Download e-book Implementing Telemedicine : Completing Projects On Target On Time On Budget

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The bad news is that a telemedicine practice is very difficult to implement.

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This book can help you and your organization prosper with a telemedicine practice, not create a storeroom with expensive, dust covered technology. This book will show you how to excel at leading change in todays complex healthcare environment, an environment that can mean success or failure for those wishing to implement telemedicine. The managers who will be successful in implementing telemedicine today and tomorrow will be the ones who can look at waves of change and see opportunity; who can design a telemedicine vision and strategy for a more positive future for their organizations; and who can implement their designs on target, on time, and on budget by capitalizing on the strengths of their organizations and their bright and dedicated associates.

You dont have to be afraid of change any longer! Dutchs work offers entertaining and simple solutions that will help you move swiftly and efficiently through the growing pains of organizational change, says Ken Blanchard, author of The Secret and The One Minute Manager. This growth is due in part to continued marketing and education efforts by liaisons who work in specific geographic territories around Georgia and in part to continued grant funding to expand the number of access points and the number of participating healthcare providers.

Previously, lack of physician buy-in was a major barrier limiting utilization. Broadening the number of participating sites and relocating equipment from nonparticipating sites has allowed the number of annual encounters to skyrocket. GPT has found, through patient feedback, that satisfaction with telehealth consultations and services is extremely high. Telehealth allows patients to schedule appointments with specialists in a much more timely fashion than waiting months for an in-office encounter.

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Patients appreciate such conveniences as reduced travel time and costs and the prevention of loss of school and work time. They are also provided the benefit of remaining under the care of the local primary care provider with whom they are familiar and comfortable. Patient satisfaction and success has also been documented in skilled nursing facilities that participated in a GPT pilot project.

The GPT telehealth network strives to increase access to specialty care throughout Georgia, improve timeliness of diagnosis and treatment, and improve the quality of care for rural patients. The goal is to enable patients anywhere in Georgia to have access to specialty care within a minute drive or less. Currently, the GPT telehealth network reaches more than rural communities in locations ranging from the mountains in the north to the seashore on the east coast to the peanut fields in the southernmost regions of the state.

More than specialists representing more than 40 specialties currently participate in the network, providing access to specialty care that overcomes barriers such as travel time and lost work time and that provides earlier access to care, preventing the high costs of untreated healthcare problems. Working with patients in a rural, agricultural environment I see the barriers they face—isolation, transportation, finances.

I've been able to offer them metropolitan medicine and an opportunity to overcome many of these barriers—that is a blessing. It has enriched and expanded my practice. I've learned a lot too.

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The GPT network offers an established, cost-effective means of solving long-standing workforce shortage problems and providing access to healthcare for populations in all areas of rural Georgia. The telemedicine network provides an array of telehealth services including specialist consultations in such areas as rheumatology, trauma, endocrinology, dermatology, diabetes education, and behavioral health. In , the top two specialties utilized for telehealth encounters through GPT were wound care 5, encounters and psychiatry 2, encounters. Wound care, in particular, has exploded as one of the top applications of the Georgia telemedicine program.


A medical center in southwest Georgia uses telemedicine to manage the wound care program for the affiliated institutions, which include four rural hospitals and four nursing home facilities. The following shows the growth of wound care encounters, representing both live and store-and-forward consultations:.

In addition to specialty care, GPT is committed to providing broadband education, awareness, training, access, equipment, and support to schools, medical and healthcare providers, community colleges and other institutions of higher learning, and other community support organizations, including organizations that provide outreach, access, equipment, and support services to facilitate greater use of broadband services by vulnerable populations, resulting in increased broadband adoption and improved health outcomes of rural Georgians. GPT continues to apply for grant funding to further expand services into underserved areas of Georgia.

The target area to be served by the TCGBH TeleConnect Georgia for Better Health program is Georgia's 91 counties in persistent poverty, with a total population of 1,, and , unserved and underserved citizens living below the poverty level. Another group that will benefit from increased broadband services is the 1, primary care physicians and approximately 6, nurses and nonphysician practitioners serving these 91 poverty-stricken counties, most of which are designated as medically underserved areas, mental health professional shortage areas, and health professional shortage areas according to the State of Georgia Rural Health Plan, published by the Georgia State Office of Rural Health.

The project also plans to implement a training and awareness program for residents and rural healthcare providers to improve healthcare delivery in areas of the state with high levels of poverty. Key public and private sector stakeholders will work together to improve healthcare access for the , poor and underserved individuals in 91 counties, create 10 new jobs, and promote broadband demand and sustainability through the expanded GPT telehealth network.

The Southeastern Telehealth Resource Center SETRC will be operated by GPT and will provide technical assistance to help healthcare organizations, networks, and providers implement cost-effective telehealth programs serving rural and medically underserved areas and populations. The program is designed for entities with a successful track record in helping to develop sustainable telehealth programs. GPT will use the experience gained over the last five years to assist other states in the Southeast in building and implementing their own successful programs by providing guidance on issues ranging from overcoming challenges and implementing best practices to training, evaluation, and addressing payment sources.

GPT plans to remain on the forefront as telehealth evolves and revolutionizes healthcare. It will continue to address the need to improve healthcare access and outcomes statewide by expanding telemedicine sites, services, clinic capabilities, and utilization. Opportunities to expand the network and grow within the region lie in GPT's trauma and stroke programs as well as in the areas of mental health, child advocacy, school systems, and other specialty services. Many primary care physicians are now incorporating telehealth into their daily practices to enhance their patient services as well.

Plans to expand the network across state lines and increase education, training, and consulting services are also currently in the works. This expansion will allow for growth in emergency departments and urgent care facilities and will provide increased opportunities for presentation sites to connect to each other for additional peer review, collaboration, and educational purposes.

GPT has achieved phenomenal success and unprecedented growth thanks to support provided from sources ranging from the gold-domed state capital in Atlanta to the tin-roofed rural physician's office in South Georgia. Moving forward, GPT's expertise will be leveraged in the oversight and management of SETRC, whose focus on the application of best telehealth practices and technical assistance is vital to the long-term success of telemedicine in the Southeast, where there is a great need for leadership.

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Over the years, GPT has learned many lessons from others and from its own experience as a statewide network. Rena Brewer, TeleHealth, Inc. Paula Guy, TeleHealth, Inc. One definition which they identified as taking into consideration the various facets is the one proposed by [ 6 ], who defined eHealth as:. In a broader sense, the term characterises not only a technical development, but also a new way of working, an attitude, and a commitment for networked, global thinking, to improve healthcare locally, regionally and worldwide by using information and communications technology.

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Despite these potential benefits, there are barriers to the full implementation of eHealth solutions, and the limitations of access, health and technology literacy, and quality measures must be addressed [ 8 , 9 ]. It was suggested earlier by [ 10 ] that if we are to maximise the benefits associated with eHealth interventions whilst minimising risks, we must be able simultaneously to evaluate eHealth interventions while they are being designed, developed, and deployed.

Solutions which are provided through eHealth initiatives within hospitals has been identified by [ 11 ] as Hospital Information Systems HIS , telemedicine services, Electronic health records and Internet services. The following is not a systematic review of eHealth in Ghana, but rather an attempt to gather a diversity of perspectives on the topic from a variety of sources.

Moreover, references were solicited from a variety of experts in the field, many of whom were responsible for building and deploying their own systems.

Interactions with eHealth experts [ 12 - 14 ]. In addition, follow-up with some of the authors' for directions to other projects. Papers were selected once they discuss an eHealth project in Ghana. Using the above criteria and personal contacts of researcher, 22 projects were identified. These projects are:.

The aim of the project is to use information technology to improve service delivery at the lowest level of service delivery — Community-based Health Planning and Services CHPS zones. It is one of the pioneer mobile health projects in Ghana. The project aims to determine how to use mobile phones to increase the quantity and quality of prenatal and neonatal care in rural Ghana, with a goal of improving health outcomes for mothers and their newborns.

Millennium Village project is a new approach for fighting extreme poverty. The concept is to target the "poorest of the poor, village by village throughout Africa, in partnership with government and other committed stakeholders, providing affordable and science-based solutions to help people lift themselves out of extreme poverty. It has a network of asynchronous servers hosted at each hospital and integrated with the referral system. It has on board doctors in 6 countries. Moorfields Eye Hospital is using the internet to share the specialist knowledge and advice of its consultant eye specialists with hospitals in the developing world.

Patients were randomly selected from three outpatient clinics in Accra and Kumasi Ghana. Patients underwent physical consultation by an onsite dermatologist. These patients also went through ClickDoc data collection and image capture using a Samsung U Soul mobile phone. Remote Ghanaian dermatologists connected to the patient database using a web-based interface africa. For each case, the remote specialists made their own diagnosis on the basis of the patient data and images.

Thirty Ghanaian Red Cross volunteers, trained over a two-day period, had no trouble with the technology, though some of them had never before used a computer. They were able to complete over 2, surveys in just three days, where the traditional paper and pen survey method generally yielded about finished surveys. Survey data was turned in at noon on the last day of the pilot; analysis was completed promptly after the data was hot synched into a computer; and a complete report was delivered to the Ghanaian Ministry of Health by 5pm.

The entire pilot was completed in less than a week, and the speed and ease of gathering this epidemiological data was unprecedented. Community volunteers using PDAs to collect data as part of measles vaccination program in Ghana. The project yielded compelling evidence of the value of PDAs for data collection and reporting.

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There are plans to use the lessons learnt from this pilot and institutionalize the use of PDAs for integrated facilitative supervision within the service. The SMSs will then be sent to a toll-free short code registered with each mobile network in Ghana. This project that is yet to be implemented.

The objective is to support African scientists and malaria researchers in their ability to connect with one another and sources of information through full access to the Internet and the resources of the World Wide Web, as well as create new collaborations and partnerships.

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In attendance were malaria research scientists, health information professionals, telecommunications experts and representatives of the major MIM funding agencies. In keeping with the underlying goal of supporting a broad spectrum of basic and operational malaria research needs, the researchers requested communications and connectivity capabilities sufficient to provide, at a minimum: robust and reliable e-mail, links to other research sites, access to full text journal articles, database searching, exchange of large files and mapping data, and timely access to electronic information resources worldwide.

The 64kbs dedicated bandwidth purchased was shared by the two sites. When these sites came on line, the overall bandwidth increased to kbs and monthly charges were reduced since more sites were sharing the bandwidth. Their mission is to provide cost-effective communications for remote regions of developing countries. Partners were located in Ghana, Uganda, Zambia and Zimbabwe, and use a low-earth-orbiting satellite LEOSAT for store-and-forward email communications suing amateur packet radio technology, and internet email gateways in developed countries.

The latter is named the mPedigree Network. NAFDAC and the Nigerian pharmaceutical companies formed a consortium in June to roll the service out for all medicines in Nigeria, though this has not happened as at end of This is an electronic health delivery system, launched to enable doctors reach their patients online and bring health care to the door steps of the citizenry.

This does not seek to prevent patients from visiting hospital but to augment existing health care delivery services. In order to assess the product one has to go online to book an appointment with a doctor on www.