Skip to main content

The Role of Telehealth in an Evolving Health Care Environment Workshop Summary (2012) / Chapter Skim
Currently Skimming:

6 The Health Care Continuum
Pages 43-54

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 43...
... Appelgate, Ph.D. Iowa Chronic Care Consortium Population health management has three parts.
Read the entire page →
From page 44...
... Experiences of the Iowa Chronic Care Consortium Telehome Care Models A large health system asked the Iowa Chronic Care Consortium (ICCC) to design a heart failure program for their Medicaid population.
Read the entire page →
From page 45...
... . $3,500,000 $3,000,000 $2,500,000 Figure 6-1.eps Cost $2,000,000 Matched cohort $1,500,000 Study cohort $1,000,000 $500,000 $0 Total Pharmacy Office visits Outpatient Inpatient ­20% +9% ­6% ­13% ­54% FIGURE 6-2Medicaid diabetes telehomecare project, preliminary cost data 2010-2012.
Read the entire page →
From page 46...
... Lehigh Valley Health Network Challenges in health care today include an aging population, an increased demand for providers, and increased costs. In turn, there is an increased demand for ICU care, which costs about $107 billion annually.
Read the entire page →
From page 47...
... , real-time audio and video into each room, which can be used to zoom in and look at pupillary reaction; the ICU electronic medical record, which is connected to the master medical record; an electronic algorithmic event system, which sends an immediate notification for any negative changes in a patient's vital signs; and direct access to all laboratory results. The tele-ICU team does not replace the health care professionals already present in the ICU.
Read the entire page →
From page 48...
... Evidence for Tele-ICU Some studies show that the implementation of tele-ICU is associated with decreases in mortality, length of stay, and costs, which may in turn lead to an increase in the overall number of ICU admissions. For example, in a 2010 study of tele-ICU at LVHN, the authors showed a 31 percent relative mortality risk reduction in the study group, as well as significant reduction in the use of mechanical ventilation (McCambridge et al., 2010)
Read the entire page →
From page 49...
... Concluding Remarks Tracy concluded that the use of telehealth technologies for acute care can keep patients close to home in a safe and lower cost environment, which may in turn increase a rural hospital's case mix index. However, reimbursement and licensure remain a persistent barrier in all of telehealth.
Read the entire page →
From page 50...
... Through the telemedicine clinics, Project ECHO provides continuing education credits to physicians and nurses at no cost. It seeks to reduce professional isolation by improving interaction for rural providers, and to bring a mix of work and learning, which is often not available for rural providers.
Read the entire page →
From page 51...
... ECHO projects now exist for cardiac risk reduction, asthma, substance abuse, chronic pain, rheumatology, HIV, and many other diseases. The ultimate vision is to transform primary care so that every primary care provider has an area of special interest, creating supporting networks of trained primary care providers (for different diseases)
Read the entire page →
From page 52...
... Concluding Remarks Arora asserted that ECHO models benefit the current health care system through improvements in quality and safety, rapid learning, reduction in the variation of care, improvements in access for rural and underserved patients, reduction in disparities, and workforce training. Additionally, Arora said, there are force multiplier effects by de-monopolizing knowledge, improving professional satisfaction, supporting the medical home model, avoiding excessive testing and travel, and integrating public health into the treatment paradigm.
Read the entire page →
From page 53...
... , Arora noted that Project ECHO seeks to give the providers the mentorship they need to provide the best practice in a particular area of their choice. The Design of Telehealth Programs One participant noted that the speakers gave examples of telehealth programs that did not achieve positive results, but suggested this may have been due to the protocols and designs.
Read the entire page →
From page 54...
... have a CMMI grant to develop a new specialty in medicine -- the outpatient intensive care team -- to target the 5 percent of Medicaid patients who consume 57 percent of the resources with the support of ECHO-like knowledge networks. Arora added that reducing variation was not an explicit goal of Project ECHO, but noted that when best practices are used and decisions are discussed in a forum of peers, variation automatically reduces.
Read the entire page →

Key Terms

  • chronic disease
  • chronic care
  • disease management
  • care management
  • heart failure

  • acute care
  • critical care
  • population health
  • care consortium
  • care provider

  • iowa chronic
  • telehealth programs
  • office visits
  • provide care
  • care clinicians

  • current health
  • icu care
  • health management
  • valley health
  • telehome care

  • care models
  • health network
  • telehomecare project
  • infectious disease
  • medicaid heart

  • matched cohort
  • monitor outcomes
  • risk reduction
  • professional isolation
  • failure program


    • This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
    More information on Chapter Skim is available.