7/23/2018 1 “VIRTUAL RT” TELEHEALTH Reliable Medical Supply Respiratory Roundup Curt Merriman, RRT, CPFT, Chief Sales Officer CORE Staffing/rtNOW Telehealth DISCLOSURES Relevant Financial Relationships: Relevant Non-financial Relationships: ➤ Chief Sales Officer CORE Staffing & rtNOW Telehealth Service OBJECTIVES ➤ Define "telehealth" ➤ Discuss the current state of telehealth legislation ➤ Highlight AARC strategic goals ➤ Why telehealth? ➤ The Future: "Virtual RT" ➤ rtNOW Case Studies WHAT IS TELEHEALTH / TELEMEDICINE? a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies “telehealth” is a more universal term for the broad array of applications in the field. Becoming more widely used over the term “telemedicine”. DEFINITION OF TELEMEDICINE "Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. Found at: The Center for Connected Health Policy @ http://cchpca.org. QUADRANTS OF TELEHEALTH Store-and-Forward (Asynchronous) Live Videoconferencing (Synchronous) Mobile Health (mHealth) Remote Patient Monitoring
Transcript
7/23/2018
1
“VIRTUAL RT”TELEHEALTH
Reliable Medical SupplyRespiratory Roundup
Curt Merriman, RRT, CPFT, Chief Sales Officer
CORE Staffing/rtNOW Telehealth
DISCLOSURES
Relevant Financial Relationships:
Relevant Non-financial Relationships:
➤ Chief Sales Officer CORE Staffing & rtNOW Telehealth Service
OBJECTIVES➤ Define "telehealth"
➤ Discuss the current state of telehealth legislation
➤ Highlight AARC strategic goals
➤ Why telehealth?
➤ The Future: "Virtual RT"
➤ rtNOW Case Studies
WHAT IS TELEHEALTH / TELEMEDICINE?
a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies
“telehealth” is a more universal term for the broad array of applications in the field.
Becoming more widely used over the term “telemedicine”.
DEFINITION OF TELEMEDICINE
"Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care.
Found at: The Center for Connected Health Policy @ http://cchpca.org.
AARC TIMES MAY 2018, "FROM RRT TO VRT"➤ Atrium Health initiated 2 pilot studies
First Study
➤ 2 RT's for 8 wk to identify ways RT could interface with VCC Team
➤ data collection assisting RT's at bedside of outlying hospitals: SBT, ideal body wt settings, standards of care
Second Study
➤ 2 RT's for 8 wks/full access to VCC Team tools-Critically ill
➤ Supported advanced ventilator modalities, high risk low volume
Result: VRT now part of VCC Team 12 hrs a day/7 days per week!
THE FUTURE
Virtual RT
CURRENT RESEARCH
Willard KS, Sullivan JB, Thomashow BM, et al. The 2nd National COPD Readmissions Summit and beyond: from theory to implementation. Chronic Obstr Pulm Dis (Miami). 2016; 3(4): 778-790. doi: http://doi.org/10.15326/jcopdf.3.4.2016.0162
Respiratory therapists should be included as central members of the health care team for people with COPD while hospitalized and post-discharge. For those organizations that have not yet included respiratory therapists in their COPD care teams as well as those who have integrated them into their care processes, efforts should be made to clearly elucidate the role of respiratory therapy and therapists at every stage of care.
CURRENT RESEARCH
Francis C. Cordova, David Ciccolella, Carla Grabianowski, John Gaughan, Kathleen Brennan, Frederick Goldstein, Michael R. Jacobs, Gerard J. Criner. A Telemedicine-Based Intervention Reduces the Frequency and Severity of COPD Exacerbation Symptoms: A Randomized, Controlled Trial. Telemedicine and e-Health, 2015; 150810084730007 DOI: 10.1089/tmj.2015.0035
Eighty-six patients were screened; 79 met entry criteria and were randomized (intervention group, n=39; control group, n=40).
Daily peak flow and dyspnea scores improved only in the intervention group.
A telemedicine-based symptom reporting program facilitated early treatment of symptoms and improved lung function and functional status.
CURRENT RESEARCH
Chitra Dinakar, MD et al. Telemedicine is as effective as in-person visits for patients with asthma. Annals of Allergy, Asthma & Immunology, September 2016 DOI: 10.1016/j.anai.2016.07.012
• All had a small, although statistically insignificant, improvement in asthma control over time.
• Telemedicine was noninferior to in-person visits.
• Most of the telemedicine group subjects were satisfied with their experience.
Of 169 children, 100 were seen in-person and 69 via telemedicine. A total of 34 in-person and 40 telemedicine patients completed all 3 visits.
CURRENT RESEARCH
Rebecca C Bell, Phoebe H Yager, Maureen E Clark, Serguei Roumiantsev, Heather L Venancio, Daniel W Chipman, Robert M Kacmarek and Natan N Noviski. Telemedicine Versus Face-to-Face Evaluations by Respiratory Therapists of Mechanically Ventilated Neonates and Children: A Pilot Study. Respiratory Care February 2016, 61 (2) 149-154; DOI: https://doi.org/10.4187/respcare.04080
• Sixteen RTs performed 40 assessments (20 face-to-face and 20 telemedicine)
• 11 subjects, (6 in the pediatric ICU and 5 in the neonatal ICU)
…telemedicine can be used to reliably assess easily visualized, pre-programmed parameters for mechanically ventilated patients in the pediatric and neonatal ICUs. It remains less clear whether dynamic, patient-triggered parameters can be reliably evaluated via telemedicine.
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Live bedside support
Disease management
Equipment troubleshooting
Patient Education
Staff Education
Research Coordination
CASE STUDIES
➤ NPPV in ED
➤ Questions @ EzPAP
➤ “Reelin’ in the Years”
NPPV IN ED
ED-12/23/16
• 73 y/o female - 42 kg• Hx: COPD, CHF• Arrived to ED via EMS with SOB
• RR 52• SpO2 98%• CXR: Clear. No infiltrates or fluid.
