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Developing Telehealth in Rural America: The Wyoming Network for Telehealth

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Developing Telehealth in Rural America: The Wyoming Network for Telehealth. Rex E. Gantenbein PhD, Senior Member IEEE Center for Rural Health Research and Education University of Wyoming. Health Care in Wyoming. Issues in access to health care in rural regions Distance and isolation - PowerPoint PPT Presentation
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CAPITAL FACILITIES

Developing Telehealth in Rural America: The Wyoming Network for TelehealthRex E. Gantenbein PhD, Senior Member IEEECenter for Rural Health Research and EducationUniversity of Wyoming

Health Care in Wyoming

Wyoming is least populous state in US (< DC even), second to Alaska in sparseness of population (5.6 people/sq mile). Many remote communities and only 28 hospitals.2Issues in access to health care in rural regionsDistance and isolationGeography and weatherShortage of providersProvider burnout

Telehealth is one way to address these issuesTelecommunications technologies to support long-distance clinical health care, health-related education, public health, and health administrationTelemedicine refers specifically to clinical applications

Example: access to mental health careWyoming has a severe shortage of mental health providersPrimary care providers have significant responsibility for mental health diagnosis and treatmentFew local options exist for referral or consultation

Telehealth supports increased access Direct intervention by a distant specialistConsultation between primary and mental health care providersEducation and training in diagnosis and care for mental health

One of our main efforts has been to develop collaborations to integrate primary and specialty care, especially in mental health. Studies have shown collaboration is valuable, but in many places co-location or even local referral isnt possible. Telehealth makes it possible! We are currently developing a pilot program to train primary care providers in brief intervention strategies and developing a network for referrals and/or direct counseling4Technical barriers to expanding telehealthBandwidthEndpoint equipmentTraining and technical supportSecurity and privacy

The Wyoming Network for Telehealth (WyNETTE)Increased bandwidth for 37 sites (hospitals, clinics, and mental health centers)Videoconferencing units at all sitesUser manuals and online educationTechnical support staff

Wyoming is addressing these issues through the use of desktop video systems and an expansion of telecommunications capacity. A bridge has been installed at one of our two major hospitals and another is being installed at a private tech company. We have a handful of champions in the state who are using telehealth and talking to their colleagues about its value. 5Wyoming Network for Telehealth (WyNETTE)

37 sites (14 hospitals, 6 primary care clinics, 16 community mental health/substance centers and UW hub connects to Internet2)6Funding for WyNETTE developmentTelecommunications: Federal Communications Commission Rural Health Care Pilot ProjectVideoconferencing: Wyoming Hospital Association, Wyoming Department of HealthManagement and education: Health Resources and Services Administration, US Department of Health and Human Services

Network configurationATM cloud aggregated at University of WyomingDual and single T-1 connections made to each siteExisting copper wire utilized

One community had to wait several months for connections due to lack of circuits!7Non-technical barriers to expanding telehealthReimbursementConnections for specialty providers to the networkLicensing and credentialingResistance to new technologySustainability

Wyoming is addressing these barriersAll major payers reimburse for telehealth careInexpensive desktop video (NOT Skype!)Innovative fast-track licensing process for out-of-state providersEducation

Wyoming is addressing these issues as well. He have implemented an innovative fast-track licensing process for out-of-state physicians. Educational material is also being developed through the Universitys Distance Learning Center and the states hospitals. We have a handful of champions in the state who are using telehealth and talking to their colleagues about its value. Were still working on the sustainability problem8Questions or comments?

Rex Gantenbein, DirectorCenter for Rural Health Research and Educationhttp://www.uwyo.edu/[email protected]

9UWYO.EDU

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