This SlideShare covers the utilization of telehealth products and services by healthcare organizations, as well as the reasons driving their adoption. This session will focus on reasons to adopt telehealth as a service line, the types of technologies widely deployed, and the financial implications associated with offering care in a virtual setting. Learning objectives: • Review the current landscape of telehealth • Assess the approach to using technology to provide care in a virtual setting • Recognize the financial impacts and reasoning associated with telehealth services

1. Designing an
eVisit:
Considerations
for Virtual
Encounters
Kathy Nieder, M.D.
Baptist Health Medical Group
October 21, 2015

2. Agenda |Overall Considerations –
Summary
• Changing Care
• Financial Considerations
• Principles of Practice and Licensure
• Process and Application of Technology
• Patient Consent and Relationship
• Evaluation and Treatment
• Quality Management Provider Education and Guidelines
• Case Studies

3. • Review the current landscape of telehealth
• Assess the approach to using technology to provide care
in a virtual setting
• Recognize the financial impacts and reasoning
associated with telehealth services
Learning Objectives

4. • Realizing the value of a virtual visit
– Changing provider’s perspectives
– Changing patient’s perspectives
• Understanding when a Virtual Visit is appropriate
– Clinical needs
– Past medical history and understanding how virtual relationships
should occur
Extending Care – Anytime, Anywhere

5. Financial Considerations
• Cost benefit
– Soft ROI: Provider and patient satisfaction
– Hard ROI: New business models; revenue generation
• Infrastructure needs for a Virtual Visit
• Understanding patient demographics
– Medicare, Medicaid, pay per visit
• Cost saving through improved outcomes
• Chronic care management and pertinent/available CPT codes

6. Principles of Practice: Treat
Telemedicine the Same
• Place the welfare of patients first;
• Maintain acceptable and appropriate standards of practice;
• Adhere to recognized ethical codes governing the medical profession;
• Properly supervise non-physician clinicians; and
• Protect patient confidentiality.
• Licensure

7. Process and Technology
• Technology
– Integration points with recordation
• Timing
– 24/7 vs. scheduled
• Environment
– Lighting and background
– External audio sources
• Documentation
• Support
– Staff to facilitate scheduling
– Staff to facilitate medical encounter
• Online consultation guidelines
– Tailor the approach for your organization
• From – MFA Video Consultation Operational Guidelines Document

8. Patient Consent and Relationship
Process
• Consent form should cover:
– Identifying information
– Provider delivering service
– Outline the limitations of service and patient rights or expectations
– Check local laws
• Establishing a Relationship – Check applicable state laws
– Verifying and authenticating the location and, to the extent possible,
identifying the requesting patient
– Disclosing and validating the provider’s identity and applicable
credential(s)
– Obtaining appropriate consents from requesting patients

9. Quality Management: Education,
Guidelines and Operational Support
• Personnel Training and Fellowships for Clinicians
– Online, in person, vs. “hi touch” experience
• Program certification programs
– Online
– Industry recognized
– Relevant local laws and regulations
• Organizational Marketing and Collateral Development
– Feedback from Patient
– Payment

10. GWU ConnectER Program
• Targeted approach to reduce ER readmissions
• Scheduling support and committed staff
• Support and education for providers
• Clear documentation and payment process
• Patient feedback after eVisit

11. Other Case Studies
• Connected Health Case Study: Mobile PHR Improves Patient
Engagement, Satisfaction and Care Children’s Medical Center Dallas
teamed up with ONC on the “PHR Ignite!” pilot program, a personal
health record (PHR) pilot program designed to engage patients,
encourage active involvement in disease management, and provide
medication reminders via an iPhone.
• Connected Health Case Study: Montefiore Health System This case
study highlights how Montefiore has built apps internally, and when
necessary, partners with vendors and development firms. Patient
focused apps undergo a marketing and branding review for continuity
across platforms and use cases.
• Connected Health Case Study: Geisinger - Reducing Patient No-
Shows With its patient engagement initiative, Geisinger Health
System implemented a platform to do text messaging and selected
appointment reminders to help reduce patient "no shows".

12. Acknowledgements
• George Washington University Medical Faculty Associates
– Neal Sikka
Associate Professor, George Washington University
Department of Emergency Medicine
– James Betz
Program Manager
Department of Emergency Medicine
– Nicholas Reed
Innovative Practice Program Coordinator
Department of Emergency Medicine
• HIMSS Connected Health Community
– Kathy Nieder M.D., Sri Bharadwaj MS, Brian Rothman M.D.
• HIMSS Staff Liaisons
Tom Martin, David Collins, John Sharp

14. Questions?

15. • Kathy Nieder, M.D.
• Baptist Health Medical Group
Thank You!