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Maryland Stroke Telemedicine Project

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Maryland Stroke Telemedicine Project

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    1. Maryland Stroke Telemedicine Project RMC Maryland Health Roundtable 9/23/08 Eric Aldrich, M.D. (with minor adaptations by Dr. Stern, 10/2/08)

    3. Current Situation Pre-hospital provider training has been developed and is ongoing Over 30 hospitals have become MIEMSS certified stroke centers Emergency Medicine physicians have completed training CHALLENGE = Neurology Coverage

    4. Telemedicine: Past Experience 1990’s: University of Maryland – St. Mary’s Hospital Project Other States: Georgia, Massachusetts, Michigan, California, New York Telestroke Companies: REACH MD, InTouch Johns Hopkins Hospital – Howard County General Hospital Pilot Project (PACS + telephone)

    5. Telemedicine: Costs Hub and Spoke model – dedicated stroke care Hub: $ 3,500 - $4,500 per month Spoke: Hardware - $ 3,300 per year Support - $ 2,000 - $ 3,000 per month 1 Hub + 10 Spokes = $ 447,000 per year 24 / 7 remote system maintenance

    6. Telemedicine: Costs Hub and Spoke model Hub: Maintains the system Spoke: Hardware - $ 10,000 one time cost Support – Annual Fee to the Hub

    7. Telemedicine: Costs MGH: Part of the annual fee REACH MD: T.B.D. by the Hub Canada: $ 250 for 24 hours, $ 500 if have to come in U.S. Hospitals: varies from $ 0 and up Note: State support for in house trauma surgeon coverage Note: Possibility of 3rd party payer coverage

    8. Telemedicine: Future Benefits Benefits community hospitals with neurology coverage problems Could be used for other specialties in demand such as otolaryngology, orthopedic surgery, plastic surgery Could be used for emergency preparedness

    9. Telemedicine: Future Options Centralized state supported system De-centralized private systems Cooperative venture State / private / hospital blend

    10. Telemedicine: Recent Efforts May, 2007: REACH MD presentation at U. of Maryland InTouch presentation in summer, 2007 December, 2007: Conference call with New York system April, 2008: DHMH “brain storming” meeting May, 2008: JHH Grand Rounds: Massachusetts system July, 2008: DHMH follow-up meeting September, 2008: State Advisory Council resolution to develop a telemedicine proposal

    11. Telemedicine: Next Steps State Advisory Council on Heart Disease and Stroke DHMH MIEMSS MIEMSS State Stroke System QIC Comprehensive Stroke Centers (possible hubs) Maryland Hospital Association Maryland Stroke Alliance American Stroke Association Other? health insurance providers

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