Industrial Health and Telehealth

in Kentucky

Rob Sprang, M.B.A. Director, Kentucky TeleCare

University of Kentucky College of Medicine

Lexington, KY

Mid-Atlantic Telehealth Resource Center Inaugural Conference

Innovation Panel #1 8:30am Friday, March 16

Telehealth in Kentucky

before 2000

• Program launched in 1994 at UK

• First encounter 1995

• No Medicaid/commercial

reimbursement

• Most encounters supported by grant

funds

• < 50 sites, primarily in Eastern KY

Telehealth in Kentucky, 2000-Today

• Legislative Mandate

• Reimbursement

• statewide initiative

• Training Centers

• BOD

• Nearly 200 sites – Created a “network of

networks”

• Traditional healthcare sites

• Prison telehealth (state and federal)

• Industrial Telehealth

Launch of Industrial Telehealth

• First meeting in May 2004 - FP MD in rural

community

• Self Insured Coal Company

• Aging workforce

• Difficult to recruit new workers

• New wellness focus

• Uncovering chronic disease

• Medication compliance

• Accessing higher level of care for

employees/dependents

• Cost of care vs. productivity

• Initial investment in mobile clinic with NP

• Soon moved to clinics at each mine

Back of

the

Mobile

Clinic

View from outside

the back of the

mobile clinic

Videoconference

system,

stethoscope and

external camera

Workspace,

medical

devices and

exam table

View from the

cab to the back

of the mobile

clinic

Patient sits in

the chair on

the left

Dr. Wells’ view into the

mobile clinic

How telehealth technology is used

• Physician oversight/consultations for

local Nurse Practitioners

• Primary care from mines or corporate

office to Dr. Wells

• Healthcare education to the corporate

office staff “Lunch and Learn”

• Medical Specialty consultations to mine

sites and corporate offices

How did it work?

• Claims data = 8-12% of employees have risk

factors and chronic disease diagnosis, after

Health Risk Assessment, actual = 95%+

• On site clinic staffed by NP

• No out-of-pocket for pharmacy (generics) and

visits (in the network)

• Deliver meds to jobsite

• Drug costs down $1M first year even with

dramatic increase in diagnosis and treatment

• In 2011, corporate healthcare costs dropped $7M

from previous year with 40,000 visits

Why did it succeed?

• Senior Leadership supported the effort

• The first NP was quite attractive

• Employees were most interested in their family going

to the doctor. Initially, their own health has been

secondary.

• The new system is so easy to access - no cost to the

employee.

• NP clinic was #2 job satisfier behind 4 on/4 off work

schedule.

• Proper diagnosis, proper treatment, better health,

higher productivity, lower costs

Rob Sprang, MBA

Director, Kentucky TeleCare

University of Kentucky

Co-Project Manager,

Kentucky TeleHealth Network

859-257-6404

rsprang@uky.edu