Sam HeadManager of Health Improvement InitiativesSouth Carolina Department of Health and Human Services

The Role of Telemedicine in

Expanding Access to Prenatal Care

OB/GYN & Telemedicine

Medicaid Accountability & Quality Improvement Initiative• Designed to increase value and transparency in the current

system, invest in hotspots of poor health, reduce per capita costs and improve health outcomes.

SCDHHS separated this proviso into seven segments:• Hospital & Clinic Innovations (sections A(1), C, D)• Hospital Transparency (section A(2))• Disproportionate Share Hospital Accountability (section B)• Graduate Medical Education (GME) Payments (section E(1))• Telemedicine & OB/GYN (section E(2))• Optional State Supplement (OSS) (section F)• Reporting (section G)

Proviso 33.34

OB/GYN & Telemedicine

“The department shall develop a program to leverage the use of teaching hospitals to provide

rural physician coverage, expand the useof Telemedicine, and ensure targeted placement

and support of OB/GYN services in at least four (4) counties with a demonstrated lack

of adequate OB/GYN resources by July 1, 2014.”

Telemedicine & OB/GYN

Selection Criteria:

• Primary OB/GYN

• Secondary OB/GYN

• Average distance to closest primary practice

County Selection

Data provided by the University of South Carolina, Institute for Families in Society, Division of Policy and Research on Medicaid and Medicare.

Allendale, Bamberg, Barnwell, and Hampton

OB/GYN & Telemedicine

OB/GYN & Telemedicine

Project DescriptionAccess • Family Physicians to provide prenatal care locally Telemedicine • Regular telemedicine consultation between primary care providers, nearby OB/GYN practices, and Maternal Fetal Medicine specialists at MUSC and USCCollaboration • MFM led, on site sessions to focus on best practices, what

to expect, and collaboration benchmarks for local providers offering prenatal care services

Care Management • Partnering with Low Country Healthy Start for enhanced

care coordination, case management, and patient outreach & education

OB/GYN & Telemedicine

Family Physicians

• Provide low-risk prenatal care in county• Participate in MFM led collaboration sessions as

scheduled• Recommended minimum of two (2) telemedicine

encounters per patient• Regular communication with delivering physician• Refer patients to Low Country Healthy Start for

enhanced care coordination & management services• Participation in LCHS led Multidisciplinary Team

meetings• Continually educate patients on the use of

telemedicine to build comfort and confidence level

Project Roles

OB/GYN & Telemedicine

MUSC/USC Maternal Fetal Medicine

• Lead on-site collaboration sessions with participating primary care providers.

• Provide MFM telemedicine consults to FPs and OBs • Regular communication with local prenatal care

provider.• Unlimited use of medically necessary telemedicine

consults for high-risk pregnancies• Participation in LCHS led Multidisciplinary Team

meetings.• Continually educate patients on the use of telemedicine

to build comfort and confidence level of patient.

Project Roles

Connectivity

Where?• Primary Care and OB/GYN

sites connected to MUSC and USC

How?• Palmetto State Providers

Network (PSPN)• Current or upgraded

internet connection• Alternate method

Proviso 33.26Target Counties(July 2015 – June 2016)

AbbevilleEdgefield

McCormickSaluda