HealthNet connectTelehealth

Rodney BrownExecutive DirectorHealthNet connect|BroadNet connect

Who are we?

Wholly owned subsidiaries of UnityPoint Health•HealthNet connect (HNc) is a consortium established for healthcare entities to securely share healthcare information using our private technology infrastructure.• HNc Services Inc. is a communications and

technology services companies developed to provide value added services to the participants of HNc.

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Why Telehealth

• It’s ALL about ACCESS and REACH!• The population that uses the

health care system the most nationwide can be categorized in two groups; adolescents (under the age of 18) and seniors (aged 65 or older). According to census data these two groups make up roughly 45% of Iowa’s total rural population.

• Make it convenient to bring others into the health care system.

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Definition

Our focus will be on three types of virtual visits...

1. eVisit - Non-video, non-emergent visit via a

secure portal

2. Video Visit - Real-time face to face visit

using secure video technology

3. Kiosk - Real-time face to face visit using

secure video technology and monitoring

equipment

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HNc Telehealth Program Scope

This initiative will initially focus on four pilots to develop proof of concept.

However the ultimate goal is to establish a comprehensive Telehealth

program expanding on these pilots and in other areas within healthcare and

in other industries (schools, correctional, business).

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Scope

• Initial scope will focus on four pilots:– eVisits and Kiosk

• integrated e-services platform that allows the patient to measure basic health data like blood pressure, heart, etc…through a set of monitoring devices.

• allow non-emergent patients to seek treatment for primary care through a kiosk or patient portal.

– TelePsychiatry

• utilize video conferencing technology to facilitate real-time, face-to-face visits between patients and specialists. Our initial focus will be ED.

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Scope

• Initial scope will focus on four pilots:

– Palliative Care• the primary goal is to utilize video capabilities to enable

consultation visits with the palliative care provider and

patient and family.

– Community Health• the pilot will target patients with high risk health care

conditions appropriate for video-enabled remote patient

monitoring.

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Expected Benefits

• The following benefits should also be used as a source of measuring success:

• Improved patient and care-giver access to health services

• Reduced unnecessary travel time and cost for patients/care-giver and clinical staff

• Improved patient and care-giver involvement in care planning

• Improved ability for rural practitioners to access specialist health services

• Improved ability to conduct screenings and health promotion within our communities

• Increased viability of providing services locally in rural and remote communities

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Key Barriers to Adoption and/or Success

• Lack of buy-in from Leadership and Physicians

• Resource capacity to support Telehealth – including both clinical staff

delivering services and Telehealth support staff

• Difficulties using the Telehealth technology – demands on clinical time for

organizing and using Telehealth technology, (i.e., integration of clinical

information systems and peripheral devices to support Telehealth

interactions).

• Lack of funding to start or keep program going – grant funding is limited

and access to technology/equipment and staff can be costly.

• No Sustainability Models – narrow focus only on reimbursements vs. cost

savings and reimbursements

• Lack of Standard Program Guidelines – availability of guidelines and

training programs. Standard processes for using Telehealth technology and

services.

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How do we overcome the barriers?

Through collaboration and a commitment to

investing in people, processes and technology.

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Executive CommitteeLeadership Representation across HNc

Review and make recommendations relative to the

administration of programs, policies and

procedures related to the HNc Telehealth initiative.

Review and make recommendations relative to

sustainability models, plans and ROI’s of entities

using the HNc infrastructure and vendors for their

Telehealth programs.

Review and make recommendations relative to

clinician needs, resources and education with

regard to the Telehealth technology, vendors and

policies.

Review and make recommendations relative to the

technology and vendors used to develop the

Telehealth infrastructure and the support of the

technology and vendors.

Review and make recommendations relative to

legal matters with regard to: Legislative and

regulatory matters that may affect Telehealth policy

or implementation.

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HNc Telehealth InitiativeMission

To define, develop and coordinate a Telehealth strategic plan and establish a comprehensive Telehealth program

throughout the HNc community. The initiative will consist of processes, programs, tools and services to help implement,

support and sustain a Telehealth business.

• Allows operational leaders and stakeholders to be involved in the planning and development process

• Manage Telehealth as a business

• Aligns with the Strategic Pillars• Care Coordination

• Physician Alignment

• Employee Engagement

• Sustainability

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Resources

• Telehealth Program Manager

• Provide overall program/project leadership

and serves as corporate liasion

• Telehealth Steering Committee

• Provides oversight and guidance for

specific pilots and programs

• Telehealth Workgroup

• Provides the tactical and operational

expertise and execution 13

Funding

• Rural Health Care Pilot Program (RHCPP)

• Funded the initial buildout of HNc

• Healthcare Connect Fund (HCF)

• Extended the buildout of HNc

• BroadNet connect

• For-profit sister company to HNc

focused on business/government

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Operational Focus

• The following should scale as we expand:

1. Administrative – The processes/workflows needed to administer and manage Telehealth

2. Financial – The financial implications and how to sustain the program

3. Clinical - The tools, education and resources needed to make adoption and use simple for clinicians and patients

4. IT - The tools, systems and partners needed to support the program

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HealthNet connect - a Powerful, Secure Infrastructure

When clinical consultations occur at a distance, a special range of issues in relation to

security, privacy and authentication emerge. Data in the form of video and audio, as well

as clinical data are transmitted between locations, all of which are exposed to the risk of

interception. The communications network and applications need to have encryption to

ensure compliance.

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Technology Guiding Principles

• Our guiding principles for any technology we use internally or via vendor products are:1. Ease of use – intuitive use by physicians, clinicians,

staff and patients

2. Compatibility – interfaces between multiple end users and facilities, both technically and operationally

3. Drives Access – increases use of Telehealth and utilization of services

4. Industry Standard – complies with industry protocols

5. Promotes Sustainability – cost effective; contributes to increased revenues or costs avoidance

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HNc Infrastructure

• Network1. HNc provides VPN-level security as well as encryptions of data transferred

over the network to meet healthcare security requirements.

2. A “flat network” that enables equal access to information for all network participants (vs. information controlled by regional hubs) with additional access to Internet2 and the National Lambda Rail for expanded research and education.

• Application1. It facilitates the aggregation and transfer of information by allowing remote sharing

of output from interoperable third-party medical devices.

2. It uses a flexible design that lets healthcare organizations take full advantage of compatible third-party applications and services, including electronic medical record (EMR) systems, directory services, and applications for practice management.

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Sustainability

• ROI and Sustainabilityo Cost Savings

• Cost of Travel• Admissions/Re-admissions• ED/Urgent care visits• Throughput

o Reimbursements• Payer• Medicaid, Medicare

• Revenue Generationo Service Revenue

• Infrastructure Access• Visits• Support

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HNc Telehealth Service Model

• HealthNet connect will offer access to the Telehealth infrastructure as a service to hospitals, clinics, physicians and other entities (ie, schools, government, business) for a monthly fee.

• At minimum the service will include:

• Access to the HNc fiber network (there may be connection charges associated)

• Telehealth application infrastructure (software, licenses and support)

• Access to Program Guidelines, Education, Training

• Technical and Operational

• Access to HNc Telehealth vendors at reduced costs

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Five Must Haves for Business Success

1. Acceptance and Buy-in

– Leadership and Physicians

2. Dedicated Resources

– Processes, Training and Support

3. Funding

– Capital and Operational Expenses

4. Focus on Cost Savings as well as Revenue

5. Robust Technology Infrastructure

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HealthNet connect

“Connecting Healthcare to our Communications and IT Infrastructure"

www.healthnetconnect.org