TELEMEDICINE

Presented by Antonio Todaro

Our Vision and Mission

Our mission is to improve patient quality care and safety through innovation and new technology, by establishing the right corporate culture through quality management strategies embedded in quality management excellence of processes, standards and systems where product concept to commercialization delivers quality value through innovation.

Discussion Points• Introduction• Benefits/Utilities• Types• Application• Telemedicine settings • Challenges• Privacy• Vir-sec solution• Appendix

What is Telemedicine

• The delivery of HealthCare services where distance is a critical factor, by all HealthCare professionals, using information and communication technologies for the exchange of a valid information for the diagnosis, treatment and prevention all diseases and injuries, research and evaluation and for the continuing education of all Health Care providers, all in the interests of advancing the health of individuals and their communities

Benefits to patients

• Access to specialized Health Care Services to underserved rural semi-urban and remote areas

• Early diagnosis and treatment• Access to expertise of medical specialists• reduced physician’s fee and cost of medicine• Reduced visits to specialty hospitals• Reduced travel expenses• Reduced burden of morbidity

Benefits to Government*

• 45% reduction in mortality rates• 20% reduction in emergency admissions• 15% reduction in A&E visits• 14% reduction in elective admissions• 14% reduction in bed days• 8% reduction in tariff costs

Types• Store and forward (asynchronic)For non emergency situationsTele-radiography, tele-dermatology,

tele-pathology• Two way interactive video

(synchronic)Video conferencing almost

equivalent of real time consultation. Tele monitoring (medical devices)

Application

• Telepsychiatry

• Collaboration: teleradiography etc

• Tele-learning, tele-education

• Telementoring

• Remote monitoring (Medical devices)

Access to Patient Information (EMR, EHR)

Telemedicine Settings

• Rural• Schools• Clinics• Hospitals• Prisons• Nursing homes/assisted living

Healthcare in rural America

• Half of our nation’s population lives in rural areas, but only 38% of nurses and less than 25 % of doctors work and live there. The federal government has helped by establishing the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (DHHS), whose primary responsibility is improving access to health care services for people who are uninsured, isolated or medically vulnerable.

Healthcare in Indian reservation

• Health care provided to Indian population is still below the average standards of a Western country. According to an article that appeared on Scope, published by Stanford Medicine, “ in Rosebud Indian Reservation in South Dakota the average life expectancy in this community was one year lower than Haiti’s – 46 versus 47 - and a full 33 years shorter than the average American”, and “Diabetes, alcoholism, and depression rates are frighteningly high. Suicide rates are 10 times the national average”

Challenges

• Lack of infrastructures: electricity, computer, broadband Internet connection.

• Privacy and security of patient’s medical information.

• Reimbursement, licensing and credentialing issues

Reimbursements

• 45 States have some Medicaid coverage for other remote video or store-and-forward services, usually for services in rural areas. The details of state Medicaid coverage vary widely and are seldom the same as in-person coverage for a specific service

• 40 states have some coverage for telepsychiatry health: Al, Ak, Az, Ar, Ca, Co, De, Ga, Hi, Id, Il, In, Ks, Ky, La, Me, Md, Mi, Mn, Ms, Mt, Ne, Nv, NJ, NM, NY, NC, ND, Ok, Or, Pa, SC, Tx, Ut, Vt, Va, Wa, WV, Wisconsin, and Wy.

• 18 States have some form of coverage for home telehealth: Al, Ak, Az, Co, In, Ks, Ky, Ma, Mn, NM, NY, Pa, SC, SD, Tx, Ut, Wa, and Wi.

• 12 states have some form of coverage for remote patient monitoring: Al, Ak, Co, Ks, Ma, Mn, NY, Pa, SC, SD, Tx and Wa.

• 7 states have some form of coverage for store-and-forward based services: Alaska, Arizona, California, Illinois, Minnesota, Oklahoma, and South Dakota.

• In addition, 20 states and the District of Columbia have enacted laws mandating the coverage of telehealth provided services under private insurance plans. They include Arizona, California, Colorado, Georgia, Hawaii, Kentucky, Louisiana, Maine, Maryland, Michigan, Mississippi, Missouri, Minnesota, New Hampshire, New Mexico, Oklahoma, Oregon, Texas, Vermont, Virginia and Washington

Privacy/ Security of medical data transmission

• The Vir-Sec technology protects all components of Telehealth including relevant compliance with HIPPA.

• Vir-Sec, Inc.’s solution involves physical presence identification of the patient. The telecommunication will be set up with vir-sec key

• Vir-Sec, Inc. will leverage its patented technology for secure information sharing and virtualized.

• The solution will employ a physical token realized as a distributable, tamper-proof electronic medium (ex: USB FLASH drive) that uniquely identifies each specific end-user.

• Once authenticated, the environment establishes a secure communication channel with an application server (ex: IHS hospital web portal) and is granted access according to predetermined policy.

• When the user finishes working with the secure application, the Vir-Sec virtual environment shuts down, leaving no traces of the user’s session or its own existence on the local computer.

How Vir-sec Technology works

APPENDIXTelemedicine Networks

• HRSA Health Resources and Services Administration. Rural Health.

• ATA American telemedicine association• ATSP Association of Telemedicine Service

Providers