Telehealth AETC Appalachian Project Principal Investigator and Executive Director Telehealth AETC Appalachian Project Linda Frank, PhD, MSN, ACRN, FAAN.

Telehealth AETC Appalachian Project

Principal Investigator and Executive DirectorTelehealth AETC Appalachian ProjectLinda Frank, PhD, MSN, ACRN, FAAN

Associate Professor, Department of Infectious Diseases Graduate School of Public Health, Community and Health Systems, School of Nursing and Clinical and Translational Science Institute, School of Medicine

TAAP Goals

• Clinical consultation which may include the use of case presentations and patient co-management (though it is not intended to supplant patient referral to an expert when needed);

• Other education and training modalities that result in a continuum of longitudinal learning opportunities for trainees; and

• Development of an informed support system for trainees.

Technology Coordinator

Matthew Garofalo

Outreach Tech Support

David Hoover

Education Coordinator

Jeanette Southerly

FiscalLissa Foster

Data ManagementDavid Korman

Evaluation Consultant

Janet Meyers

Project DirectorDr. Linda Frank

Clinical ConsultantsPharmacy,

Subspecialist, Psychiatry, Nursing &

Substance Abuse

NCCC Dr. Ronald

Goldschmidt

Clinical DirectorsDrs. Rashida Khakoo,

David Wheeler, Pamposh Kaul, Jane Cecil, Bruce Gilliam

Organizational Chart

TAAP Cores

Telehealth AETC Appalachian Project:Selecting WebEx Web Conferencing Technology

Matthew GarofaloTelehealth Coordinator

TAAP Goals

• Clinical consultation which may include the use of case presentations and patient co-management (though it is not intended to supplant patient referral to an expert when needed);

• Other education and training modalities that result in a continuum of longitudinal learning opportunities for trainees; and

• Development of an informed support system for trainees.

Specialist ConsultationsPeer Learning Clinical Practice Portal

(Resources, scheduling, tracking, etc.)

Technology as a medium to interact with resources

Patient in need of clinical services

Interact with provider

Patient receives primary care and specialty services

Provider

Que

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Ans

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Implement treatment plan

Trea

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Mat

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Develop atreatment

plan

Technology System Marketing Concept

Project Goals Technological Support

Clinical consultations and related training

Web conference System

Other education and training modalities

Virtual catalog of additional support material

Support system for trainees

Interactive portal to prompt, schedule and connect with support, conference system and catalog

Technology Support Design

Technical support

Technology Coordinator

Clinical Practice Portal

Patient

Resources•Literature: print, online•Guidelines•Best practices•Performance indicators

Store & Forward•consultations•case studies •training

Targeted Clinicians: physicians, dentists, nurse practitioners, advanced practice nurses, pharmacists, physician assistants

Peer Learning•Group discussions•Peer to peer input

Clinical expert consultation•Weekly, bi-weekly based on needs assessments

Telehealth Intervention•Ongoing interactive training events•Problem-based learning, case studies•Regular clinical consultation•Ongoing technical assistance events

Intervention needed: •Assessment•Prevention•Clinical management •Decision making

Evaluation of outcomes•Resource utilization tracking•Surveys, questionnaire results•Summary of key informant interviews•Capacity building documentation•Longitudinal training outcomes: practice, policy changes; patient clinical outcomes

Technology System Concept

Targets for Technological Support

1. Low volume health care providers in Appalachia community health centers

2. Project clinical directors who provide consultation

3. Project team

Project Goals Technological Support

Clinical consultations Web Conference SystemOther education and training modalities

Virtual Catalog of additional support material

Support system for trainees

Interactive Portal to prompt, schedule and connect with support, conference system and catalog

Web Conferencing Options: WebEx

• Polycom• Adobe Connect• GotoMeeting• WebEx

WebEx

What is WebEx?

• WebEx is an Application Program Interface (API)

• Uses Https (S stands for SSL or secure socket layers)

• 128 bit HIPAA compliant encryption

• Password protected scheduling, archival and webcasts

• Works across platforms (Mac, PC, Unix, and Linux)

Advantages of WebEx

• Packaged product- features don’t change• Infrequent updates• Provides a free secure video server• Quick to set up• Minimum CPU and software requirements to

run• Works with standard webcams• Host controlled synchronization

Rural Health TechnologyA number of criteria have been promoted for a systemic approach to telecommunications for rural health, including:

•Interoperability (ability to exchange information with other systems)

•Scalability (elements that work equally well in small or large settings)

•Flexibility in approach and in tools used

•Use of low-end and more readily available “off-the-shelf” technologies

•Recognition of the different starting points of most programs

•Broad consideration of various technological approaches without bias or preference for any particular technology and appreciation of the situational and cost needs of host communities and institutions

•Designing systems that are secure and promote patient confidentiality

(Neuberger, Payne, & Wakefield, 2001)

Neuberger, N., Payne, M. E., & Wakefield, M. (2001). Rural Health Care and the Internet: Issues and Opportunities for Using Interactive Communications to Improve Rural Health Care Services. VA: Health Tech Strategies, LLC.

Low-End & Readily Available Technologies

The Telehealth Training Center’s approach to technology must be neither “high tech,” nor “low tech,” but “appropriate tech.” Just as consultation and education services must be tailored for the specific needs of the provider and patient, so must the communication medium. Rural areas often have less access to technology and training resources. (Meit, 2004)

Meit, M. (2004). Rural Public Health Preparedness: The Rural Public Health Research Agenda. Pittsburgh, PA: University of Pittsburgh, Center for Rural Health Practice.

Standard WebEx Features• Invite and remind participants - invite participants to an online meeting

that has already started via email, voice conference, or instant messenger, and send reminders about your upcoming meeting.

• Use integrated WebEx audio – create a more productive meeting experience with integrated WebEx audio.

• Record your meeting - record your actions during your meeting so you can review the discussion at a later time, or send to colleagues who couldn’t attend.

• Share content - get everyone on the same page. Open any document or application and discuss it in real time with other participants.

• Pass the ball - let other participants share and present documents from their computers and assign privileges to individual participants.

• Transfer files - avoid sending emails back and forth by exchanging files – no matter how large – in your meeting quickly, easily, and securely.

• Interact within a meeting - use polling and chat, and learn how to integrate webcams into your meeting for a more personal experience.

Questions