1. Sherilyn Pruitt, MPH
U.S. Department of Health and Human Services
Health Resources and Services Administration
Office of Rural Health Policy
Office for the Advancement of Telehealth
2. Office of Rural Health Policy
• Voice for Rural” within HHS
• Rural-Focused Review of HHS
Regulations
• Research and Policy Development
• Rural-Specific Grant Programs
• Technical Assistance
3. Mission
To advance the use of telehealth technologies for
improving access and quality of health care services for
the underserved.
Serves as the operational focal point for coordinating
and advancing the use of telehealth technologies.
6. • Purpose – to demonstrate how telehealth
technologies can help expand
access, coordinate and improve quality of
health services
• 25 TNGP grantees – 16 hub and spoke, and 9
telehome care grantees
• New grants awarded September 1, 2012
• Funding for up to four years at $250k per year
7.
8.
9.
10. WA St.
Northeast TRC
Lawrence, Frank
MT lin, Clinton, & ME
ND
Essex Counties
New York VT
OR MN
NH
MA
ID WI NY
SD
WY MI RI
CT
IA PA NJ
NV NE
OH
DE
IL IN
UT
CO WV MD
VA
CA KS MO KY
NC
TN
AZ
OK SC
AR
NM
MS AL
GA
TX
LA
Tex-LA TRC
FL
AK
HI
TelehealthResourceCenters.org
11. • Purpose: to increase the delivery of quality
mental health and other healthcare services to
all rural veterans, their families and other rural
residents
• Three years of funding each to entities in
Alaska, Montana and Virginia
12. IOM Workshop on The Role of Telehealth in
an Evolving Health Care Environment
• http://www.iom.edu/Activities/HealthServices/Telehealth.aspx
• August 8 - 9, 2012, Washington, DC
• Live Webcast and Archived
• Summary in November
13. Cross Federal Workgroup on Telehealth – FedTel
• Shared website
• Six subcommittees
• Short-term and long-term goals
• 26 agencies/departments
14. CMMI Partnership
• 15 Innovations Award Winners focusing on
Telehealth
• Collaboration on “Rapid Cycle Change”
• TRC-HCIA Webinar
15. E-ICU Study - What is the impact of Tele-ICUs on
rural hospitals?
• Policy & Program Development
• Human Factors
• Technology
• Cost Effectiveness
• Clinical Outcomes
16. Contact
Sherilyn Pruitt
Office for the Advancement of Telehealth
Office of Rural Health Policy, HRSA
spruitt@hrsa.gov
301-594-0819
Notas do Editor
Key Points to Make: ORHP plays a unique role, serving as the Department of Health and Human Services but residing in HRSA given its focus on vulnerable populations and improving access to care. For our policy role, we review all the key regulations that may affect rural providers with an eye toward making sure rural considerations are taken into account in the HHS policy process. We support rural health services research to help assist in those policy activities We also operate a number of grant programs that support rural communities We also provide a broad range of technical assistance. Note: For folks presenting who do not feel comfortable with policy or programs, it is okay to acknowledge it is not your area but tell the audience you can connect them with the right people.
OAT supports several grant programs, three contracts, and several partnerships within and outside of the Federal Government. The Licensure Portability Grant Program (LPGP) is a competitive grant program that provides support for State professional licensing boards to carry out programs under which licensing boards of various States cooperate to develop and implement State policies that will reduce statutory and regulatory barriers to telemedicine. The Telehealth Network Grant Program (TNGP) is a competitive grant program that funds projects that demonstrate the use of telehealth networks to improve healthcare services for medically underserved populations in urban, rural, and frontier communities.The Telehealth Resource Center Grant Program (TRC) is a competitive grant program that provides support for the establishment and development of Telehealth Resource Centers (TRCs). These centers are to assist health care organizations, health care networks, and health care providers in the implementation of cost-effective telehealth programs to serve rural and medically underserved areas and populations.Flex Rural Veterans Healthcare Access Program -Contract to evaluate the last six years of the TNGP Program, and developing performance measures for the TRCs. We are also completing a study on the impact of tele-ICUs on rural communities, and Tele-ICUs in rural hospitals have been shown to have positive impacts on patient outcomes and are perceived to be beneficial by patient families and rural staff. Although Tele-ICUs are expensive, changes to policies and increased funding may help offset costs and logistical issues. In further efforts to enhance their effectiveness, modifications to National and State laws and policies are recommended. In addition, efforts to improve hub and rural site team relations are encouraged to foster collaboration, utilization, and communication, all of which can improve clinical outcomes. In sum, Tele-ICUs have the potential to save lives, improve patient and family medical care experiences, and enhance rural facility capabilities and resources. With some systemic changes, Tele-ICU programs may lead to even better healthcare outcomes. We also have lots of partnerships within and outside of the Federal government.
Here is a map of our telehealth resource centers. They have been established to provide technical assistance to HRSA grantees and rural communities that are interested in starting or enhancing a telehealth program. They have a joint website and offer a free webinar once a month. The Northwest Regional Telehealth Resource Center is one of our most experienced resource centers. What you don’t see here is the Telehealth Technology Assessment Center, we refer to as T-TAC. Also, we’ll begin funding a new national policy resource center beginning in a couple of days, and they will be added to the website.
The Flex Rural Veterans Grant Program is a new program to OAT. It is in the second of three years. The purpose is to increase the delivery of mental servicesProvide access to quality health care to all rural veterans, their families and other rural residents via telehealth. RVHAP grantees collaborate with the VA, facilitated through a Memorandum of Understanding. This partnership assists rural providers with connecting rural veterans to the VA’s programs and benefits. Partners and rural stakeholders at the state and local levels include critical access hospitals (CAH), hospital associations, federally qualified health centers, rural health clinics, home health agencies, and community mental health clinics. These partners and stakeholders work to expand healthcare delivery to rural veterans. Grantees are working to implement innovative projects that utilize regional approaches, promote outreach activities and build networks. Funded grantees are located in Montana, Virginia and Alaska.
Another activity I’m proud to announce is an Institute of Medicine two-day workshop focusing on Telehealth. The six person planning committee is chaired by none other that our own Karen Rheuban. The purpose of this two-day workshop is to Discuss the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth.2. Discuss the current evidence base for telehealth including available data and the gaps in data.3. Discuss how technological developments including m-health, electronic intensive care units, remote-monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. 4. Discuss actions that the Department of Health and Human Services can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment. The meeting will take place early this summer.
Another activity that I’m very happy to tell you about is the creation of FedTel. The purpose of this group is to facilitate info sharing/education amongst our members, coordinate guidance and other programmatic materials, explore opportunities for joint funding, and develop a summary of the key activities of the participants. Our membership comprises agencies and offices across the Federal government who have an interest or investment in telehealth. Evolution of Workgroups. When we first started, there were already telehealth-related workgroups in existence, specifically the M-Health Workgroup and the Federal Partners Telemental Health Work Group. To make sure we didn’t duplicate the efforts of these groups and to inform FedTel members about their activities, we made updates from their committees a standing item on our agenda. Put together a survey of long term and short term goals: Short TermSummarizing evidence of telehealth data demonstrating lower costs and increase qualityCreating a one stop shop for telehealth resourcesCoordinating funding opportunitiesDefining licensure barriers and next stepsRole of telehealth in HIT (e.g. incorporation of Meaningful Use) Long Term (18 months to 3 years)National licensure or reciprocity, Telehealth comparative effectiveness studies, Summarizing evidence of telehealth data demonstrating lower costs and increase qualityIncreasing access to care (e.g. developing measures of access to care)Developing metrics for reliability Decided we needed additional subgroup to focus on the following issues: Access; Public Education of Telehealth; Technology/Innovation/ and Standards; and Telehealth and HIT. Each sub-group committee can go over their goals in addition to giving an update on their activities
Another activity that I’m very happy to tell you about is the creation of FedTel. The purpose of this group is to facilitate info sharing/education amongst our members, coordinate guidance and other programmatic materials, explore opportunities for joint funding, and develop a summary of the key activities of the participants. Our membership comprises agencies and offices across the Federal government who have an interest or investment in telehealth. Evolution of Workgroups. When we first started, there were already telehealth-related workgroups in existence, specifically the M-Health Workgroup and the Federal Partners Telemental Health Work Group. To make sure we didn’t duplicate the efforts of these groups and to inform FedTel members about their activities, we made updates from their committees a standing item on our agenda. Put together a survey of long term and short term goals: Short TermSummarizing evidence of telehealth data demonstrating lower costs and increase qualityCreating a one stop shop for telehealth resourcesCoordinating funding opportunitiesDefining licensure barriers and next stepsRole of telehealth in HIT (e.g. incorporation of Meaningful Use) Long Term (18 months to 3 years)National licensure or reciprocity, Telehealth comparative effectiveness studies, Summarizing evidence of telehealth data demonstrating lower costs and increase qualityIncreasing access to care (e.g. developing measures of access to care)Developing metrics for reliability Decided we needed additional subgroup to focus on the following issues: Access; Public Education of Telehealth; Technology/Innovation/ and Standards; and Telehealth and HIT. Each sub-group committee can go over their goals in addition to giving an update on their activities
Another activity that I’m very happy to tell you about is the creation of FedTel. The purpose of this group is to facilitate info sharing/education amongst our members, coordinate guidance and other programmatic materials, explore opportunities for joint funding, and develop a summary of the key activities of the participants. Our membership comprises agencies and offices across the Federal government who have an interest or investment in telehealth. Evolution of Workgroups. When we first started, there were already telehealth-related workgroups in existence, specifically the M-Health Workgroup and the Federal Partners Telemental Health Work Group. To make sure we didn’t duplicate the efforts of these groups and to inform FedTel members about their activities, we made updates from their committees a standing item on our agenda. Put together a survey of long term and short term goals: Short TermSummarizing evidence of telehealth data demonstrating lower costs and increase qualityCreating a one stop shop for telehealth resourcesCoordinating funding opportunitiesDefining licensure barriers and next stepsRole of telehealth in HIT (e.g. incorporation of Meaningful Use) Long Term (18 months to 3 years)National licensure or reciprocity, Telehealth comparative effectiveness studies, Summarizing evidence of telehealth data demonstrating lower costs and increase qualityIncreasing access to care (e.g. developing measures of access to care)Developing metrics for reliability Decided we needed additional subgroup to focus on the following issues: Access; Public Education of Telehealth; Technology/Innovation/ and Standards; and Telehealth and HIT. Each sub-group committee can go over their goals in addition to giving an update on their activities
