Developing Telehealth in Rural America:

The Wyoming Network for Telehealth

Rex E. Gantenbein PhD, Senior Member IEEECenter for Rural Health Research and

EducationUniversity of Wyoming

Health Care in Wyoming

Issues in access to health care in rural regions• Distance and isolation• Geography and weather• Shortage of providers• Provider burnout

Telehealth is one way to address these issues• “Telecommunications technologies to support long-

distance clinical health care, health-related education, public health, and health administration”

• Telemedicine refers specifically to clinical applications

Example: access to mental health care• Wyoming has a severe shortage of mental health providers• Primary care providers have significant responsibility for

mental health diagnosis and treatment• Few local options exist for referral or consultation

Telehealth supports increased access • Direct intervention by a distant specialist• Consultation between primary and mental health care

providers• Education and training in diagnosis and care for mental

health

Technical barriers to expanding telehealth• Bandwidth• Endpoint equipment• Training and technical support• Security and privacy

The Wyoming Network for Telehealth (WyNETTE)• Increased bandwidth for 37 sites (hospitals, clinics, and

mental health centers)• Videoconferencing units at all sites• User manuals and online education• Technical support staff

Wyoming Network for Telehealth (WyNETTE)

Funding for WyNETTE development• Telecommunications: Federal Communications Commission

Rural Health Care Pilot Project• Videoconferencing: Wyoming Hospital Association,

Wyoming Department of Health• Management and education: Health Resources and Services

Administration, US Department of Health and Human Services

Network configuration• ATM cloud aggregated at University of Wyoming• Dual and single T-1 connections made to each site• Existing copper wire utilized

Non-technical barriers to expanding telehealth• Reimbursement• Connections for specialty providers to the network• Licensing and credentialing• Resistance to new technology• Sustainability

Wyoming is addressing these barriers• All major payers reimburse for telehealth care• Inexpensive desktop video (NOT Skype!)• Innovative “fast-track” licensing process for out-of-state

providers• Education

Questions or comments?

Rex Gantenbein, DirectorCenter for Rural Health Research and Education

http://www.uwyo.edu/healthrex@uwyo.edu

UWYO.EDU