1. Telehealth and Premier HealthCare: Looking toward the future 6/10/14 PHC is a member of the YAI network. PHC Platform for Connected Health

2. Overview: Premier HealthCare – Then and now Pre-PHC –1983 to mid 90’s Premier HealthCare opens 1997 NCQH Recognition Summer 2011 –Electronic Health Record 2013 PCMH Level III Meaningful Use 100,000+ visits per year Adding components to EHR & upgrading

3. Premier HealthCare Services Primary Care Medicine for adults and children Assistive Technology Audiology Dentistry Dermatology Endocrinology Gastroenterology Gynecology Medical Social Work Neurology Ophthalmology Rehab: OT/PT/SP/MH Physiatry Podiatry Psychiatry

4. Premier HealthCare Locations

5. What we do online Banking Education Dating Wedding planning Participation in Support groups Divorce Wills, trusts Socialize Job seek/Network

6. Benefits of Telehealth Improved access Decreased costs Improved quality of care Patient satisfaction –Decrease number of visits to and time spent in a doctor’s office

7. Challenges to Telehealth Legalities Billing Technical Challenges Resources (human and Monetary) Patient and staff resistance

8. Challenges Telehealth can address: Access –Transportation Can be difficult to get same day transport for patients who are non-ambulatory Weather –Caregiver availability/time off from work –Residence staff availability Quality of care and of life –Specialist availability –Challenges of Coordination of care between care givers and providers and within provider teams –Multiple visits to multiple specialties

9. Remote visits –With nursing staff in Residences –At Schools or Day Programs Specialty consults –real time from the PCP office –stored information sent and reviewed later Telehealth Applications

10. Huddles and multidisciplinary rounds Home monitoring –Patient or caregiver uploads data to the electronic health record –Nursing staff in residence can access EHR Virtual establishment of therapeutic relationship

11. Portal –Scheduling and document exchange –Care plans can be created stored and updated –Access by specialists to view and address these plans –Refill requests Telehealth Applications

12. Telehealth and Nursing Practice Nurse Call Centers Home Visits Chronic Disease Management

13. Telenurse’s Role in Ambulatory Care Telephone Triage Enhanced Follow-up Care Patient Education Partnerships with other Care Providers

14. Considerations Competencies Legal Implications Research

15. Questions?