Children s Special Health Care Services Telemedicine Project Facilitating

Children’s Special Health Care Services Telemedicine Project Facilitating access to care for children and youth with special health care needs

Presenter n Linda Fletcher, MS, CPNP n n Project Coordinator, HRSA grant Children’s Special Health Care Services 2

Goals of Presentation n Demystify telemedicine n n It’s easy and useful Consider applications for genetics n This is a face to face appointment with another provider completing the physical exam 3

Telemedicine Definition n Telemedicine is the use of live two-way audio and video conferencing technology to support connecting the local site to a distant site to provide access to care. Encrypted software is used. n Centers for Medicare and Medicaid Services 4

Telemedicine Works n n n Telemedicine is a tool to improve access to care. It is in real time It is two-way videoconferencing n n It is not Skype Medical home and care coordination n Instant care coordination 5

CSHCS Telemedicine n n Demonstration Project Design Children and Youth with Epilepsy and More……. . n Originating site n n n Child/Youth/Family Local Doctor Distant site n Specialist

Telemedicine Successes n n n N = 37 100% patient satisfaction 95% provider satisfaction Family included in plan Provider education Parent Partners 7

Telemedicine Barriers n n n Established patients versus new patients Reimbursement Intensity of work at the patient site and specialist site at start-up Identification of patients Labs and studies 8

Telemedicine Applications for Genetics n n If you can imagine it…. . Access to care Access for follow-up Education 9

Equipment 10

Telemedicine IT Support n n n IT and Statewide Interoperability generously supported by the University of Michigan IT Department and the Department of Pediatrics and Communicable Disease Valerie Castle, MD Joe Kryza, MBA 11

Telemedicine Reimbursement n n Current payers are Michigan Medicaid and CSHCS Medicaid Policy Mandated MHP enrollment Reimbursement for originating site and distant site 12

Telemedicine Reimbursement n n The bill specifies that health insurers could not require face-to-face contact between a health care provider and patient for services appropriately provided through telemedicine — subject to all terms and conditions of the policy or certificate agreed upon between the health insurer and the policy, certificate, or contract holder. Public Acts 214 and 215 of 2012. 13

Telemedicine Reimbursement n Only a policy, certificate, or contract issued or renewed on or after January 1, 2013, would be affected. 14

Quality Improvement n Child Health Research and Evaluation Research (CHEAR), U of M n n n Metrics/Measures Care coordination Patient/family evaluation 15

Questions? 16

Resources n n Alcona Health Center American Academy of Pediatrics n n American Telemedicine Association n n www. americantelemed. org CHEAR n n www. aap. org chear. org Children’s Special Health Care Services n www. michigan. gov. cshcs 17

Resources n CMS n n n www. cms. gov http: //www. medicaid. gov/Medicaid-CHIP-Program. Information/By-Topics/Delivery. Systems/Telemedicine. html http: //www. cms. gov/Medicare-General. Information/Telehealth/index. html? redirect=/Tele health/ 18

Resources n Family Center n n Medical Home n n www. michigan. gov/cshcs http: //medicalhomeinfo. org/ Michigan Medicaid n http: //www. michigan. gov/mdch/ 19

Resources n Public Acts 241 and 215 of 2012 n http: //legislature. mi. gov/doc. aspx? 2012 -HB-5408 20

Resources n Contacts Linda Fletcher, fletcherl@michigan. gov Phone: 517. 241. 5071 21

Thank you! 22