Telehealth Grantee Directory

Network Partners:

The Northcentral Montana Healthcare Alliance (NMHA) and Realizing Education And Community Health Telehealth Network (REACH) consists of Benefis Healthcare (hub) and sites in Havre, White Sulphur Springs, Chester, Chinook, Chouteau, Ft. Benton, Big Sandy, Conrad, Cut Bank, Shelby, and Box Elder. Benefis Healthcare Foundation is an additional partner.

Project Purpose:

To expand and enhance the connectivity and clinical capabilities of the existing REACH network. To improve access and reduce costs overall of providing medical specialty and mental health services to rural residents. To positively impact the financial, psychological, emotional, and spiritual well-being of rural communities by improving retention of healthcare services and revenues.

Outcomes Expected/Project Accomplishments:

Attain financial, strategic, and operational synergies (measure) - financial data, retention and turnover rates, budget comparisons (tool). Expand clinical and education capabilities of Network (measure) - participant evaluations (tool). Reduce costs of providing specialty and mental health services (measure) - archival data comparison (tool). Positively impact well-being of communities (measure) - comparative data for financial, participant satisfaction surveys for psychological, emotional, and spiritual (tool).

Service Area:

Benefis Healthcare, Center for Mental Health, Sletten Cancer Institute (Cascade); Fort Belknap Service Unit, Sweet Medical Center, Sweet Memorial Nursing Home (Blaine); Big Sandy Medical Center, Missouri River Medical Center (Chouteau); Liberty County Hospital (Chester); Teton Medical Center (Teton); Pondera Medical Center (Pondera); Northern Rockies Medical Center, Blackfeet Community Hospital (Glacier); Chippewa Cree Health Center, Northern Montana Healthcare (Hill); Phillips County Hospital (Phillips); Mountainview Medical Center (Meagher), Marias Medical Center (Toole).

Services Provided:

The REACH Network currently provides services including CME for credit, professional development (non-credit), mental health consults, pre-surgery education, genetic counseling, educational programming, and the clinical service of teleradiology (limited). Intend to expand teleradiology and include telepharmacy and other clinical services such as oncology, cardiology, dermatology, and pediatrics.

Equipment:

All fourteen REACH sites use Polycom equipment, either FX view stations or VSX-series units. Most sites use Sony video monitors, with a few sites using Sharp Aquos monitors.

Transmission:

The REACH network uses a private (full, dedicated) T-1 based network to provide IP (Internet protocol) connectivity to the 14 REACH sites. The network uses a Polycom Accord MGC100 bridge, which allows video conferencing at a speed of 384kbps.

Network Partners:

Not applicable.

Project Purpose:

Consists of two separate research studies. 1.) Medication Errors Study: to determine: a.) systems irregularities that lead to increased medication errors during hospitalization and upon discharge home; b.) to determine effect of computerized inpatient pharmacy system on these errors; c.) use of inpatient nurse case managers to reconcile medications during acute hospital stay. 2.) Quality Measures Pilot Study: to determine: a.) effect of computerized Disease-specific Registries on providers' adherence to best practice guidelines in managing congestive heart failure, acute myocardial infarction, and bacterial pneumonia; b.) effect these Registries have on the health care system's ability to monitor quality and improve operational efficiencies.

Outcomes Expected/Project Accomplishments:

1.) Medication Errors: a.) demonstrate a significant number of medication errors and discrepancies during care transition, i.e. hospital discharge; b.) inconsistencies in medications patients take at home compared to discharge medications; c.) implementation of CIS will reduce errors during discharge process; d.) improve patient compliance; e.) improve provider knowledge of patient's altered regimen; f.) RN case manager led reconciliation program will reduce provider/RN related errors at discharge. Measurement tools: USP Med MARx program, medical record reviews and patient, family/caregiver interviews. 2.) Quality Measures: demonstrate that CIS will abstract and integrate patient clinical information to generate robust chronic disease registries. Measurement tools: Review of medical records and electronic Disease Registries.

Service Area:

Serves 31 central and eastern Montana counties and 9 northern Wyoming counties. Of the 40 counties: 17 are HPSA designated for Dental; 38 for Mental Health and 22 for Primary Care.

Services Provided:

DBC includes Billings Clinic, Deaconess Hospital, Psychiatric Center, Welch Heart Center, Cancer Center, Wellness Center, Orthopedics & Sports Medicine and the DBC Foundation. The DBC Heights, DBC West, The Wellness Center and Aspen Meadows Retirement Community and Nursing Home. DBC has ten regional clinics and affiliate relationships with eight regional hospitals.

Equipment:

Utilizes Eastern Montana Telemedicine Network's videoconferencing using V-Tel TC 1000 and Polycom View Station. Cerner Integrated Clinical Information System (CIS).

Transmission:

Dedicated T1 running at 384kbps for videoconferencing, PRI ISDN for off-network videoconferencing, DSL for desktop videoconferencing.

Network Partners:

Billings Clinic, Billings Clinic Heights, Billings Clinic West in Billings, Montana; Cody Clinic in Cody, Wyoming; Columbus Clinic in Columbus, Montana; Forsyth Clinic in Forsyth, Montana; Miles City Clinic in Miles City, Montana; Red Lodge Clinic in Red Lodge, Montana.

Project Purpose:

Improve the care for diabetes patients of all ages in our service area by focusing on two specific projects: (1) consolidating the pediatric diabetes services into one identified area; and (2) improving the quality of diabetes care by modifying office practices and continuing the development of a diabetes registry to provide quantitative data for diabetic patients of all ages.

Outcomes Expected/Project Accomplishments:

Improve the percentage of DM patients who receive HbA1c, cholesterol, nephropathy, foot, eye exams; improve the percentage of DM patients who are as well controlled for HbA1c, blood pressure, and cholesterol; improve the percentage of DM patients using aspirin for anticoagulation; improve the percentage of DM patient receiving influenza and pneumonia vaccinations when indicated.

Service Area:

Central and Eastern Montana; northern Wyoming.

Services Provided:

Clinical data repository/electronic medical record, MicroMedics, MedMARx.

Equipment:

Mobile Intel Celeron 800 MHz processor, electronic Medical Administration Record (MAR).

Transmission:

100 Base T backbone, Citrix Terminal Servers, Ethernet 10 Base T.

Network Partners:

The Foundation has teamed with Partners in Homecare effective 10/1/2006 to serve an estimated average census of 80 patients for an estimated 29,000 encounters in a year.

Project Purpose:

1. To expand the existing HomMed system to rural sites and populations;
2. Create an interoperable data collection system for home health patients in the network;
3. To create a telemonitoring network model that can be replicated in other sites;
4. To prove the cost effectiveness of home monitoring systems versus standard models of care.

Outcomes Expected/Project Accomplishments:

• Reduce incidence of acute care admissions of CHF patients;
• Improve access to technology in rural regions;
• Decreased number of home visits and Cost of Care; and
• Improvement of patient's sense of well being and control.

Service Area:

Missoula; Mineral; Granite Counties in Montana.

Services Provided:

Bringing Healthcare Home was established in October 2006 and provides the service area with 30 HomMed remote telemedicine monitoring devices and an integrated home health electronic medical record.

Equipment:

30 Honeywell HomMed telemonitoring devices to be increased to 80 as the grant progresses.

Transmission:

Plain old telephone service to patient homes.

Network Partners:

Northern Rockies Healthcare Network - est. 1995. Marcus Daly Memorial Hospital; St Joseph Hospital; Clark Fork Valley Hospital; Mineral County Hospital; Community Hospital Anaconda; Granite County Medical Center. Others in network: Teton Medical Center; Barrett Hospital; Marias Medical Center.

Project Purpose:

1. To implement a regional cardiac Electronic Patient Medical Record (EMR);
2. To provide digital patient test transference capability at all targeted rural sites;
3. To conduct a Patient Tele-consultation Demonstration as "proof of concept"; and
4. To thoroughly evaluate, report and disseminate results of the MCTN project.

Outcomes Expected/Project Accomplishments:

• Improved Quality and Efficiency of Patient Care (mortality, Guideline Care);
• Successful Patient Teleconsultation Demonstration;
• Decreased Cost of Care; and
• Provider/End-User/Beneficiary Satisfaction will also be measured.

Service Area:

Missoula; Ravalli; Lake; Mineral; Deer Lodge; Beaverhead; Granite; Sanders; Teton; Toole Counties in Montana.

Services Provided:

The MCTN was established in June 2005 and provides the service area with an ECG and Echocardiography network and cardiac electronic medical record. Toole County is also served with a cardiac telemedicine exam service. Mineral & Sanders County are to receive similar telemedicine exam services.

Equipment:

Heart Lab ECG data repository and network tool. 40+ ECG's distributed throughout Western Montana and eastern Idaho. Phillips EnConcert Echocardiology data repository and archiving system. General Electric Vivid Echocardiology equipment.

Transmission:

T1 lines or multiples or fractions of T1 lines depending on development of transmission infrastructure.

Network Partners:

The Mansfield Health Education Center (MHEC) is a state of the art-high tech conference center available for educational, training, or telehealth telecommunications use statewide, nationally and internationally. MHEC provides telehealth activities such as grand rounds for pathology and radiology physicians.

Project Purpose:

To provide the cornerstone for health education and conferencing programs regionally, expanding to national and international health education programs; to provide a venue for healthcare forums addressing current local, national and international issues regarding the state of healthcare. MHEC deploys video telecommunications to extended community areas, providing access to high speed Internet services, store and forward technology, satellite education and two way videoconferencing.

Outcomes Expected/Project Accomplishments:

Outcomes include increased educational programs improving public information about health topics and increased educational opportunities. Health Library consumers have access to a library that is centrally located in the medical corridor. Increased space in the Library provides better services to consumers with a private area for family consultation, and access to HIPAA compliant computer terminals and training materials. Evaluation consists of Customer Service Surveys.

Service Area:

The Mansfield Center provides health education and training services to the whole state of Montana, but the primary service area is the area served by St. Vincent Healthcare, a regional tertiary care center. That area consists of 28 counties in south-central Montana; and 2 counties in Wyoming. All or part of the 28 counties served by St. Vincent are designated as HPSAs/MUAs, Mental Health shortage areas and Dental Shortage Areas, with the exception of Fergus County (Lewiston).

Services Provided:

The Mansfield Center was completed in November of 2003. Telehealth services have been provided for grand rounds by the Pathologists and Radiologists. The Partners in Health Telemedicine Network uses the center for ongoing education and training for network sites and physicians as they develop telehealth services which include orthopedics, mental health, dermatology, radiology, pediatrics, Perinatology, congestive heart failure, administrative and education. PHTN has been in existence since 1998.

Equipment:

PolyCom Video Codecs from IP based Via Video to FX and Custom VS4000 room systems, VCONN Executive IP systems, Accord Polycom MGC 100 MCU that performs audio, ISDN, and IP video bridging and data collaboration services, Panasonic 3 CCD Cameras, and AMD General Exam cameras.

Transmission:

Standardized delivery at 12 channels, @ 64 Kpbs over leased T1 lines, microwave wireless, cellular and IP based transmission services.

Network Partners:

The Northwest Regional Telehealth Resource Center (NRTRC) is a region-wide (eight state) consortium of healthcare organizations and educational institutes. St. Vincent Healthcare Foundation, located in Billings, Montana, is the recipient and fiscal agent for the project and INHS in Spokane, Washington is the operations center. NRTRC promoted a "best practices" approach to telehealth service delivery in the Northwest.

Project Purpose:

To ensure that Federal and state investments in telehealth programs are effectively used through collaborative growth and opportunity development; to promote effective delivery of telehealth services through sharing of information and leveraging of developed resources across multiple telehealth systems; and to assist in the development of new telehealth programs through expertise sharing and organized technical assistance in a peer based, non-competitive, objective environment.

Outcomes Expected/Project Accomplishments:

The NRTRC will help provide improved access to healthcare by enhancing the clinical care programs available to rural communities via telehealth. These programs include access to specialists for clinical consults, ongoing care management programs to support individuals with chronic conditions, and enhanced emergency care through programs that connect emergency room specialists with providers in rural hospitals.

Service Area:

The Northwest Regional Telehealth Resource Center (NRTRC) represents 8 northwest and western states (Alaska, Hawaii, Idaho, Oregon, Montana, Utah, Washington, and Wyoming, as well as the six island groups in the U.S. Affiliated Pacific Islands). NRTRC assists healthcare organizations, networks, and providers implementing cost-effective telehealth programs serving rural and medically underserved populations.

Services Provided:

The NRTRC will collect and disseminate shared resources as well as coordinate and manage projects, activities, communications, meetings, marketing, and advocacy. NRTRC will develop cross-state expertise groups led by regional content experts and focused on specific issues including: Regulatory Issues (licensing, credentialing); Technical Issues and Interoperability; Clinical Delivery Models; Content Development and Distance Education; Evaluation; Business Models; Marketing; and Disaster Planning.

Equipment:

PolyCom Video Codecs from IP based Via Video to FX and Custom VS4000 room systems, VCONN Executive IP systems, Accord Polycom MGC 100 MCU that performs audio, ISDN, and IP video bridging and data collaboration services, Panasonic 3 CCD Cameras, and AMD General Exam cameras.

Transmission:

Standardized delivery at 12 channels, @64 Kbps over leased T1 lines, microwave wireless, cellular, and IP based transmission services. Segmentation of circuits for voice/video or data provided for more cost effective utilization.