“Using Technology To Tame The West”

1. “Using Technology To Tame The West” The Story of the Cooperative Telehealth Network

2. What Is CTN? • The Cooperative Telehealth Network is one of over 200 video based networks that is focused on improving access to care and education through clinical, educational and administrative services • Part of The Hospital Cooperative, a collaborative of 14 hospitals in Southeast Idaho and West Wyoming (also includes Health West clinics

3. What Is Telehealth?

4. What Is Telehealth?

5. Partners/Connections • The Hospital Cooperative Administrative Office • Hospital Members of THC • HealthWest FQHC Clinics • Idaho State University • Utah Telehealth Network • Partners in Health Telemedicine Network • Other partner sites in Idaho and Wyoming

6. Current and Future Locations • Bear Lake Memorial Hospital – Montpelier • Bingham Memorial Hospital – Blackfoot • Caribou Memorial Hospital – Soda Springs • Franklin County Medical Center – Preston • Harms Memorial Hospital – American Falls • Lost Rivers Medical Center – Arco • Madison Memorial Hospital – Rexburg • Minidoka Memorial Hospital – Rupert • Oneida County Hospital – Malad • Portneuf Medical Center – Pocatello • St. Benedicts Family Medical Center-Jerome • Star Valley Medical Center – Afton, WY • Steele Memorial Medical Center – Salmon • Teton Valley Hospital – Driggs • Health West Clinics – Bannock, Bingham, Power Counties

7. History • 2004-Site development with 4 hospital sites in East Idaho and West Wyoming • 2006 to current-appropriation funds (Portneuf Medical Center) and Office of the Advancement of Telehealth (OAT) grant helped fund installation of high speed lines (T-1), purchase of additional equipment, and staff • 2007-Idaho State University provided funding for new video equipment

8. Clinical Service • First clinical application: Tele-psychiatry (May 2007) • First provider-adult psychiatrist • Both Idaho and Wyoming are complete statewide Mental HPSA • State grades: ID-D and WY-D from NAMI • Overall visits • Entire Program: 750+ • Financial data: • Entire Program-Miles: 91,365 • Miles at $0.55 (IRS rate): $50,250 • Time saved: 105,495 minutes or 1,758 hours

9. Other Accomplishments • 14 current sites on CTN system • Providing tele-radiology services • Services developing in cardiology, child psychiatry, diabetes, obstetrics and oncology • Developed and sponsored first ever Telehealth Summit for the state of Idaho • Patients are seen regardless of ability to pay-$20,000 from private Idaho foundations

10. Internal Education • Portneuf Medical Center programs • Weekly physician CME • Cath Conference • Heart and Vascular Grand Rounds • Diabetes Support Group • Cultivating Compassion Series • Nursing Excellence Series • The Hospital Cooperative • Brown Bag Lunch Series • Business Series • Case Review with William Hazle, M.D. • Certified Nursing Assistant (CNA) courses

11. External Education • Utah Telehealth Network-Diabetes Brown Bag Series • Partners in Health Telemedicine Network- Variety of topics • Idaho State University-Rural Nurse Residency

12. Benefits of CTN • Retention of services and dollars in local healthcare facilities (x-rays, lab, etc.) • Decreased costs for physicians, patients, and staff • Time away from work • Travel • Meals, hotel, babysitters, etc. • Increased confidence in local hospital and positive community perception • New services available locally • Education available locally

13. Future • Complete installation of sites by December 2009 • Increase provider depth in psychiatry-all levels • Cultivate new opportunities for clinical services and delivery • Maintain internal educational programming • Add “series” type programming-Leadership/Legal • Additional partnerships in West and North Idaho; Wyoming-CAH network for education • Clinical certification courses (TNCC, PALS) taught centrally

14. Lessons Learned • With technology, everything takes longer than you plan • Technology constantly changes-$ • Healthcare is still very “hands on” • Expectations today are higher than in the past • Changes create different objectives; educate! • Providers struggle to see telemedicine as a benefit to their current practice; timing in life means everything

15. More Lessons • Always have an answer for reimbursement questions • Many paths can lead to success • Determine clear plan for system deployment at sites • Often, staff have other responsibilities • Don’t reinvent the wheel • Set clear expectations for partners

16. Keys to Success • Identify all players before you start-experience • Obtain multiple physician buy-in at start • Ensure that services are wanted and needed-commitment from participants • Clinical services housed at healthcare entity • Technology assessment complete

17. Additional Keys • Appropriate policies, procedures and processes spelled out • Develop partnerships with grant agencies • Discuss plans with insurance companies • Provide multiple options for education

18. Questions? Jon Smith, Executive Director The Hospital Cooperative 850 East Young Street Pocatello, Idaho 83201 (208) 239-2162 jons@portmed.org www.hospitalcooperative.org