1. TELEHEALTH Solution to Americas healthcare disparity problems, or an expensive solution looking for a problem? Rob Sprang, MBA Kentucky TeleCare/Kentucky TeleHealth Network University of Kentucky

2. What is Telemedicine? Move information, not people What is Telemedicine? Move information, not people

3. Problem...Problem... Many Americans are geographically isolated from needed healthcare services, not available in their local communities

4. The Result... Patients and clinicians must leave their community to access needed healthcare resources, or those needs remain unmet.

5. Solution...Solution... Bring healthcare resources to those who are in need

6. More Clearly Stated... Get the right services to the right people in the right place at the right time

7. BENEFITS TO THE PATIENT Reduce need to travel - Cost, inconvenience, travel anxiety Reduce need to travel - Cost, inconvenience, travel anxiety Personal physician manages patient care & collaborates on treatment plan development Personal physician manages patient care & collaborates on treatment plan development Enhanced continuity of care Enhanced continuity of care Remain close to home, family and natural support systems Remain close to home, family and natural support systems Better access to care = Better health Better access to care = Better health

8. Benefits to the Rural Clinician Personal physician manages care Personal physician manages care Greater involvement with patient Tx plan Greater involvement with patient Tx plan Better compliance seeking specialty care Better compliance seeking specialty care Retain more patients/Capture more revenue Retain more patients/Capture more revenue Access to educational resources not locally available helps reduce professional isolation and improves professional development Access to educational resources not locally available helps reduce professional isolation and improves professional development

9. Other Healthcare Stakeholders Who Benefit From Telemedicine Patients family/friends Patients family/friends Specialists Specialists Rural healthcare facilities Rural healthcare facilities Employers Employers Medicaid/Medicare/private payors Medicaid/Medicare/private payors Taxpayers Taxpayers

10. Who benefits from Telemedicine Services? Everyone!

11. Telehealth is expensive! A network site can cost $10K-$50K, and a hub can cost $150K+

12. Why Sustainability Planning is Important for Telehealth Programs that fail have a negative impact on the telehealth industry Programs that fail have a negative impact on the telehealth industry Except for correctional telehealth programs, the telehealth office normally does not have a positive cash flow Except for correctional telehealth programs, the telehealth office normally does not have a positive cash flow If your program fails… If your program fails…

13. YOU ARE UNEMPLOYED!

14. How can telehealth succeed ?????????

15. Define Success… Plan for Success

22. This story teaches us that it is much easier to plan here:

24. Than here:

26. What is success? Expand clinical service area? Expand clinical service area? Improve continuity of care/outcomes? Improve continuity of care/outcomes? Deliver educational programming? Deliver educational programming? Reduce travel for administrative meetings? Reduce travel for administrative meetings? Cohesive medical informatics system? Cohesive medical informatics system? Positive cash flow? Positive cash flow? Create research/external funding opportunities? Create research/external funding opportunities? Public health/disaster preparedness/response Public health/disaster preparedness/response Other??? Other???

27. Kentucky TeleHealth Network Success Legislative mandate Legislative mandate Supports medical student education Supports medical student education Education promotes University clinicians Education promotes University clinicians Correctional/other contracts medicine generates $ Correctional/other contracts medicine generates $ Awarded over $1.5M in grants in 2003 Awarded over $1.5M in grants in 2003 Supports disaster preparedness/response efforts Supports disaster preparedness/response efforts Recruitment/retention of community clinicians Recruitment/retention of community clinicians Telehealth is a great marketing/PR tool Telehealth is a great marketing/PR tool Provides a great story for University/State leaders Provides a great story for University/State leaders Focus on VALUE Focus on VALUE

28. Does Kentucky TeleCare generate a positive cash flow? NO!

29. Are we considered successful? YES!

30. How do you position telehealth for long term success? Telehealth is a vital component of the infrastructure of the healthcare facility, just like air conditioning.

31. The single greatest challenge faced by telehealth... You!

33. 1 1415 16 5 22 6 17 18 31 25 27 28 7 30 21 9 24 26 4 12 61 19 13 49 3 20 2 50 51 62 56 63 64 11 32 33 34 35 36 37 38 47 48 53 52 60 57 58 46 41 39 40 59 55 29 42 65 8 43 44 45 Kentucky TeleHealth Network (KTHN) Sites For more information, contact 859-257-6404 54 10 23

34. Disaster Preparedness/ Response Activities We can never imagine what disaster is just down the road, so we must prepare ourselves

36. PROACT (Preparedness and Response on Advanced Network Technology) Disaster preparedness education is a top priority for KY DPH Disaster preparedness education is a top priority for KY DPH Needed a core group of geographically disperse, dependable sites Needed a core group of geographically disperse, dependable sites Signed LOAs from CEOs committing to 24x7 response in the event of a disaster Signed LOAs from CEOs committing to 24x7 response in the event of a disaster Can connect to CDC, DHS and other vital agencies Can connect to CDC, DHS and other vital agencies

37. Kentucky Kentucky PROACT Network P reparedness and R esponse O n A dvanced C ommunications T echnology For more information, contact 859-257-6404 2 3 1 10 6 7 8 4 9 11 13 12 14 15 16 5 Central Control Site Network Hub Sites Network Sites 18 Kentucky Department of Public Health 17 19 Click on any site for further information on that site 20

38. Whats Next? Whats Next? Generate more revenues from educational programming support Generate more revenues from educational programming support Pursue more clinical contracts Pursue more clinical contracts Promote clinicians to include telehealth in clinical grants (more $ than clinics) Promote clinicians to include telehealth in clinical grants (more $ than clinics) More interstate/international activities More interstate/international activities Coordinate UK/UL collaborative activities (Genetics, grants…) Coordinate UK/UL collaborative activities (Genetics, grants…)

39. Thank you for your time and attention. It was a privilege to have the opportunity to speak to you. Rob Sprang, MBA rsprang@uky.edu 859-257-6404 rsprang@uky.edu