Presentation by David Cattell-Gordon, Director, Office of Telemedicine, Center for Telehealth, University of Virginia

1. Developing the Telehealth
Workforce
MATRC 2013 Summit
David Cattell Gordon
Director, Office of Telemedicine
Co-Director, Healthy Appalachia Institute
Instructor, Public Health Sciences, Nursing
March 18, 2013

2. Purpose of Presentation
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Are we at a tipping point?
What are the indicators?
What are the consequences?
What are the resources?
What training is needed?
What are the opportunities?
Where we are headed?

3. The Tipping Point in Telemedicine
The tipping point is that magic moment when an
idea, trend, or social behavior crosses a threshold,
tips, and spreads like wildfire.
If you want to bring a fundamental change in
people's belief and behavior...you need to create a
community around them, where those new beliefs
can be practiced and expressed and nurtured.
It’s not just the network stupid, it’s the
network.

4. Engage
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Moving to warp speed: Broadband speeds continue to
trend faster across all provider segments; In Virginia,
average speeds have doubled since 2010.
Expanding the universe: Continued increase in
broadband penetration; Communities & providers are
starting to see broadband as a public health metric.
Resistance is futile: The Commonwealth is now national
leader in the use of telehealth - 54% utilization by health
systems; EMRs & HIEs continues to grow (VA is 4 th).
Going where no one has gone before: CVS, home
monitoring, EMS…
Policy, Practice and Reimbursement is paving the way

5. Technology is Exploding
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Costs continue to decline
Access continues to increase–mobile, 4G…
Adoption of standards-based operations
Greater movement to the desktop and hand-held
Processes are becoming simpler

6. Demand is Growing
Patient Encounters
TOTAL
FY 2011
Monthly Avg.
30,120+
21.3%
4,563
335
Fiscal Year Progress
7 8 5 8 0 6 7 . 4 2
TOTAL VA MILES SAVED

7. Specialty Services Are Increasing
Examples of Innovative Thinking
Stroke Network
Video-colposcopy
Remote Home Monitoring
ALS & Huntington’s Clinic
High Risk OB Clinic
Stone Clinic
Diabetic Retinopathy
Cystic Fibrosis Clinic
Ostomy Clinic
Surgical Clinic
Emergency Tele-psychiatry
Pediatric Inpatient
Research
40+

8. Partner Networks are Rapidly Expanding
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Community Hospitals
Health Systems
Rural Clinics (FQHCs, Free Clinics)
Virginia Department of Health
Virginia Department of Corrections
Community Service Boards
School Health
Nursing Facilities
PACE Programs
Home Telehealth
108

9. Commitments to Telehealth are Increasing
State of Virginia
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Virginia Health Reform Initiative
Virginia Medicaid
State Rural Health Plan
Virginia Cancer Plan
State Stroke Systems of Care Task
Force
Virginia Telehealth Network
Virginia Department of Health
Joint Commission of Health Care
Tobacco Indemnification
Commission
Medical Schools
Health Systems
Medical Society of Virginia
Mandated Coverage
Federal
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Grant funding (HRSA, USDA,
Commerce)
Medicare Reimbursement (rural)
CMMI
Rural healthcare support
mechanism (USF)
Indian Health Service
Veteran’s Telehealth
Military Telehealth
NIST
FDA
FCC Healthcare Connect

10. Benefits of Telehealth Are Well-Established
 Patients
 Timely access to locally unavailable services
 Spared burden and cost of transportation
 Improvement in quality of care
 Health Professionals
 Access to collaborative consultative services and CME
 Spared burden and cost of time and travel
 Referral network
 Rural Communities
 Enhanced healthcare/economic empowerment
 Health Systems
 Increased accessibility and state-wide presence

11. Radically Changing
Health Care Environment
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Demands for Preventing Readmission
Focus on Accountable Care
Increased Outreach to Veterans
Success of Home Monitoring Pilots
Federal Support such as FCC Healthcare Connect
Increasing Medicaid Patients
Medical Homes

12. The Problem:
Limited Telehealth Workforce
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Limited training for health professionals
Example: no set curriculum at UVA
Limited number of training programs
Few advanced degree programs
See one, do one, teach one model
Use of physicians to work equipment
The consequences…..

14. Moving From Blue Screen to
Full View HD
Formation of the STAR Center
• Establishment of the Certified Telehealth Technologist
Putting the right person in the right place with the right skills
• Improved Capacity in Communities
• Standardized Training/Setting the Standard
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Mission: To increase access to health care, improve health outcomes

15. The Southside Telehealth Training and
Resource Center Partnerships

16. Goals
The Star Center
• Address shortages and access to care by training
a workforce proficient in employing technologies
• Develop a telehealth simulation lab at NCI
• Train 250 telehealth technologists by Fall 2013
• Deploy capability throughout the Commonwealth
and MATRC region
• Create a standardized curriculum and delivery
model
• Evaluate outcomes of the training
• Foster develop of regional telehealth networks,
remote patient monitoring

17. Training Topics
•Overview of Telemedicine
•Impact on Community Health
•Best Practices in Telemedicine
•Tools of the Trade
•Etiquette and Protocols
•Home & Healthy: Remote Patient Monitoring
•Technology Lab Experiences
•Application to Community

18. Opportunities
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ED Techs
ED Nursing
CNAs
Home Health Workers
Clinic LPNs and RNS
Paramedics
Home Monitoring Center Staff
Inpatient Staff
Advance Practice Nurses
Community Health Workers
IT Professionals
Administrators

19. Applications
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Telemedicine
Telestroke Programs
Patient Monitoring
Access to Specialty Services
Community Health
Emergency Departments
Population Health
Hospitals, Clinics
Accountable Care Organizations
Inpatient Units
Correctional Telemedicine
Schools
Nursing Homes
etc.

20. Benefits of a Trained Telehealth Workforce
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Continues establishment of telehealth networks
Lets physicians do what they do best
Ensures standardized skills & training
Allows for rapid incorporation of new technology
Facilitates ease of integrate with health
information systems
Responds rapidly to increased competition
Integrates TMED into mainstream medicine
Develops novel approaches
Improves outcomes
Advances remote patient monitoring

21. Questions & Contacts
Leanna Blevins
New College Institute
276-403-5602
www.newcollegeinstitute.org
Edie Bowles
Virginia Telehealth Network
1-804-453-6286
www.ehealthvirginia.org
Kathy Wibberly
Mid-Atlantic Telehealth Resource Center
1-855-MATRC4U
www.matrc.org
David C. Gordon
UVA Office of Telemedicine
434-924-5470
www.healthsystem.virginia.edu/telemedicine