Monday , April 15, 2013

9:00–9:15 Welcome and Overview, Conference Kick-off

Kathy J. Chorba, Executive Director, California Telehealth Resource Center
Margaret Laws, Director, Innovations for the Underserved, California HealthCare Foundation


9:15–9:35 Overview of National and State Telehealth Policy Trends

Introduction: Margaret Laws, Director, Innovations for the Underserved, California HealthCare Foundation


Telehealth: Current & Future Policy Considerations Policy
Presented by: Mario Gutierrez, Executive Director, Center for Connected Health Policy

This presentation will draw from data acquired through CCHP’s 50 state scan of State telehealth laws and reimbursement policies to demonstrate policy trends around telehealth throughout the nation. The ways in which policies diminish or create barriers to the use of telehealth will be addressed. The presentation will also include policy developments at the federal level.


9:35–10:45 Panel Presentation

Model eHealth Communities: Promising Practices
Introduction and Panel Moderator: Jana Katz-Bell, MPH, Assistant Dean, Interprofessional Programs, UC Davis Health System


Model eHealth Community Project Overview
Jackie Hausman, MPH, Program Manager, Center for Health and Technology, UC Davis Health System
This presentation will describe the Model eHealth Communities project, a statewide initiative of the California Telehealth Network Broadband eHealth Adoption program. Through a competitive and rigorous process, 15 communities throughout California were selected to receive eHealth equipment to support the implementation of broadband dependent technology. The presentation will include a discussion of the impact or projected impact of some of the projects as well as some early lessons.


The Use of Videoconferencing with Hospital Based Community Resource Centers
Frank Anderson, RN, BSN, Director of Telehealth Development,
Open Door Community Health Centers
One of the goals of our initiative is to link the hospital owned Community Resource Centers with clinics and other non-profit agencies to help further the work done in all the sites. Areas such as psychological counseling, diet and exercise, and other lifestyle support can be better achieved through the direct cross pollination of ideas and expertise which can occur via video. We will discuss the challenges and successes we have experienced to this point, as well as future plans.


Primary Care and Remote Patient Monitoring in Senior Housing Facilities
Davis Park, Director, Front Porch Center for Technology Innovation and Wellbeing
The Model eHealth Community for Aging (MeHCA), is a multi-intervention initiative that
uses broadband-enabled technologies to target a population of underserved seniors in the
Los Angeles area. The project is composed of 4 major activity areas that include digital
and health literacy and brain health, health education workshops through distance learning, remote patient monitoring and tele-consultations, and EHR planning/implementation support. MeHCA promotes these activities through training and education programs in English, Korean, and American Sign Language.


San Francisco Model eHealth Community:
A Telehealth Collaboration with Community Health Clinics, UCSF and the San Francisco Department of Health

Maria Powers, Vice President, Finance, Information and Operations,
San Francisco Community Clinic Consortium
Ms. Powers will present the unique San Francisco collaboration between the local university, the city’s public health department and 11 community health clinics. Using telehealth technology, the partnership is increasing access to primary and specialty care and enhancing the patients’ experience in receiving health services.


Developing Access to Specialty Care and Provider Education in a Rural Environment
Gregory W. Bergner, MD, Barton Health System
As a county-wide collaborative, ACCEL is using our telehealth equipment to access specialties including Psychiatry, Endocrinology, Cardiology, Neurology, Dermatology, Infectious Disease and Concussion. ACCEL has successfully piloted noontime CME presentations to partners across El Dorado County. ACCEL is exploring additional uses for telehealth equipment, leveraging it to improve quality, reduce cost, and improve patient’s healthcare experience.


10:45–11:45 Panel Presentation

Financial Sustainability for Traditional Telehealth Services
in California’s Safety Net

Introduction and Panel Moderator: Arthur L. Gruen, MD, Chief Executive Officer,
Clarus Telehealth Physicians Medical Group
Reimbursement for telemedicine professional services remains a significant obstacle in developing and maintaining California’s healthcare safety net. In order to establish sustainable telehealth programs to ensure healthcare access for Californians especially in remote and rural areas, financially viable models must be created and implemented. The goal of this session is to hear from industry experts on how to manage the connection of patients with remote presence healthcare providers through resourceful and efficient logistics and revenue cycle management.


Emerging trends with potential to reduce telehealth program costs and improve patient outcomes
Bruce Carothers, Senior Vice President, AMN Healthcare
Traditional hospital-based telehealth programs often rely on special purpose and expensive technology solutions. These technology platforms can be cost prohibitive for rural clinics and other safety net care providers. New market forces and technology innovations offer exciting potential for lower-cost and high-quality solutions. This session will consider recent developments and a near-term outlook for continued technology innovation in the telehealth market.


Overview of telehealth revenue cycle management issues including privileging, enrollment, coding, billing, and compliant payment methodologies
Kevin Derrick, President, EA Health
Implementing financially sustainable clinical telemedicine programs, particularly in the
absence of grants or other external funding, is challenging but ultimately achievable.
This session will offer guidance and observations about the full spectrum of revenue cycle
management issues that must be mastered on the way to a sustainable program.


The Palm Drive Hospital Experience 2007-8;
From Bankruptcy to Solvency Using Telemedicine Services

James K. Gude, MD, Medical Director, OffSiteCare,
Clinical Professor of Medicine, UC San Francisco
Palm Drive Hospital is a 37 bed hospital with a 5 bed ICU located 10 miles west of Santa
Rosa. Without specialty physicians the ICU was closed for over one year, and the hospital
accumulated over $2 million in debt. It continued to lose $500,000/month filing for Chapter 9 bankruptcy. With Telemedicine services, OffSiteCare provided specialists in Critical Care Medicine and other specialties reopening the ICU increasing ICU patient days from 771 in 2007 to 1,864 in 2008 with net revenues of $1.6M in 2007 and $5.2M in 2008. Palm Drive Hospital came out of bankruptcy and has been successful medically and financially.


1:00-1:30 Keynote Address

Healthcare in the Digital Age:
New Models of Care to Improve Quality and Contain Costs

Introduction: Michael Minear, Chief Information Officer, UC Davis Health System
Presented by: Thomas S. Nesbitt, MD, MPH, Associate Vice Chancellor for Strategic Alliances and Technologies, UC Davis Technology has the potential to not just improve health and healthcare, but to drive transformation. Dr. Nesbitt will discuss how California can implement technology-enabled applications that improve health, contain cost, and transform our system in the near term and as we look toward the future.


1:30–3:00 Panel Presentation

Service Applications: Where Does the Industry Go From Here?
Introduction and Panel Moderator: Lawrence Friedman, MD, Medical Director,
Ambulatory Care, Quality and Safety, Clinical Telemedicine, UC San Diego Health System


eReferral–UC San Francisco
Alice Huan-mei Chen, MD, MPH, Chief Integration Officer, San Francisco General Hospital
eReferral is a web-based referral and consultation program developed by UCSF/SFGH for San Francisco’s safety net system. All referral requests are submitted electronically and reviewed by a specialist clinician, who can communicate with the referring provider in an iterative fashion until the clinical issue is resolved, with or without an appointment. Evaluations of eReferral have documented improved timeliness of specialty care, specialist assessment of the appropriateness and completeness of referrals, and primary care providers’ ability to track referrals and receive pre-visit guidance. Recognized nationally as an innovative model for improving specialty care, eReferral is now being replicated by multiple health systems across the country.


Sutter Health eICU
Teresa Rincon, RN, BSN, CCRN-E, Director of Nursing, eICU Services, Sutter Health
More than a decade after the Institute of Medicine’s (IOM) proposed six aims to improve
care delivery a struggle to provide safe, timely, effective, efficient, equitable and patient centered care (STEEEP) continues. Data suggests that errors that harm patients have not
decreased, electronic health records have not been correlated with improving process or
outcome measures, care coordination flounders, and inconsistent application of evidence based practice is rampant. Unrealistic expectations on human cognition and vigilance as
well as lack of relevant and usable knowledge have been examined as barriers to achieving
these aims. Tele-ICU is a platform in which real-time knowledge translation and expert
vigilance for early identification of complex disease states and execution of evidence-based
practice can support timely and appropriate care.


VA Home Health and Remote Patient Monitoring
Sandy Murphy, RN
Ms. Murphy will provide an overview of Home Telehealth services, outcome measures and
future direction of the Department of Veteran Affairs.


Clinical Outcomes and Financial Considerations of a Telehealth Enhanced Pediatric Critical Care Unit
James Marcin, MD, MPH, Professor, Pediatric Critical Care Medicine,
Director, Pediatric Telemedicine, UC Davis Children’s Hospital
Several descriptions of clinical telemedicine will be discussed for the purposes of inpatient,
ICU, and emergency medicine consultations for pediatric patients. Clinical outcomes, patient safety and financial outcomes will also be discussed for these different models of care.


3:30–4:45 Panel Presentation

Health Plans: Current and Future Policies for Telehealth Reimbursement
Introduction and Panel Moderator: Patrick Johnston, President and Chief Executive Officer,
California Association of Health Plans


Partnership HealthPlan of Northern California
Robert Moore, MD, MPH, Chief Medical Officer, Partnership HealthPlan of California
Partnership HealthPlan covers residents in rural areas of Northern California, characterized by large distances between patients and providers and shortages of many specialists. Partnership has promoted the spread of telehealth, in particular with an innovative reimbursement policy. Nonetheless, spread of telehealth has been slow in our region. Dr. Moore will share the experience of Partnership in this area and reflect on lessons learned that will inform future spread efforts.


Anthem Blue Cross
Michael P. Martineau, Senior Product Development Consultant,
Anthem Blue Cross Telehealth Program
Mr. Martineau will discuss: telehealth reimbursement from a health plan’s perspective; the status of the Anthem Blue Cross Telehealth Network; and future Telehealth opportunities explored by Anthem Blue Cross.


MediCal and California Children’s’ Services
Robert J. Dimand, MD, Chief Medical Officer, California Children’s Services,
Department of Health Care Services, State of California
Dr. Dimand will discuss the many implementation details of AB 415, Telehealth Advancement Act of 2011 and challenges associated with integration into aspects of the ACA. We will also be going into details of California Children’s Services (CCS) implementation, focusing on inpatient facilities and CCS Special Care Centers (outpatient).


4:45–5:15 California Telehealth Network

Introduction: Sunne Wright McPeak, President and Chief Executive Officer,
California Emerging Technology Fund


California Telehealth Network
Presented by: Eric Brown, President and Chief Executive Officer, California Telehealth Network Mr. Brown will summarize the new FCC broadband subsidy program and how CTN plans to leverage the funding on behalf of California health care providers. Mr. Brown will also review current and planned expanded CTN member benefit offerings.



Tuesday , April 16, 2013

Welcome Back
Kathy J. Chorba, Executive Director, California Telehealth Resource Center


9:00–9:20 Current Policies Affecting Telehealth

Introduction: Mario Gutierrez, Executive Director, Center for Connected Health Policy


Licensing, State & Federal Telehealth Policy Update
Presented by: Mei Wa Kwong, JD, Senior Policy Associate, Center for Connected Health Policy, Program Director, National Telehealth Policy Resource Center
This presentation will provide an overview of licensing requirements, a status update on the State’s implementation of AB 415, pending state legislation and where California stands in telehealth policy in comparison to the other states.


9:20–10:00 Panel Presentation

Health Information Exchange and Personal Health Records
Introduction & Panel Moderator: Pam Lane, Deputy Secretary, HIE,
Health and Human Services Agency


Leveraging Telehealth and Health Information Exchange to Improve Care
Katherine Kim, MPH, MBA, Professor in Residence, San Francisco State University,
President, Kim Consultants
New models of care such as learning health systems, accountable care organizations and
patient centered medical homes as well as federal priorities such as meaningful use of electronic health records seek to improve quality, access, and cost. These models can take advantage of a broad range of telehealth and health information exchange technologies to accomplish these objectives. This session will provide an overview of interesting new technologies and how organizations can leverage them to improve care coordination and empower patients.


Personal Health Records–Paving the Way to Continuity of Care
Cynthia Solomon, Chief Executive Officer, FollowMe
Conventional patient-specific medical information frequently scattered among multiple
hospitals, doctors and caregivers with no single place to access all relevant information
in a timely manner contributes to medical errors, increased medical expenses and lack of
coordinated care. Electronic Personal Health Records (PHRs) allow users to create and store personal health information from multiple places and providers, in a format accessible in one single place from anywhere the Internet is available. The evolution of PHRs and their benefits and role in improving continuity of care will be presented.


10:00-10:30 Affordable EHealth Technology Innovations

Telemedicine Technology: Low Cost Solutions
Daniel Kurywchak, President and Chief Executive Officer, Inc.
This session will go over alternative methods in video conferencing, data transfer capabilities, and medical peripherals. We will discuss future capabilities on the horizon to assist in reducing your Telemedicine technology costs. We will also go over the benefits and challenges, as well as help you to identify what changes are right for you and your organization and if you’re actually ready to implement alternative methods.


10:50–11:10 Eceptionist Demonstration


11:10–11:40 The Telerehabilitation Revolution

The Telerehabilitation Revolution
Kourosh Parsapour, MD, MBA, Chief Executive Officer, 5Plus, Inc.
Physiotherapy has been proven to reduce the emotional and financial burden of disabilities, yet various factors impose major impediments for adequate care. These include: geographic isolation, the need for frequent travel, lack of caregiver support, physical limitations from disability, limited medical coverage and personal financial limitations. In addition provider shortages, the increase in elderly, chronically ill and underinsured populations, as well as poor compliance secondary to dull and monotonous therapies pose unique barriers in rehabilitation medicine. Telerehabilitation provides a potential mechanism to address many of these issues.


11:40–12:40 Panel Presentation

CTN Specialty Service Providers
Introduction and Moderator: Steven Henry, Senior Director,
Treasury Investment Management, UnitedHealthcare


Clinicians Telemed Medical Group, Inc.
Thomas P. Bell, Chief Operating Officer
Clinicians Telemed (CT) is a multi-specialty medical group established by physicians to
help provide solutions to the ever changing delivery of health care. CT is comprised of
medical doctors and professionals who encompass a broad range of medical, technical and
operational expertise. Telecommunication technologies now enable CT to offer physician
specialists to any clinic, anytime, anywhere.


Direct Dermatology
David Wong, MD, Co-founder and Chief Executive Officer, Direct Dermatology
Direct Dermatology is a tele-dermatology service company that enables community clinics
to have timely access to top quality dermatology specialty care at affordable cost for their
patients. Clinics simply log into their secure account on our HIPAA-compliant website, enter the patient’s medical information, and upload images of the skin problem. Your patient’s case will be reviewed by our network of US board-certified dermatologists who trained at the leading US medical centers and are leaders in the field, and you will receive a consultation report in less than 2 business days. It is quick and easy to get set up to use our service and the only equipment cost is a simple point-and-shoot camera.


Barb Johnston, Chief Executive Officer
HealthLinkNow is today’s technology linking health providers to patients—Convenient,
Private & Secure. A fully integrated virtual clinic links Telemedicine technologies with online billing, scheduling and electronic health records. HealthLinkNow connects to any PC, MAC, iPad, iPhone or legacy video systems.


Renee Kavon, Member & Vice President, TeleMed2U
TeleMed2U is a multi-specialty medical group that is working in partnership with the
California Telehealth Network to provide specialty care to patients using real-time, audiovideo teleconferencing. We serve Acute Care, Critical Access, and Rural Hospitals, FQHCs, Community Health Centers, State & County-based programs, Correctional Facilities, Skilled Nursing Facilities and Native American Health Centers. We consider it a privilege to serve you.


12:40–1:00 Closing Remarks and Conference Wrap Up

Conference Wrap Up
Margaret Laws, Director, Innovations for the Underserved,
California HealthCare Foundation