Transcript Overview of the Office for the Advancement of Telehealth (OAT)

U.S. Department of Health and Human Services
Health Resources and Services Administration
HHS Perspective on U.S.
Telehealth
Dena S. Puskin, Sc.D.
Director, Office for the Advancement of Telehealth
Office for the Advancement of Telehealth
What We’ll Cover:
• What is telehealth/telemedicine?
• Status of TM in U.S.
• An introduction to HRSA’s
telehealth office (OAT)
• Joint Working Group on
Telemedicine
• Barriers and solutions to
advancing telehealth
Office for the Advancement of Telehealth
What is Telehealth?
• Telehealth - the use of telecommunications in health services
• Term includes distance learning and
clinical care (also called telemedicine)
• Other uses include administration,
data sharing, and public health
Office for the Advancement of Telehealth
TELEVILLAGE
TELEHEALTH
Health
Professional
Education
Consumer
Health
Services
K-12
Education
TE LEMEDICINE
Business
Administration
Public
Health
Libraries
Justice
Examples of Telehealth
Clinical exam
Distance learning and
patient education
Real-Time Telemedicine
• Provider presents
patient to remote
specialist
• Very interactive
• Using special
peripherals,
remote doctor can
exam patient from
miles away
Remote specialist (on TV) uses digital
stethoscope to check patient’s heart.
Other Examples
Remote doctor examines a
patient’s inner ear from a
remote location
Patient in rural ER gets benefit
of local care plus remote
consultation with specialists.
Home Health
Patient and nurse interacting during a
“video home visit.”
• Low-cost
equipment that
needs only a
regular phone line
• Used to check
vital signs, monitor
medications,
visualize patient,
provide enhanced
support
Store-and-Forward
Clinician reviews scan which was
forwarded for consultation.
• Primary care provider
takes a still image
and sends it to a
consulting physician
who later reviews it
• No real time
interaction between
patient & consultant
• Commonly used for
dermatology,
radiology
Office for the Advancement of Telehealth
Telemedicine Nationally *
• Over 130 programs in 48 states
• Network of medical center “hub”
and about 10 rural “spokes”
• Average 600 encounters a year
• Average 25 clinical services per site
* Information from the 1999 National Survey of Telemedicine Service Projects by the
Association of Telehealth Service Providers
Office for the Advancement of Telehealth
Expected Benefits
• Improve access to services in rural
and underserved areas
• Reduce travel time and lower costs
• Improve quality of health care through
more timely diagnosis and treatment
• Reduce isolation of rural practitioners
• Expand educational offerings
Office for the Advancement of Telehealth
Characteristics
• Most common services: mental health,
dermatology, cardiology, orthopedics
• Common settings: rural hospitals,
prisons, homes, school clinics
• Three major types of telemedicine:
1) store-and-forward
2) real time
3) remote monitoring
Office for the Advancement of Telehealth
Educational and
Administrative Uses
• Continuing
education
• Patient
education
• Administrative
meetings
Rural providers can receive continuing
education without the need to travel.
Office for the Advancement of Telehealth
What is OAT?
• Began August 1998
• Spun out of Office of Rural
Health Policy at HRSA
• Staff of 14
• FY 2000 budget of about
$20 million
Office for the Advancement of Telehealth
OAT’s Responsibilities
•
•
•
•
Administer telemedicine grants
Evaluate telehealth programs
Develop telehealth policy
Assess technology for HRSA and its
grantees
• Develop distance learning programs
• Manage HRSA videoconferencing
network
Office for the Advancement of Telehealth
Distance Learning
• Develop multimedia productions
using satellite and Web
• Chair Public Health Council’s
Distance Learning Workgroup
• Lead HRSA strategic planning
about distance learning
• Administer distance learning
projects
Office for the Advancement of Telehealth
Technology Assessment
• Goal: make educational programs
low-cost, high-quality, widely
accessible to HRSA and its grantees
• Pilot test of satellite-to-desktop
distance learning system
• Users view educational programs on
their computer desktop either live (real
time) or on-demand
Office for the Advancement of Telehealth
Telehealth Grants
• Funded 19 new projects in FY 2000
through the Rural Telemedicine Grant
Program
• Administered 40 other special or
continuing projects
• Services must be in rural areas
• Goals: 1) increase access
2) reduce provider isolation
3) develop integrated
systems of care
Office for the Advancement of Telehealth
Telehealth Grants
• Anticipate funding a total of 65-70
projects in FY 2001, 19 0f which are
through the Rural Telemedicine Grant
Program
• Remaining projects are in urban and
rural areas and cover a range of
technologies and applications
• e.g., distance learning, advanced
brain imaging, infrastructure
development
Office for the Advancement of Telehealth
Policy Development
Joint Working Group on
Telemedicine
• Federal interagency group that coordinates
members’ telemedicine activities
• Ensures no overlap in Federal funding
• Provides a forum to share information, to
educate its members, and to develop specific
actions that could reduce barriers to the use of
telemedicine.
Office for the Advancement of Telehealth
Policy Development
• Reports to Congress
• Model for estimating Medicare
expenditures for expanded
Telemedicine services
• Guidelines on technical standards
and privacy
• Author of upcoming Telemedicine
Report to Congress
• Filings about Universal Service Fund
Office for the Advancement of Telehealth
Barriers to Telemedicine
• Limited reimbursement
• Clinical acceptance
• High cost or limited availability of high
speed telecommunications lines
• State licensure laws
• Standards
• Evaluation
• Sustainability
Office for the Advancement of Telehealth
Emerging Issues/Trends
• Technology Changes: NGI; Digitization
of information/growth of wireless
technology
• Policy Lag: HIPPA; Technical
Standards; Spectrum Allocation
• Aging Demographics: Long-term
Care/home care; urban telemedicine
• Globalization: trade issues; crossnation legal challenges (e.g., prescription
drug trade; licensure)
Office for the Advancement of Telehealth
Necessary Steps
• Better evaluation to improve
acceptance and reimbursement
• Improved Infrastructure/Lower
telecommunication and equipment
costs
• Improve standardization of
equipment and practices
• Address Privacy/Security/
Confidentiality
Office for the Advancement of Telehealth
Contact us!
Phone
301.443.0447
Web site
http://telehealth.hrsa.gov