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August 2017    
HTRC's monthly telehealth bulletin

HTRC funding extended

HTRC is pleased to announce an additional three years of funding awarded by the Health Resources & Services Administration (HRSA). We are grateful for the opportunity to continue to serve the heartland region, expanding access to quality healthcare for rural and underserved communities in Kansas, Missouri and Oklahoma. Here's to three more years of access, connectivity and integration! 

National Maternal and Infant Nutrition Intensive Course

HTRC Director Eve-Lynn Nelson, Ph.D., recently presented for the HRSA-funded, National Maternal and Infant Nutrition Intensive Course to highlight telehealth programs for pregnant and postpartum women. Nelson overviewed the MomHealth Pilot, an effort to improve outcomes for teen mothers and their children. This innovative intervention augments "traditional" telemental health visits and telesupport groups with iPads preloaded with educational YouTube videos; text messages; and apps designed to help moms cope with daily stress. 

"Our goal," explained Nelson, "is to use  teen-friendly technologies to help young mothers breastfeed, prevent depression, and live healthy and active lives. We know that we need to make things simple for these busy, stressed moms - that's why we developed the program to be delivered right in their homes." 

Nelson, who serves alongside Karen Wamback, Ph.D., and Ann Davis, Ph.D., as co-PIs, said the intervention was designed to consider several interrelated factors that are more prominent in teen moms. They have lower rates of breastfeeding, are more likely to gain and maintain excessive weight and have higher rates of postpartum depression. Increased breastfeeding has health benefits for both mother and child, and preventing and treating depression also positively impact health outcomes. Influencing these behaviors, therefore, can enhance overall health of both mother and child.

The pilot was based on the Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS) model, developed through a partnership among the  University of Arkansas College of Medicine, the Arkansas Department of Human Services and the Arkansas Medical Society.  Though still in its infancy, so far nine mothers have completed the MomHealth program and participants have shown high rates of satisfaction with the individual counseling televideo sessions and the text messaging component. The National Institute for Health trial will start this fall. For more information about the program, please contact HTRC at 877-643-HTRC.  


Columbia, Mo.
September 26 & 27, 2017 

Missouri Telehealth Network provides formal and informal training to new and existing members of the network. This training offers a thorough overview of telehealth including:
  • How to use telehealth devices and trouble-shoot equipment problems 
  • Public and private policies impacting telehealth, billing requirements, JCAHO standards and HIPAA regulations
  • Clinical, administrative and educational applications of telehealth
  • Telehealth use in specialties and other programs such as Show-Me ECHO

ECHO schedule

Pain Management Ongoing Kansas
Asthma Starts fall 2017 Kansas
Child Behavioral Health Starts in fall 2017 Kansas
Back-to-School Starts September 21 Kansas
Impact Asthma New round starts in September Missouri
Ongoing Missouri
Healthcare Ethics Ongoing Missouri
Chronic Pain Management New round starts in September Missouri
Dermatology Ongoing Missouri
Hep C Starts September 1 Missouri
Child Psychology Ongoing Missouri
Community Health Worker
Opioid Use Disorder Starts September 8 Missouri


Tribute to a friend and telehealth champion

This week, HTRC joins with other telehealth resource centers (TRC) across the nation in mourning the loss of Mario Gutierrez, executive director of the Center for Connected Health Policy. Mr. Gutierrez's passion for increasing access to quality health care through telehealth was evident in his work at the Center and was an inspiration to us all. He was a tireless advocate for underserved communities including Native Americans and migrant farm workers and he will be greatly missed. 

All of us at HTRC extend our deepest condolences to Mario's family, friends and colleagues. We will do our best to carry on his legacy. 

Mario Gutierrez (upper right) pictured with other TRC representatives

Telehospice providing comfort in rural Kansas

One need look no further than the windshield of a hospice nurse to understand why telehealth is a good fit for hospice. From mud to snow, traveling through rural Kansas can be a challenge, one which determined nurses traverse daily to ensure they can be with their patients in their hour of need. Those trips are still necessary, but telehospice can help augment those home visits so nurses can decrease their windshield time and maximize their patient interaction time.
This month at the Kansas Hospice and Palliative Care Organization Summer Meeting, Eve-Lynn Nelson, Ph.D., and Karen Porter-Williamson, M.D., presented on telehospice and palliative care outreach. In addition to the decreased travel time for nurses and increased responsiveness to patient needs, Nelson revealed other benefits of telehealth linkages for patients:
  • Social workers and spiritual advisors can be linked to patients in their homes.
  • Family members can help from a distance with hospital admission processes or medication reconciliation. 
  • Clinicians can guide caregivers through processes such as changing wound dressing.
  • In some cases, telehospice can even connect patients to loved ones to say their final goodbyes.
Under Dr. Gary Doolittle's leadership, the University  of Kansas Center for Telemedicne and Telehealth established one of the first telehospice programs in the country in 1998. Those years of experience have been leveraged to update the telehealth program, now dubbed Telehospice 2.0. Stay tuned for an article profiling Telehealth 2.0 in an upcoming HTRC newsletter. 

Additional credits and resources:
Thanks to Hospice Services, Inc. Executive Director Sandy Kuhlman, R.N., and Medical Director Joe Barnes, M.D. for their contribution to the presentation and to the national presenter, Judi Lund Person, MPH, CHC, VP of Regulatory and Compliance at the National Hospice and Palliative Care Organization

New Missouri Hospital Foundation Report

A Missouri Hospital Foundation Report released last week, "The Status of Telehealth in Missouri," made a strong case for telehealth in the state, particularly within the vast rural counties. According to the report, there are 13 Missouri counties with only one primary care physician. And those doctors working in rural counties without hospitals are chronically overworked - with an average workload that is nearly three times the load of doctors in counties with hospitals. 

The report delved into several of the chronic obstacles to telehealth delivery, such as reimbursement and limited broadband, but pointed to several promising signposts:
  • New proposed Medicaid rules would increase eligible provider types, eligible originating sites and add store-and-forward as a reimbursed form of telehealth. 
  • Of the half of rural hospitals in Missouri using telehealth, over 80 percent said telehealth helps them retain rural patients in the community, according to an MFH survey.
  • Rural health systems are forging ahead regardless of reimbursement out of their commitment to provide quality care for patients and build relationships among "patients, providers, employers and payers." 

Project ECHO

Project ECHO is a program using telemedicine to revolutionize medical education  and improve access to specialty care. Project ECHO, which was developed by the University of New Mexico School of Medicine, works by connecting primary care clinicians with specialist teams via videoconference. 

Each specialty area has its own ECHO, such as autism or chronic pain. ECHO teams meet regularly to hear cases from providers and make recommendations.

Heartland Telehealth Resource Center | | 
 4330 Shawnee Mission Parkway   Fairway, KS 66205