Sam Head Manager of Health Improvement Initiatives South Carolina Department of Health and Human Services The Role of Telemedicine in Expanding Access.

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Sam Head Manager of Health Improvement Initiatives South Carolina Department of Health and Human Services The Role of Telemedicine in Expanding Access to Prenatal Care

OB/GYN & Telemedicine Medicaid Accountability & Quality Improvement Initiative Designed to increase value and transparency in the current system, invest in hotspots of poor health, reduce per capita costs and improve health outcomes. SCDHHS separated this proviso into seven segments: Hospital & Clinic Innovations (sections A(1), C, D) Hospital Transparency (section A(2)) Disproportionate Share Hospital Accountability (section B) Graduate Medical Education (GME) Payments (section E(1)) Telemedicine & OB/GYN (section E(2)) Optional State Supplement (OSS) (section F) Reporting (section G) Proviso 33.34

OB/GYN & Telemedicine “The department shall develop a program to leverage the use of teaching hospitals to provide rural physician coverage, expand the use of Telemedicine, and ensure targeted placement and support of OB/GYN services in at least four (4) counties with a demonstrated lack of adequate OB/GYN resources by July 1, 2014.” Telemedicine & OB/GYN

Selection Criteria: Primary OB/GYN Secondary OB/GYN Average distance to closest primary practice County Selection Data provided by the University of South Carolina, Institute for Families in Society, Division of Policy and Research on Medicaid and Medicare. Allendale, Bamberg, Barnwell, and Hampton

OB/GYN & Telemedicine

Project Description Access Family Physicians to provide prenatal care locally Telemedicine Regular telemedicine consultation between primary care providers, nearby OB/GYN practices, and Maternal Fetal Medicine specialists at MUSC and USC Collaboration MFM led, on site sessions to focus on best practices, what to expect, and collaboration benchmarks for local providers offering prenatal care services Care Management Partnering with Low Country Healthy Start for enhanced care coordination, case management, and patient outreach & education

OB/GYN & Telemedicine Family Physicians Provide low-risk prenatal care in county Participate in MFM led collaboration sessions as scheduled Recommended minimum of two (2) telemedicine encounters per patient Regular communication with delivering physician Refer patients to Low Country Healthy Start for enhanced care coordination & management services Participation in LCHS led Multidisciplinary Team meetings Continually educate patients on the use of telemedicine to build comfort and confidence level Project Roles

OB/GYN & Telemedicine MUSC/USC Maternal Fetal Medicine Lead on-site collaboration sessions with participating primary care providers. Provide MFM telemedicine consults to FPs and OBs Regular communication with local prenatal care provider. Unlimited use of medically necessary telemedicine consults for high-risk pregnancies Participation in LCHS led Multidisciplinary Team meetings. Continually educate patients on the use of telemedicine to build comfort and confidence level of patient. Project Roles

Connectivity Where? Primary Care and OB/GYN sites connected to MUSC and USC How? Palmetto State Providers Network (PSPN) Current or upgraded internet connection Alternate method

Proviso Target Counties (July 2015 – June 2016) Abbeville Edgefield McCormick Saluda