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October 2017    
 TELEHEALTH BEAT 
HTRC's monthly telehealth bulletin
HTRC and a happy patient usher in telehealth in Kansas CAH



Minneola District Hospital in Minneola, Kan. is embracing change under the leadership of CEO Debbie Bruner, and after their first telehealth patient to receive outpatient services "raved about how wonderful it was," they are increasingly sure they're headed in the right direction.   
 
When a patient requested telehealth two years ago, it was a different story. The hospital had limited space and the staff was still a little unsure about the technology. But just as necessity is the mother of invention, psych evals are the mother of telehealth initiation. The shortage of mental health professionals and commensurate  difficulty finding timely, inpatient emergency evaluations inspired the hospital to try telehealth technology, though they were not billing for it at the time.
 
After a second request for telehealth from the mother of a child who had been referred to a physician at the University of Kansas, Bruner decided it was time to look at a strategic telehealth plan. HTRC Project Director Janine Gracy was called in to assist with Minneola's plans to start using, and billing for telehealth.  
 
"[Gracy] explained how the process would work, step-by-step and what that needed to look like to make sure it was the best benefit for our patients," said Bruner.
 
In addition to a site visit to walk her through technical aspects like room lay-out and lighting, Gracy connected Bruner with another critical access hospital in the area to further advise, and help her gain comfort with the billing process.
 
Bruner said the collaborative, team-based care approach of the specialist on the first consult was a welcome surprise. The psychiatrist recommended medication changes, but the patient stayed in the hands of the primary care physician, who then coordinated the care without feeling like the patient had disappeared into a black hole.  
 
The hospital is now exploring ways to expand their telehealth services. Meanwhile, the hospital is renovating to expand their outpatient facility, more than doubling their current number of exam rooms and expanding their capacity for telehealth.
 
For information about how your hospital can benefit from an HTRC consult, call us at 877-643-HTRC. Most of HTRC's services are free. 

EVENTS
Atlanta, Ga.
November 4-8

The annual APHA Conference brings together public health practitioners and partners from across the globe. This year's theme will examine the health impact of a changing climate. Telehealth champions, including Telehealth Resource Centers, will be there to exhibit and present and HTRC members will be among the TRC members staffing the booth. Come see us! 

November 16, 2017



Join the monthly Telehealth Resource Center Webinar to learn more about the Rural Health Care (RHC) Program. The RHC Program supports health care facilities in bringing world class medical care to rural areas through increased connectivity. Learn more about what the RHC Program is, its current state, and what to expect in the future. Participants will have the opportunity to pose questions to RHC Program team members.




One out of five people living in the U.S. calls rural communities home. Rural residents face challenging health issues, including a greater share of chronic health conditions and a lower proportion of health care providers and facilities. National Rural Health Day is an opportunity to recognize the value of rural life and invest in solutions to improve the quality of care for rural dwellers. 

Missouri Telehealth Summit
Jefferson City, Mo. 
February 1

The 2018 Missouri Telehealth Summit will focus on financial barriers and incentives for rural hospitals, successful Missouri telehealth projects, legislative updates and more. The keynote speaker will be Yulun Wang, Ph.D., founder and CIO of InTouch Health. 

For those who want a crash course in telehealth basics, a pre-summit Telehealth 101 Workshop will be held January 31, also at the Capitol Plaza Hotel in Jefferson City, Mo. 

ECHO schedule

ECHO
WHEN
STATE
Pain Management Ongoing Kansas
Airway  Starts November 2017 Kansas
Child Behavioral Health Starts fall 2017 Kansas
Back-to-School Ongoing Kansas
Impact Asthma Next cohort starts January, 2018 Missouri
Autism
 Year round Missouri
Healthcare Ethics Ongoing Missouri
Chronic Pain Management Ongoing Missouri
Dermatology Year round Missouri
Hep C Year round Missouri
Child Psych New cohort starts November 10 Missouri
Community Health Worker
Starts November 7
Missouri
Opioid Use Disorder Ongoing Missouri
Addiction Medicine Ongoing Oklahoma
Obesity Medicine Ongoing Oklahoma
HIV/Viral Disorders Ongoing Oklahoma
Psychiatry Ongoing Oklahoma



REGIONAL AND NATIONAL NEWS

Project ECHO: One billion lives by 2025



Reaching Project ECHO's goal of touching one-billion lives by 2025 looks more attainable with each passing month. The program has proliferated to include 139 ECHO hubs in 23 countries. ECHO (Extension for Community Healthcare Outcomes) is often described as a force-multiplier, a way to help primary care providers gain specialty care skills that they can then pass on to their patients, rather than referring patients out for treatment.
 
But ECHO is about more than just passing on skills - it's about creating a virtual peer network that can give providers the confidence and support they need to use those new skills. This requires creating an "environment of generosity and caring," said ECHO founder, Dr. Sanjeev Arora. Speakers at last month's Meta ECHO conference in New Mexico emphasized that ECHOs should feel collaborative not instructive. Dr. Kristin Sohl, who leads an autism ECHO for Missouri's Show-Me ECHO, put it this way:
 
"If ECHO feels like a webinar it won't flourish. We want [participants] to come partner with us, come learn with us, and come have fun with us."
 
Beyond emphasizing caring within the professional learning network, the conference underscored the need to reach underserved populations and practice compassion for the vulnerable, including those in correctional facilities and addicted to opioids. Arora encouraged all hubs to form palliative care ECHOs to assist patients with pain management and end-of-life issues. 

HTRC Director Eve-Lynn Nelson, Ph.D. shared her research expertise when she presented at the  Meta ECHO Research Symposium in a session called "What's the Potential for Implementation Readiness at the ECHO Assessment Table?" 

Members of Missouri Telehealth Network (MTN), HTRC's Missouri partner, also shared their ECHO experience in a number of well-attended conference sessions. Dr. Karen Edison, MTN's medical director, joined Project ECHO founder Dr. Sangeev Arora for a panel discussion called, "Getting Government to Champion Your ECHO." Additionally, Dr. Edison joined MTN Assistant Research Professor Mirna Becevic, Ph.D., and MTN Associate Director of Outreach Gwen Ratermann for a panel discussion entitled, " Show-Me ECHO: Innovative Telementoring to Increase Access to Care and Reduce Patient Suffering." 


Oklahoma regulatory update

Remote patient monitoring (RPM) has been added to the rules of Oklahoma's Medicaid administrator, the Oklahoma HealthCare Authority (OHCA). However, it will only be reimbursable if and when funding becomes available to cover RPM services. According to a representative of OHCA, they are currently considering an RPM pilot for patients diagnosed with diabetes. 


Project ECHO

Project ECHO is a program using telehealth 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 collaborate with primary care providers.


Heartland Telehealth Resource Center | questions@HeartlandTRC.org | 
 4330 Shawnee Mission Parkway   Fairway, KS 66205