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Telemedicine
          Working Together for Better Care




                            July 14, 2011




          Best Care…Healthier Kids




1.23.13
When spider webs unite, they can
tie up a lion.
         - Proverb




         Telemedicine: Working Together for Better Care   2
Who We Are




 Telemedicine: Working Together for Better Care   3
Children’s Healthcare of Atlanta

• Children's serves our community with three hospitals and 17
neighborhood locations, including four Immediate Care Centers and a
Primary Care Center.




  … at Egleston        … at Scottish Rite                         … at Hughes Spalding




                      Telemedicine: Working Together for Better Care                     4
System Mission:
   To make kids better today and healthier
tomorrow

Program Mission:
    To partner with Georgia’s communities to increase
access to pediatric specialty care and offer pediatric
specific education to clinicians and providers.




                    Telemedicine: Working Together for Better Care   5
Program Development


                            Subspecialist at
                               Egleston




      Stephanie
     Blank Center
     for Safe and
                       Telemedicine                   Marcus Autism
        Healthy
       Children
                         Program



                            Subspecialist at
                             Scottish Rite




                Telemedicine: Working Together for Better Care        6
Presenting Sites


• Healthcare Organizations

• Private Practices/clinics

• Community Health Sites
   – Schools
   – Public Health Departments
   – Child Advocacy Centers



                     Telemedicine: Working Together for Better Care   7
Current Sites
                                                 • Participating with 43
                                                   presenting sites
                                                   throughout Georgia

                                                 • 14 specialties with 25
                                                   physicians
                                                    - Future: 15 specialties
                                                       27 physicians

                                                 • + 23 Child Advocacy
                                                   Sites

          (Map does not include Child Advocacy Centers)


          Telemedicine: Working Together for Better Care                       8
Clinical Services Offered

Current Specialties and Number of                                           Coming soon:
   Physicians:                                                              •    Autism (1)
•   Allergy and Immunology (1)                                              •    Apnea (1)
•   Autism (1)
•   Cardiology (1)
•   Child Protection (3)
•   Concussion/Neurosurgery (1)
•   Endocrinology (1)
                                                              Specialist Participating
•   Fetal ECHO (9)
                                                                                               27
•   Gastroenterology (1)                                 30
                                                                                     25

•   Nephrology (2)                                       20
                                                                        2
•   Orthopedics (1)                                      10
                                                          0
•   Pulmonology (2)                                              2009           Current   Future
•   Sports Medicine/Concussion (1)
•   Urology (1)



                              Telemedicine: Working Together for Better Care                        9
Technology and Scopes




        Telemedicine: Working Together for Better Care   10
Our Patients…
  • We have served 2,343 patients since inception
                              2012
                      Number of Patients Seen

    Total                                           971

  Marcus                          524

Specialist                 355

     CPC         92


             0       200    400    600    800    1000     1200
                                                                                         Total/Overall
                                                                                       Number of Patients Seen

                 •
                                                                      1200
                      2009: 88                                        1000
                                                                                                        823
                                                                                                                 971
                                                                       800

                 •    2010: 461                                        600
                                                                       400
                                                                                             461

                                                                       200       88
                 •    2011: 823                                          0
                                                                                2009         2010       2011     2012


                 •    2012: 971
                                           Telemedicine: Working Together for Better Care                               11
Program Growth and Opportunities

• Community Health
  • School-based Telemedicine (41)
  • Child Advocacy Centers (24)
  • Public Health (14)
  • Division of Family and Children Services (159)


• Internet-based solutions
• Remote Patient Monitoring / Care Coordination
• Distance Learning – building relationships,
  referrals
                    Telemedicine: Working Together for Better Care   12
Outcomes




 Telemedicine: Working Together for Better Care   13
Convenience and Savings for Patients

   Year to Date…Per visit:                            Median            Range
   Miles Saved                                        362               72-524
   Cost of miles saved                                $199              $39-$288
   Hours Saved Traveling                              6.6               1.3-9.5
   School days                                        84% of our patients would have missed
   *Children greater than 5 y/o                       school to travel to Atlanta
   Work Days Missed                                   >80% of our parents would have missed
   *One adult present                                 a full day of work to travel to Atlanta

• Patients served live in 74 of the Georgia’s 159 counties
    • 47% of all counties
    •All outside of the MSA
•78% of our patients are covered by Medicaid /CMO’s
• Overall cost of miles saved: $139,655 (0.55/mile)

                                  Telemedicine: Working Together for Better Care            14
Collaborative Consults




         Telemedicine: Working Together for Better Care   15
Better Patient Outcomes


• The patient:
    • 17 y/o female diagnosed with Nephrotic syndrome (a kidney disorder)
    • Lives in Columbus with her 70 year old grandmother

• Before Telemedicine:
     • Her grandmother would drive her to Atlanta to see Dr. Larry Greenbaum
       when she was able, but it was difficult.
     • Her condition was worsening and she was not making appointments to his
     clinic here in Atlanta. At that time Mary was at very high risk for Kidney failure.

• After Telemedicine:
     • He has seen her several times via Telemedicine with The Medical Center in
       Columbus Georgia since her first Telemedicine appointment in March of
       2011.
     • She is consistently making appointments, her condition is improving and her
       risk for kidney failure has drastically decreased!
                            Telemedicine: Working Together for Better Care         16
Happy Parents


… It was extremely convenient rather than
driving 4 hours to Atlanta. The staffing was
exceptional. Very friendly and
accommodating.
                               …I think this was an awesome opportunity
                               especially for those who are unable to travel to
                               Atlanta.

                                                            …The visits are always great. Staff
                                                            and doctor are very caring and
           …The visit was great! The
                                                            concerned about my child's
           staff was very courteous and
                                                            condition. I enjoy these visits every
           helpful. This was a first time
                                                            time.
           visit with telemedicine and a
           wonderful experience. Thank
           you and your staff.


                             Telemedicine: Working Together for Better Care                   17
Coming together is a
                      beginning, staying together
                      is progress and working
                      together is success.

                                                 - Henry Ford




Telemedicine: Working Together for Better Care                  18
Contacts


  DD Fritch-Levens, MSN, MHA, RN
                  Contact Center Director
                d.d.fritch-levens@choa.org




               Jill Davis, MPH
             Telemedicine Program Manager
                  Jill.davis@choa.org
                      404-785-9333




           Telemedicine: Working Together for Better Care   19

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5.march 19 2013 gpt conference dd fritch levens

  • 1. Telemedicine Working Together for Better Care July 14, 2011 Best Care…Healthier Kids 1.23.13
  • 2. When spider webs unite, they can tie up a lion. - Proverb Telemedicine: Working Together for Better Care 2
  • 3. Who We Are Telemedicine: Working Together for Better Care 3
  • 4. Children’s Healthcare of Atlanta • Children's serves our community with three hospitals and 17 neighborhood locations, including four Immediate Care Centers and a Primary Care Center. … at Egleston … at Scottish Rite … at Hughes Spalding Telemedicine: Working Together for Better Care 4
  • 5. System Mission: To make kids better today and healthier tomorrow Program Mission: To partner with Georgia’s communities to increase access to pediatric specialty care and offer pediatric specific education to clinicians and providers. Telemedicine: Working Together for Better Care 5
  • 6. Program Development Subspecialist at Egleston Stephanie Blank Center for Safe and Telemedicine Marcus Autism Healthy Children Program Subspecialist at Scottish Rite Telemedicine: Working Together for Better Care 6
  • 7. Presenting Sites • Healthcare Organizations • Private Practices/clinics • Community Health Sites – Schools – Public Health Departments – Child Advocacy Centers Telemedicine: Working Together for Better Care 7
  • 8. Current Sites • Participating with 43 presenting sites throughout Georgia • 14 specialties with 25 physicians - Future: 15 specialties 27 physicians • + 23 Child Advocacy Sites (Map does not include Child Advocacy Centers) Telemedicine: Working Together for Better Care 8
  • 9. Clinical Services Offered Current Specialties and Number of Coming soon: Physicians: • Autism (1) • Allergy and Immunology (1) • Apnea (1) • Autism (1) • Cardiology (1) • Child Protection (3) • Concussion/Neurosurgery (1) • Endocrinology (1) Specialist Participating • Fetal ECHO (9) 27 • Gastroenterology (1) 30 25 • Nephrology (2) 20 2 • Orthopedics (1) 10 0 • Pulmonology (2) 2009 Current Future • Sports Medicine/Concussion (1) • Urology (1) Telemedicine: Working Together for Better Care 9
  • 10. Technology and Scopes Telemedicine: Working Together for Better Care 10
  • 11. Our Patients… • We have served 2,343 patients since inception 2012 Number of Patients Seen Total 971 Marcus 524 Specialist 355 CPC 92 0 200 400 600 800 1000 1200 Total/Overall Number of Patients Seen • 1200 2009: 88 1000 823 971 800 • 2010: 461 600 400 461 200 88 • 2011: 823 0 2009 2010 2011 2012 • 2012: 971 Telemedicine: Working Together for Better Care 11
  • 12. Program Growth and Opportunities • Community Health • School-based Telemedicine (41) • Child Advocacy Centers (24) • Public Health (14) • Division of Family and Children Services (159) • Internet-based solutions • Remote Patient Monitoring / Care Coordination • Distance Learning – building relationships, referrals Telemedicine: Working Together for Better Care 12
  • 13. Outcomes Telemedicine: Working Together for Better Care 13
  • 14. Convenience and Savings for Patients Year to Date…Per visit: Median Range Miles Saved 362 72-524 Cost of miles saved $199 $39-$288 Hours Saved Traveling 6.6 1.3-9.5 School days 84% of our patients would have missed *Children greater than 5 y/o school to travel to Atlanta Work Days Missed >80% of our parents would have missed *One adult present a full day of work to travel to Atlanta • Patients served live in 74 of the Georgia’s 159 counties • 47% of all counties •All outside of the MSA •78% of our patients are covered by Medicaid /CMO’s • Overall cost of miles saved: $139,655 (0.55/mile) Telemedicine: Working Together for Better Care 14
  • 15. Collaborative Consults Telemedicine: Working Together for Better Care 15
  • 16. Better Patient Outcomes • The patient: • 17 y/o female diagnosed with Nephrotic syndrome (a kidney disorder) • Lives in Columbus with her 70 year old grandmother • Before Telemedicine: • Her grandmother would drive her to Atlanta to see Dr. Larry Greenbaum when she was able, but it was difficult. • Her condition was worsening and she was not making appointments to his clinic here in Atlanta. At that time Mary was at very high risk for Kidney failure. • After Telemedicine: • He has seen her several times via Telemedicine with The Medical Center in Columbus Georgia since her first Telemedicine appointment in March of 2011. • She is consistently making appointments, her condition is improving and her risk for kidney failure has drastically decreased! Telemedicine: Working Together for Better Care 16
  • 17. Happy Parents … It was extremely convenient rather than driving 4 hours to Atlanta. The staffing was exceptional. Very friendly and accommodating. …I think this was an awesome opportunity especially for those who are unable to travel to Atlanta. …The visits are always great. Staff and doctor are very caring and …The visit was great! The concerned about my child's staff was very courteous and condition. I enjoy these visits every helpful. This was a first time time. visit with telemedicine and a wonderful experience. Thank you and your staff. Telemedicine: Working Together for Better Care 17
  • 18. Coming together is a beginning, staying together is progress and working together is success. - Henry Ford Telemedicine: Working Together for Better Care 18
  • 19. Contacts DD Fritch-Levens, MSN, MHA, RN Contact Center Director [email protected] Jill Davis, MPH Telemedicine Program Manager [email protected] 404-785-9333 Telemedicine: Working Together for Better Care 19

Editor's Notes

  • #3: There are many types of outcomes when we think of Telemedicine, and the first is usually the patient outcomes. But there is also an outcome that reflects in our tag line “Working together for better care” – a programmatic and partnership outcome of better care. We can all provide good care for our patients, but often time we can provide better care when we partner and work together. If we are all the spider webs, we can tie up that lion that represents better health outcomes/access for the children of Georgia.
  • #5: How we reach that outcome of better care…Who we are
  • #6: Our mission
  • #7: How we formulated our program to reach the outcome
  • #8: The sites we use to reach that outcome, which wouldn’t be possible without our partner, GPT
  • #10: Our services
  • #11: Our technology
  • #12: And as we look to 2013 (go to next slide to discuss program growth)
  • #13: Our opportunities for the futureChallenges for the future include regulations, supply meeting demand (i.e. the right type of specialties offered and an adequate amount of practitioners to meet demands)
  • #14: So what are the outcomes that we have seen as a result of working with Telemedicine sites and referring physicians across Georgia?
  • #16: First tele-fetal echo, pictured is Dr. Cyrus Samai and Dr. Nanci Stauffer, pediatric cardiologists.
  • #19: We look forwarding to continue with our partnerships throughout Georgia and build new ones in the future.