Health IT

Will this model for telemedicine adoption get more hospitals to move forward?

Ernst & Young on Thursday unveiled an adoption model for telemedicine – outlining eight levels […]

Ernst & Young on Thursday unveiled an adoption model for telemedicine – outlining eight levels of telehealth adoption that it hopes will begin to carve a path hospital systems nationwide can follow.

“We wanted to create a standard way to communicate,” said Dr. Bill Fera, a principal in the Health Care Advisory practice at EY. “We need to understand where people are. But no one defines what adoption means to this point.”

EY created the adoption standards with the help of health leaders from University of Pittsburgh Medical Center, Thomas Jefferson University, Duke University Health System and Vanderbilt University Medical Center, among others. It unveiled them at HIMSS 2015 in Chicago.

Fera said they took their queue from HIMSS’ approach in creating an adoption model for electronic medical records. In the EY telemedicine model, level zero health systems have a basic framework in place to make sure their telemedicine program is in regulatory compliance. By level 3, hospitals are capable of transmitting images and clinical data to other providers.

At level 7, the highest level, a health system has achieved “full interoperability:” it can receive information from wearables and medical devices and analyze them in an electronic health record, for example.

EY did a survey as they built the model. Among the findings: 51 percent of providers will use patient-supported remove monitoring in the next three years (up from 37 percent currently). Seventy percent of patient rooms already have cameras and other equipment that can be accessed remotely.

Fera didn’t collaborate with either the American Telemedicine Association or HIMSS on this project. “We are trying to put it into a framework made by users and then it can be given to the trade associations,” he said. “We’d like HIMSS to use this. We’d like the ATA to adopt it. We were trying to make it so there was no commercial bias.”

The model does not take into account accreditation or credentialing processes, reimbursement and regulatory or state policies. Also, EY acknowledged that a high level in their model doesn’t necessarily guarantee certain clinical quality and outcome standards.

Here are the levels:

  • Level 7: Full interoperability.  All medical device data, including data from patient-provided wearables, is transmitted to and analyzed in an internal EHR.  Data is easily exchanged with external organizations.
  • Level 6: Offers telemedicine services to patients across the care continuum for multiple specialties.  Highly integrates telemedicine into ongoing patient care.
  • Level 5: Remotely monitors patients at home.  Telemedicine equipment is dispensed by the provider as part of the care treatment plan.
  • Level 4: Uses complex telemedicine technology to support care for various levels of patient acuity across several specialties and sites.  This may include the use of specialized cameras and telemedicine-enabled monitoring and exam instruments.
  • Level 3: Uses simple exam cameras and viewing monitors to perform virtual consults with patients.  Capable of transmitting images and clinical data across providers.
  • Level 2: Able to transmit personal clinical data and customized education to patients through a dedicated patient portal.
  • Level 1: Uses technologies such as video conferencing to support provider-to-provider consults and education.
  • Level 0: Emerging telemedicine program.  Telemedicine operations are centrally managed.  Policies are in place to ensure security and regulatory compliance.

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