1. Arkansas Telehealth: Shaping the Future of Healthcare Curtis L. Lowery, M.D. Professor and Chair Department of Obstetrics and Gynecology University of Arkansas for Medical Sciences Medical Director, ANGELS Co-Director, Center for Distance Health

2. Arkansas’ Healthcare Population How do we measure up?

3. 50 th in Stroke Mortality 49 th in Per Capita Health Spending 49 th in Immunization Coverage 41 st in Adequacy of Prenatal Care 45 th in Poor Mental Health Days 44 th in Poor Physical Health Days 41 st in Infant Mortality 44 th in Cardiovascular Deaths 43 rd in Cancer Deaths 46 th in Premature Death 41 st in Lack of Health Insurance 44 th in Occupational Fatalities 44 th in Obesity 40 th in Prevalence of Smoking 46 th in Overall Health Source: United Health Foundation, 2006

4. Arkansas’ Medically Underserved Areas © AR Dept. of Health and Human Services, 2009 In a state where 73 of 75 counties are designated as medically underserved, healthcare access is the most overwhelming cause for Arkansas’ poor health standing.

5. Two Successful Models Arkansas SAVES (Stroke Assistance Through Virtual Emergency Support) Antenatal & Neonatal Guidelines, Education and Learning System

6. The ANGELS Program Improved access to specialized care Improved outcomes for Arkansas’ high-risk Moms and Babies

7. ANGELS Tele-Health Sites: May 2009 Tele-Nursery Clinical Services

8. Arkansas’ National Rating for Stroke 1 st nationally for stroke mortality 7,534 heart disease-related and another 1,948 stroke- related deaths in 2004 alone US Stroke Mortality Rates (1991-1998, Adults Age 35 Years and Older) by County, Source: www.cdc.gov

9. Facilitates Neurology Telemedicine Support to participating Hospital ER’s Administers a Protocol-driven Medical Management System Promotes effective use of t-PA Results in improved outcomes for Arkansans who suffer a STROKE

10. Year 1 Sites: Hospital ER’s

11. Education & Training for Providers Case Coordination & Evidence Based Guidelines/Protocols Centralized Tech Support & Scheduling Call Center 24/7 Telemedicine Network & Infrastructure Evaluation/Research The Key to Building a Successful Telemedicine Model

12. In 2008, ANGELS facilitated a total of 1,675 telemedicine consults ANGELS Clinical Telehealth Services

13. Subspecialty Medical Support Training & Education opportunities Centralized Network Management

14. Ophthalmology Geriatrics Psychiatry Rehab Medicine ER Trauma Current Initiatives

15. Neurology (AR SAVES) Internal Medicine Division of Behavioral Health Cardiology Pediatrics

16. CDH Training Center Offers Technical expertise Equipment choice –Clinical –Education –Administrative Network connectivity Training

17. Statewide Network Management ATOM: Arkansas Telehealth Oversight & Management ATOM Operations Board Members:ATOM Operations Board Members: University of Arkansas for Medical Sciences Baptist Health Arkansas Department of Health Stuttgart Regional Medical Center Magnolia Hospital “Oversees daily activities related to the Arkansas Telehealth Network.”

18. Arkansas Center for Health Improvement Arkansas Department of Health Arkansas Department of Human Services Arkansas Department of Information Systems Arkansas Foundation for Medical Care Arkansas Hospital Association Arkansas Research Educational & Optical Network Baptist Health Community Health Centers of Arkansas Mental Health Council of Arkansas St. Vincent Health System University of Arkansas for Medical Sciences ATOM Advisory Committee “Responsible for keeping communication between Board and Membership, while providing recommendations and advice to the Operations Board.”

19. General ATOM Membership “Each member may make recommendations and decisions regarding the pilot program to the Advisory Committee that will then be presented to the Operations board.” Hospitals & Clinics Medical Education Sites Therapy Centers Community Health Centers 244 Health- related Sites

20. Arkansas TeleHealth Plan Addresses Utilization of National Telehealth Policies Quality (network reliability) Network Security (Hipaa compliance) Standards (appropriate telemedicine services) Regulatory Mechanisms (credentialing)

21. Building the Healthcare Broadband Highway

22. Conclusion