Telemedicine and the Native American Cardiology Program

Transcription

1 Telemedicine and the Native American Cardiology Program Eric A. Brody MD, FACC Native American Cardiology and Medicine Service Program Assoc. Professor of Clinical Medicine University of Arizona, Sarver Heart Center Disclosures None The Native American Cardiology Program Initiated areas of the Indian Health Service Collaborative effort between IHS, UMC and University of Arizona Deliver quality care (Primary and Tertiary) to NA people in the region Program Transition in

2 Telemedicine and the Native American Cardiology Medical Services Program Unique Synergy Outreach to rural settings Technology based specialties Growth of digital imaging Internet and industry efforts 2

3 Native American Cardiology and Medical Service Program and Telemedicine Over 15 years of collaboration Education Consultation Clinical services 3

4 NAC-MSP and Telemedicine Continuing Medical Education Lectures NACP Staff Other U of A faculty Interactive Case Presentations ECG Bingo/Jeopardy 4

5 Telemedicine and NAC-MSP Clinical Services Tele-consultation Patient Interviews Telemedicine Auscultation Telemedicine Case Reviews Telemedicine and NAC-MSP Clinical Services Store-and-Forward Echocardiography Review Rapid review of important clinical echo findings Early communication of recommendations for care 5

6 NAC-MSP and Telemedicine Regional Echocardiography Center Contracted Echocardiography Technicians Centralized Reading and Interpretation Immediate Faxing of Results (phone consultation as required) Several IHS facilities already involved Primarily Rural Echocardiography equipment on site Telemedicine and NAC-MSP Clinical Services Dobutamine Stress Echocardiography A form of Tele-mentoring and improved Care delivery Two way real time feedback to/from performing physicians Patient symptoms ECG findings Hemodynamic responses Regional wall motion abnormalities 6

7 NAC-MSP and Telemedicine An Integrated Systems Approach to distant cardiovascular medicine services 24/7 telephone consultation New and established patients Medical Record Accessibility ECG review and clinical feedback Exercise ECG Review Regional Holter/Event Monitor System 7

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9 Native American Cardiology Program and Telemedicine: Expanded Clinical Services Native American Cardiology Program and Telemedicine Internet based technology Tuba City Chinle Northern Navajo MC Hopi Health Center Flagstaff NACP Office NAC-MSP (Tucson) Ultralinq Web Based Echocardiography Instantaneous review of abnormal findings using web-based technologies Immediate triage and clinical decision making Early diagnosis Serves both physicians/providers and echo technicians 9

10 Benefits of a Web-Based Solution No special hardware purchases, only broadband Internet service Auto-population of worksheets eliminates redundant data entry. Interfaces with ultrasound devices, eliminating the need for videotapes, DVDs, or other media. allows studies to be read anytime, anywhere resulting in a faster response to the referring physician. Easy sharing and distribution of all exams and reports. Transfer from the Field or Hospital Access Study List Anywhere 10

11 Review Images Viewing Options NAC-MSP and Telemedicine: The Future is Here Permanent pacemaker/aicd interrogation and follow-up Newer Telemedicine technologies from industry are changing this need CareLink (Medtronic Corp.) Guidant Boston Scientific 11

12 Medtronic Boston Scientific/Guidant Web based Device Interrogation St. Jude Medical NAC-MSP and Telemedicine: The Future is here Tele-cardiology Clinics Talented and interested physicians at a distance from tertiary care facilities Patient presentations via telemedicine system Focuses care on primary physicians with specialists acting as true consultants Patients present (optional) for additional history Chart review, faxed ECG s, other pertinent records Save time, travel (patient and physician) Expense, discomfort, cultural issues of travel avoided Telemedicine: Improved Access to Medical Records with NAC-MSP CITRIX access to University Medical Center electronic health record Coordinated by NAC-MSP IHS providers can readily review study results and discharge summaries by web access 12

13 Conclusions: Telemedicine and NAC-MSP Optimizing patient care at a distance Interactions/Interfaces with the 3 most important components of patient care Patient Providers Imaging modalities 13

14 NAC-MSP and Telemedicine Exciting Opportunity Enhance patient care Increase continuing medical education Improve Sub-specialist outreach Improve patient outcomes Decrease unnecessary patient transfers Cost Savings Questions?? 14