Host: Office of Telemedicine, University of Virginia, Charlottesville, Virginia
Moderator: Cynthia Barrigan, RN, MPH, President/CEO, Telehealth Strategies, LLC, Centreville, VA
Attending: Dr. Vladimir Lavrentyev, Virginia Commonwealth University; Dr. Karen Rheuban, University of Virginia Health System; Justin Samson, Castle Technologies, Inc.; Arden Seay, RN, Virginia Commonwealth University
Attending Remotely: Steve Holstein, TeleHealth Strategies; Ted Kummer, Virginia College of Osteopathic Medicine; Kathy Wibberly, Virginia Department of Health; Dr. Jan Wilcox, Virginia College of Osteopathic Medicine
Meeting was convened at 2:00pm with the introduction of participants.
Moderator Cynthia Barrigan, TeleHealth Strategies, advised that she is volunteering with the Virginia Department of Health to chair the meeting and lead any subsequent activities that would come from the meeting.
Ms. Barrigan provided a PowerPoint presentation which highlighted the following:
Meeting objectives were to explore an approach for establishing a charter and action plan for a VTN Clinical Workgroup to complement the existing Infrastructure Workgroup, and to discuss how the Clinical Workgroup could add value in developing an expanded VTN strategy in support of the FCC grant opportunity.
The VTN accomplishments to date were reviewed including the development of a strategic plan
Introduced a five-step work process which the new Work Group could utilize to structure its efforts over the next 30-45 days to prepare for the FCC response as well as for the long-term
Identify VTN primary function – specific mission based on need
Develop a framework by which the function is defined and evaluated
Select specific applications/services
Define the business process and clinical workflows that will support those applications
Based on the clinical and business requirements, define the system’s functional requirements and communicate to the infrastructure workgroup
The group entered into a discussion revolving around the primary function/mission of the VTN and the impact/role that the pending FCC grant opportunity might have on this determination. Towards the later part of the meeting, there was a brief discussion regarding the scope and function of this particular work group.
The group expressed some of the following questions and opinions around three major areas:
More specificity is needed in the clinical/business portion of the VTN Strategic Plan. The plan should be updated and expanded.
The FCC opportunity should not dominate VTN decision-making relative to an over-arching strategy for 2007, but instead, fold into a larger strategy.
Need to find a “nexus” in terms of where VTN intersects with valid needs and other priorities for the Commonwealth. For example, increase awareness and understanding of;
In terms of a Vision, the VTN should be focused on ensuring equity of care across the Commonwealth through enhanced access to health services for the under-served or disenfranchised populations –the concept of “Advanced Access” was raised.
Important missions for the VTN should include;
Advocacy- make progress on key inhibitors that are impacting most of the members’ programs, i.e. reimbursement
Fostering a culture of information-sharing and technology use
Policy development
VTN should support the use of telehealth in a way that integrates or flows into the existing public and private health systems’ business management, policy, and clinical infrastructure vice being an independent component.
VTN benefits must be measurable and tied to metrics relative to health status and/or improvements in the efficiency or effectiveness of the health system. Beware of relying solely on utilization #’s to demonstrate a benefit.
Should the FCC opportunity be used to build upon/strengthen/expand existing business/ clinical relationships that are working well, or be used to forge relationships between new parties or both? The thought was that it probably would be best to keep it simple and leverage existing relationships for purposes of the FCC pilot given the accelerated timeline. However, more information on real-world needs is required to make the final determination.
Do not want to start a program that will stop when the funds run out. The idea is to develop strategies that tie the FCC funds and program into complimentary efforts that support the larger VTN initiative.
Criteria for evaluating/selecting an application area(s) for FCC were discussed.
Critical to find a focus area that is a “lightning rod” for business and political leaders as the first step. This would make the VTN story easier to describe/sell in order to build further support.
Need to choose an “initial” application that is sustainable. Therefore, reimbursement is a serious consideration.
Physical space is a consideration in some locations.
Just because a particular application may have lots of risk, we should not necessarily rule it out but identify and actively work the issues.
Find a way to leverage the Anthem Grant.
A clearer idea of member costs needs to be articulated after an application is selected.
What should the charter be for this work group? Clinical focus only or a broader perspective?
What should be the composition of this workgroup? Should it be comprised of all clinicians and focus purely on clinical requirements? Or given the range of overlapping issues that need to be addressed as functional requirements are identified, should the group be multidisciplinary in nature to better understand the various operational considerations? If so, what domains should be included?
Need to ensure cross-talk with the Infrastructure Workgroup.
No final determination was made regarding the specific activities of this new work group
VTN Strategy
Revisit the VTN Strategic plan’s original vision/mission for “VTN” and craft recommendations to enhance those statements.
FCC Proposal
Consensus was reached to follow the five step process proposed by Ms. Barrigan to structure a work process leading up to the FCC application, and ensure a systematic approach for long-term planning efforts.
The following were actions that align with that process:
Collect and study information relative to the “as is” health care system regarding current relationships and shared services/overlaps to see where short-term opportunities may lie for the FCC pilot.
Conduct needs assessment focused on community health centers to provide insight into clinical requirements and other issues. Contact the Virginia Primary Care Center http://www.vpca.com/Refine a list of evaluation criteria
Work Group Form and Function
Consensus was reached to expand the focus of the workgroup to encompass the spectrum of operational issues, as well as, functional requirements. The following actions are directed towards the formation and functions of the work group.
Draft a charter and detailed work plan focused on a broader “operations” workgroup.
Identify key stakeholders, and expand the membership to include representatives from rural sites.
Ms. Barrigan closed the meeting indicating that future meetings would be held at locations throughout the state and that she would provide meeting minutes. The group agreed to work primarily by email and phone, and hold the next in-person meeting in approximately 2 weeks at VCU.
Meeting adjourned at 4:00 pm.
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