U.S. Department of Health and Human Services
Health Resources and Services Administration
Invitational Workshop on
Personal Devices
Tele-home Care: Expanding the
Opportunity for Personal Medical
Devices
Dena S. Puskin, Sc.D.
Health Resources and Services
Administration
U.S. Department of Health and Human Services
Health Resources and Services Administration
VISION
NO MATTER WHO YOU ARE
OR
WHERE YOU ARE
YOU GET
THE HEALTH CARE YOU NEED
WHEN YOU NEED IT
U.S. Department of Health and Human Services
Health Resources and Services Administration
Office for the Advancement of
Telehealth (OAT) Responsibilities
•Administer telemedicine grants
•Evaluate telehealth programs
• Develop telehealth policy
• Joint Working Group on
Telemedicine
U.S. Department of Health and Human Services
Health Resources and Services Administration
OAT APPROPRIATIONS
• Awarded over $225 million in
grants since 1989
• FY2004: Approximately $31 million
• Competitive and congressionallymandated projects
• FY2003: 110 programs, in 43
states and District of Columbia
U.S. Department of Health and Human Services
Health Resources and Services Administration
What is Telemedicine?
What is Telehealth?
TELEVILLAGE
TELEHEALTH
Health
Professional
Education
Consumer
Health
Services
K-12
Education
TELEMEDICINE
Business
Administration
Public
Health
Libraries
Justice
U.S. Department of Health and Human Services
Health Resources and Services Administration
Telehealth can be thought
of as a tool box of
technologies applied to
diverse health care needs in
a wide range of health care
settings.
U.S. Department of Health and Human Services
Health Resources and Services Administration
Educational and
Administrative Uses
• Continuing
education
• Patient
education
Rural providers can receive
continuing education without
the need to travel.
• Administrative
meetings
Real-Time Telemedicine
Remote doctor examines
a patient’s inner ear
from a remote location.
Patient in rural ER gets
benefit of local care plus
remote consultation with
specialists.
U.S. Department of Health and Human Services
Health Resources and Services Administration
Store-and-Forward
Clinician reviews scan
which was forwarded for
consultation.
• Primary care
provider takes a still
image and sends it
to a consulting
physician who later
reviews it
• No real time
interaction between
patient & consultant
• Commonly used for
dermatology,
radiology
Home Health
Patient and nurse interacting
during a “video home visit.”
• Low-cost
equipment that
needs only a
regular phone
line
• Used to check
vital signs,
monitor
medications,
visualize
patient, provide
enhanced
support
U.S. Department of Health and Human Services
Health Resources and Services Administration
U.S. Department of Health and Human Services
Health Resources and Services Administration
Disease Management
U.S. Department of Health and Human Services
Health Resources and Services Administration
Te le me dicine Applications FY 2002
45
40
35
25
20
15
10
5
Special Settings/Applications
Long Term Care
Facilities
Prisons/Jails
School
Rehabilitation
Services
Home Care
Prof Degree
Education/Preceptor
0
Continuing Education
Programs
30
U.S. Department of Health and Human Services
Health Resources and Services Administration
Emerging Technology
Applications
• Emphasis on low cost applications
• Applications that improve quality of
care
• Integration of information and
imaging applications in low cost
devices
Department of Defense (DoD)
Smallpox Vaccination
Patient Monitoring
U.S. Department of Health and Human Services
Health Resources and Services Administration
Informatics
U.S. Department of Health and Human Services
Health Resources and Services Administration
Informatics
I. Example: Encounters by Setting
(12 months)
Services/Encounters by Setting; all types
of services combined: Sept '02 - Feb '03
N = 24,874
Private
Medical
Practice or
Physician's
Office
3%
Prison
1%
Patient's
Hom e
25%
Non-Hospital
Clinic (e.g.
rural health
clinic, m igrant
health clinic)
6%
School
3%
Other
0%
Health
Departm ent
and Mental
Health
Agency
4%
Services/Encounters by Setting; all types of
services combined:March '03-August '03
N = 30,584
Private Medical
Practice or
Physician's
Office
3%
Prison
1%
Hospital InPatient
25%
Hospital
Outpatient
33%
Patient's Hom e
24%
Non-Hospital
Clinic (e.g.
rural health
clinic, m igrant
health clinic)
4%
School
2%
Other
1%
Health
Departm ent
and Mental
Health Agency
2%
Hospital InPatient
30%
Hospital
Outpatient
33%
U.S. Department of Health and Human Services
Health Resources and Services Administration
Evaluation Key Questions
• Who
•
•
•
•
What
How
When
Where
U.S. Department of Health and Human Services
Health Resources and Services Administration
U.S. Department of Health and Human Services
Health Resources and Services Administration
U.S. Department of Health and Human Services
Health Resources and Services Administration
CONTACT US
Dena Puskin, Sc.D.
5600 Fishers Lane
Room 7C-22
Rockville, MD 20857
Phone: (301) 443-0447
Fax: (301) 443-1330 Fax
E-Mail: dpuskin@hrsa.gov