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Lawrence Wechsler, M.D. Vice President for Telemedicine, UPMC Physician Services Division Professor and Chair, Department of Neurology University of Pittsburgh.

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Presentation on theme: "Lawrence Wechsler, M.D. Vice President for Telemedicine, UPMC Physician Services Division Professor and Chair, Department of Neurology University of Pittsburgh."— Presentation transcript:

1 Lawrence Wechsler, M.D. Vice President for Telemedicine, UPMC Physician Services Division Professor and Chair, Department of Neurology University of Pittsburgh Medical School Telehealth: Transformational opportunities for academic medical centers in workforce, clinical care, teaching, research, innovation and public service

2 $9 billion in revenue 20 hospitals operating over 4,200 beds; 187,000 admissions per year 4.5 million outpatient admissions; 750,000 emergency visits per year 1.5 million UPMC Health Plan members More than 400 outpatient locations 54,000 employees; 2,700 employed physicians $1.3 billion invested in IT over past 5 years UPMC Background

3 Addresses an unmet clinical need Enhances physician productivity Extend high quality care to regions/communities in need Telehealth: Why do we need it?

4 Regional Hospital Affiliations 120 MILES 60 MILES I 79 I 76 I 90 I 70 I 70/I 76 I 70 30 MILES I 80 WASHINGTON ALLEGANY GARRETT ALLEGHENY MERCER CRAWFORD VENANGO FAYETTE BEDFORD SOMERSET LAWRENCE WESTMORELAND GREENE WARREN JEFFERSON CLEARFIELD BLAIR HUNTINGDON CAMERON ERIE BUTLER ARMSTRONG ELK CLARION INDIANA CENTRE MCKEAN PRESTON MONONGALIA BROOKE OHIO HANCOCK MARSHALL MORGAN JEFFERSON MAHONING COLUMBIANA Pennsylvania Maryland West Virginia Ohio Mercy Jeannette Southwest Regional Sharon Grove City Med Ctr Uniontown Somerset Med Ctr Beaver Ellwood City Westmoreland Conemaugh Lee Conemaugh Main Latrobe Frick Mon Valley Windber Brookville Bon Secours Altoona St Vincent Millcreek Elk Titusville Hamot UPMC Bedford UPMC Passavant Cranberry BEAVER CAMBRIA FOREST POTTER WASHINGTON MARION WETZEL ASHTABULA TRUMBULL Butler Dubois Washington Highlands Meadville Armstrong Bradford Clarion Clearfield Jameson - North Punxsutawney Warren Canonsburg Mt. Nittany Charles Cole Corry Indiana J C Blair Kane Meyersdale Miners Nason Jameson - South Tyrone UPMC Northwest UPMC Horizon - Shenango UPMC Horizon - Greenville I 79 US 22/30 I 279 I 79 PA 60 I 76 PA 28 ALLEGHENY COUNTY Forbes Alle-Kiski UPMC Mercy Ohio Valley West Penn Suburban AGH St Clair Jefferson Sewickley Valley Magee-Womens Hospital of UPMC CHP UPMC Presbyterian UPMC Shadyside UPMC St. Margaret UPMC McKeesport UPMC Passavant UPMC PSD Telemedicine Locations Competitor Hospitals 13 UPMC Hospitals EHR HIE ED staffing Hospitalists Revenue cycle Administrative support Telemedicine

5 UPMC PSD Telemedicine Activities Telestroke Teledermatology Teleconsults Telewound care TeleICU Teleophthalmology Telecardiology Pre and post-surgical care Telepsychiatry Telepathology Teleradiology TeleMFM TeleEndocrine TeleTrauma TelePediatrics eVisits 16 Service Lines 19 Facilities in WPA 3 International Sites

6 Unmet need for stroke expertise at small rural hospitals 2-8% of stroke patients treated with IV tPA 64% of hospitals did not treat with tPA over 2 years * Telestroke Audebert et al. Cerebrovasc Dis 2005 * Kleindorfer et al. Stroke 2009

7 UPMC Stroke Institute: IV tPA - PUH v. Outside Hospital Transfers

8  Passavant  St. Margarets  McKeesport  Northwest  Horizon – Greenville  Horizon – Shenango  Bedford  Cranberry  Magee  Mercy  Mon Valley  Jefferson  Meritus - MD  Washington Hosp  Jameson  Heritage Valley - Beaver UPMC Stroke Institute Telemedicine Sites 2011 UPMC Non - UPMC

9 Telestroke By Hospital Consults by Hospital 2007-2011

10 Telestroke Metrics and Outcomes Results – (N=239) 90 day Outcomes - (N=183) 11 141 min 83 min 38% 9%9% 3% 12 14 41% 39% 45% 48% 10% 5% 2% 6%

11 Telestroke v. Stroke Center tPA Patients 90 day Outcomes Zaidi et al. Stroke 2011

12 TPA Use Before and After Telestroke: All UPMC Hospitals 1235 Pts Before 2175 Pts After

13 Elements of Telestroke Program Bidirectional real time video and audio Protocols / order sets In service training Stroke team Community education EMS awareness

14 Grants Government Insurance reimbursement Contractual arrangements Subsidies from insurers or hospitals Self-pay How Do We Pay for Telehealth?

15 Telemedicine Platform – UPMC and ALU Scalable Hub and Spoke Model Service Line Coverage Clinical Protocols Video Device Agnostic Efficient Support Model


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