based Etc…

49. Remote Monitoring Home Health ICU Connectivity What is available? What is needed? Integrated vs. Stand-alone

50. Peripherals Stethoscope Otoscope Examination Camera Dermascope Ultrasound Scale Etc…

51. Equipment

52. Equipment Resources

53. Rules & Regs Licensing Credentialing/Privileging HIPAA Reimbursement Liability/Risk

55. Licensing Physicians Nurses Pharmacy Others…

56. State Medical Board Unique to each state Federal of State Medical Boards

57. State Nursing Board Nurse Compact 23 States (approx.) No? Check with your state’s Board of Nursing

59. Credentialing CMS JCAHO Your facility’s risk manager or attorney Center for Telehealth & eHealth Law

60. Privileging www.jointcommission.org

61. HIPAA Center for Telehealth & eHealth Law http://telehealthlawcenter.org/?c=181

62. Reimbursement CMS Center for Telehealth & eHealth Law State Medicaid Third party payors

63. CMS http://www.cms.gov/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf

64. CTeL http://telehealthlawcenter.org/

65. State Medicaid

66. State Medicaid Example Take a look at each state’s laws and/or rules/regulations.

67. State Medicaid Example As of: July 1, 2009

68. Other Payers Just bill ‘em… Call and ask Check at CTeL Check at ATA

69. Other Payers Some states have mandates for coverage Otherwise… Aetna Blue Cross Etc.

70. evaluation Determining the Value Tracking & Collection Forms

72. www.southwesttrc.org

75. General Resources TRCs ATA Other Centers

76. Comments

77. Comments

81. 4 New TRCs Georgia Arkansas Kansas Hawaii

83. One at a time…

84. Contact me: Mary DeVany, Outreach Director medevany@gmail.com Toll-Free: 888-239-7092 www.gptrac.org