By: Gienna Shaw, for HealthLeaders Media, February 13, 2011
Despite small measures of progress, payment is still a big challenge, says John P. L. Manke, RN, BSN, PCCN, who manages the telemedicine program at the two-hospital St. Joseph's Healthcare System in Paterson, NJ.
The conventional wisdom is that payers will only be willing to fully reimburse for telemedicine services when they see hard evidence that the programs are saving them money and improving access and quality.
That proof will lie in outcomes, says Manke, including improvements in quality of care, declines in readmission rates, and increases in volume. "Our regional craniofacial center is one of four centers of excellence in this country. So let's watch the referral base and see how many more patients are coming to us and getting the care they deserve," he says. Insurers save money when a patient is able to see the right expert rather than seeing several different doctors before getting a proper referral and diagnosis. "Instead of spending that money and paying five docs, you're now just paying one."
Until there's enough empirical evidence to sway payers, healthcare organizations can find funding in other places.
Manke says physicians can also negotiate reimbursement rates privately with payers. Beyond that, he tells them to focus on how the technology can improve their practice. "This technology allows you to deliver better quality," he says. You might not be able to make money off of it, but the quality of care you can deliver is tenfold."
Eventually, payers will get it, Manke says. "I see in the future, hopefully, that these insurance companies will understand, embrace, and take advantage of the technology [and] realize the benefit."
Tele-Care: St. Joseph's Regional Medical Center's sophisticated video teleconferencing system extends doctors' reach and provides better patient care
By: David Weiss, for Healthcare AV, February 2012
For SJRMC, the ability to transcend geography comes from an intelligently designed HD video teleconferencing (VTC) facility that was pressed into action immediately upon completion. The result of a highly collaborative effort between SJRMC's Manager-Telemedicine Program John P.L. Manke, RN, BSN, PCCN, design consultants Shen Milson & Wilke (SMW), and integrator HB Communications, the hospital's A/V upgrade has provided a crucial tool for medical education, diagnosis, therapy, and legal applications since Day One.
"The whole goal of the technology -- and where telemedicine is going -- is providing quality care to patients in a timely manner," notes Manke. "It's going to speed everything up, and it takes away the geographic challenges of health care. As a result of the increased quality and reduced costs of HD VTC , it doesn't matter where you are anymore – patients and doctors can have vastly increased access to essential medical resources, anywhere in the world."
Enabling SJRMC's HD VTC capabilities is a three-way-divisible, 260-seat multipurpose room, part of an overall facility upgrade that also included a new physician's lounge and boardroom, as well as a lobby that includes an eye-grabbing 29.5' x 28.5' LED wall. Visuals in the multipurpose room come courtesy of 10,000-lumen DLP Panasonic PT-DW10000U projectors, beaming to Da-Lite 78" x 139" screens. Presenter audio is transmitted via Shure ULXS handheld/lavalier wireless mics, while four Sony EVI-HD1 Pan-Tilt-Zoom cameras monitor the room's visual action. A 16-channel Polycom SoundStructure C16 powers the audio's DSP, while AMX components provide system control.
At SJRMC, applications for high-grade HD VTC go far beyond doctor-to-doctor medical education uses, allowing the hospital to offer patients access to an ever-expanding range of long-distance benefits. "Victims of domestic violence can be connected to the Passaic County Superior Court via HD VTC . The judge or hearing officer can get a good look at them, and make a decision on issuing a temporary restraining order," says Manke. "Likewise, a stroke patient that comes into the emergency room may need to be assessed by a neurologist who is offsite – they can connect extremely quickly now via HD VTC . So anything where decisions need to be made in a timely manner, and visualization is a part of the assessment, benefits greatly from this facility."
In addition to the ability to video teleconference live, equally essential is the ability for post-session recall, editing and redistribution. "Afterwards, we can cut, paste and move around any footage that was recorded," Manke explains. "We can record into either Sonic Foundry Mediasite, or the Polycom RSS 4000 recording streaming server, and edit within those systems. Afterwards, we can stream the video out to people in multiple locations."
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