Alabama Pharmacy Association Mid Winter Conference - Feb. 23, 2014

1. Reaching Out With
Telehealth
Lloyd Sirmons
Executive Director
Alabama Partnership for Telehealth

2. Can you imagine what
healthcare would be like if…
• Clinical care was available anytime and anywhere
• Clinicians could obtain consultations with medical
centers of excellence anytime and anywhere
• Home bound patients could be monitored
remotely anytime and anywhere
• Medical education programs were available
anytime and anywhere
This is the potential of Telehealth!!!

3. What is Telehealth
Telehealth is the use of
telecommunications and information
technology to provide access to
health assessment, diagnosis,
intervention, consultation,
supervision and information across
distance.

4. APT
Alabama Partnership for TeleHealth,
Inc. (ATP), is a 501(c)3, nonprofit
corporation, with a focus on
increasing access to healthcare
through the innovative use of
technology.

6. Business Model
• 501(c)3 – Not for Profit
• Network of Partners
• Services Provided:
• Field-Based Telehealth Liaisons
• Support for Credentialing
• Scheduling System
• Centralized PACS System
• 24/7 support for network partners

9. The Need for Telehealth
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Clinician shortages
Rural/Urban underserved
Aging population
Administrative meetings
Clinical education programs
Travel time
Delayed treatment

10. The Need for Telehealth
• Healthcare providers are coming under increasing
pressure to improve the quality of care delivered to
patients while decreasing the cost to provide this
improved care.
• As the population ages and chronic disease explodes, the
healthcare delivery system will be forced to treat larger
numbers of patients with fewer and limited resources.
• The main DRIVERS behind the expanding application of
telehealth:
1.
2.
the desire to improve healthcare services for all, especially
in rural areas and
the need to decrease costs and increase efficiencies while
improving workflow.

11. Telehealth Applications
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Hospitals
SNF (Skilled Nursing Facilities)
Clinics
Schools
Corrections
Physician’s Office
Remote Patient Monitoring
Pharmacies

12. Barriers to Telemedicine
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Reimbursement
Physician buy-in
Infrastructure and Hardware costs
Limited bandwidth
Program Sustainability
Resistance to new technology
Political agendas that can derail
progress and health system reform

13. Telehealth Reimbursement
Medicaid and private insurance coverage
Medicaid
Private insurance
No required coverage

14. Ethics in Telemedicine
• Security & Confidentiality
• Diminished level of care
• Overuse or Abuse
– Doctor shopping

15. Not For
Everyone/Everything

16. Telepharmacy Services
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drug review/monitoring
oral and sterile compounding verification
medication therapy management (MTM)
patient assessment
patient counseling

17. Evaluating The Impact of Telepharmacy by
Philip J. Schneider, looked at the Impact of remote
pharmacist review of medication orders in three small
community hospitals
A longitudinal study was conducted in three community
hospitals without 24-hour pharmacy services before and
after the implementation of telepharmacy services.
Override reports from automated dispensing cabinets
were reviewed. Charts were reviewed for errors and
potential adverse drug events. Pharmacist interventions
during times when the pharmacy was closed were
evaluated. Cost estimates were based on a proprietary
intervention tracking program. Surveys were
administered to staff nurses and pharmacists to assess
concerns about medication-use, safety and job
satisfaction.

18. The number of times that nurses obtained and
administered medications without pharmacist review
declined by 35.3% after implementation of the
telepharmacy service. There was a significant reduction
in the percentage of high-risk medications obtained
without a pharmacist review. Three potential adverse
drug events were discovered before implementing
remote order review versus none in the
postimplementation period. The number of pharmacist
interventions increased from 15 to 98 per week after
implementing remote order review by pharmacists.
Estimated cost savings resulting from preventing,
identifying, and resolving medication-related problems
were $261,109 per hospital in total cost saved or
avoided. Nurses’ survey scores reflected increased
comfort with the medication-use system, patient
safety, and job satisfaction.

19. Remote review of medication orders by
pharmacists when the hospital pharmacy was
closed decreased the number of potential
adverse drug events reported and improved job
satisfaction among nurses.
http://www.ajhp.org/content/70/23/2130

20. “The best cure for a sluggish
mind is to disturb its routine.”
William H. Danforth

22. Lloyd Sirmons
Executive Director
912-337-6183
lloyd.sirmons@alabamatelehealth.org