Download - Industrial Health and Telehealth in Kentucky
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Industrial Health and Telehealth
in Kentucky
Rob Sprang, M.B.A. Director, Kentucky TeleCare
University of Kentucky College of Medicine
Lexington, KY
Mid-Atlantic Telehealth Resource Center Inaugural Conference
Innovation Panel #1 8:30am Friday, March 16
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Telehealth in Kentucky
before 2000
• Program launched in 1994 at UK
• First encounter 1995
• No Medicaid/commercial
reimbursement
• Most encounters supported by grant
funds
• < 50 sites, primarily in Eastern KY
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Telehealth in Kentucky, 2000-Today
• Legislative Mandate
• Reimbursement
• statewide initiative
• Training Centers
• BOD
• Nearly 200 sites – Created a “network of
networks”
• Traditional healthcare sites
• Prison telehealth (state and federal)
• Industrial Telehealth
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Launch of Industrial Telehealth
• First meeting in May 2004 - FP MD in rural
community
• Self Insured Coal Company
• Aging workforce
• Difficult to recruit new workers
• New wellness focus
• Uncovering chronic disease
• Medication compliance
• Accessing higher level of care for
employees/dependents
• Cost of care vs. productivity
• Initial investment in mobile clinic with NP
• Soon moved to clinics at each mine
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Back of
the
Mobile
Clinic
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View from outside
the back of the
mobile clinic
Videoconference
system,
stethoscope and
external camera
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Workspace,
medical
devices and
exam table
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View from the
cab to the back
of the mobile
clinic
Patient sits in
the chair on
the left
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Dr. Wells’ view into the
mobile clinic
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How telehealth technology is used
• Physician oversight/consultations for
local Nurse Practitioners
• Primary care from mines or corporate
office to Dr. Wells
• Healthcare education to the corporate
office staff “Lunch and Learn”
• Medical Specialty consultations to mine
sites and corporate offices
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How did it work?
• Claims data = 8-12% of employees have risk
factors and chronic disease diagnosis, after
Health Risk Assessment, actual = 95%+
• On site clinic staffed by NP
• No out-of-pocket for pharmacy (generics) and
visits (in the network)
• Deliver meds to jobsite
• Drug costs down $1M first year even with
dramatic increase in diagnosis and treatment
• In 2011, corporate healthcare costs dropped $7M
from previous year with 40,000 visits
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Why did it succeed?
• Senior Leadership supported the effort
• The first NP was quite attractive
• Employees were most interested in their family going
to the doctor. Initially, their own health has been
secondary.
• The new system is so easy to access - no cost to the
employee.
• NP clinic was #2 job satisfier behind 4 on/4 off work
schedule.
• Proper diagnosis, proper treatment, better health,
higher productivity, lower costs
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Rob Sprang, MBA
Director, Kentucky TeleCare
University of Kentucky
Co-Project Manager,
Kentucky TeleHealth Network
859-257-6404