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September 2015 
HTRC's monthly telehealth bulletin

Heartland Telehealth Resource Center is here to meet your telehealth needs. We are a government-sponsored organization serving Kansas, Missouri and Oklahoma, with a wide range of services, and many of them are free. Email us at or call us at 877-643-HTRC.

Telehealth Straight Talk: FaceTime lets INTEGRIS offer patient care anytime, anywhere

With more people using real-time video platforms like FaceTime to communicate, INTEGRIS Health recently began using this technology to offer convenient care to Oklahomans no matter where they are.
Through INTEGRIS Virtual Visit, patients can connect with a health care provider anytime, anywhere via any web-integrated device. That includes mobile smartphones, tablets, computers, TVs and other connected devices. Patients have a choice to connect their devices through several videoconferencing software apps, although the app FaceTime is the most popular platform with 65 percent of patients using it to connect with a provider on Virtual Visit.
While getting care is convenient, patients can rest easy knowing that their care visits are secure and private. Carena, the company behind the Virtual Visit software, built HIPAA security and privacy requirements into their product and also provides the technical support and staff to run the virtual visits.

In their seven months of offering virtual visits, INTEGRIS has received a 94 percent satisfaction score from the nearly 500 patients who have used the service. It's shown to not only be convenient for patients, but also a great way for them to set up continuing care with providers.
Screen shot from INTEGRIS Virtual Visit
"Our service is not at all to replace your primary care physician," said Tina Mathes, INTEGRIS Retail eHealth Program Manager. "It is the continuing of care for after hours, it's to reduce those ER visits. This is another option for them... About 60 to 70 percent of people who do use the service do not have a primary care physician, and our goal at the end of that virtual visit is to help them establish care with a primary care physician. Providers are really starting to see that."

September 23-25
Lawrence, Kan.

The 2015 Kansas Association for the Medically Underserved (KAMU) conference will take place in Lawrence, Kansas from September 23-25. New to the conference are unique peer learning sessions where health care administrators gather in either CEO, CFO, COO or clinician/IT peer learning groups to foster learning and dialogue. HTRC and the University of Kansas Center for Telehealth and Telemedicine will be on hand to answer any questions relating to telehealth and the medically underserved. Check us out at our booth in the exhibition hall.

Salina Regional to expand telehealth program

Salina Regional Health Center (SRHC) of Salina, Kan. recently announced plans to scale up their pilot telehealth program, expanding services to other specialties and to 14 distant sites. But if there's one thing Kelsey Blackburn, SRHC system referral coordinator has learned, it's that it can take a lot of coaching to get staff on the same page.
As Blackburn noted, it's important to get all staff onboard in the early stages. Not only do physicians have questions about how comprehensive the care can be via telemedicine, but other staff from IT and accounting services often have questions about the changes the new service will bring.
To get physicians onboard, Blackburn relied on research from Heartland TRC's Janine Gracy. Gracy shared a number of case studies from Heartland TRC's service areas in Kansas, Missouri and Oklahoma that demonstrate the benefits and outcomes of telemedicine services. "You bring in those facts and those figures to a physician and they are at least more likely to hear what you're saying," Blackburn said.
For hospitals wanting to implement telemedicine services, Blackburn advises telemedicine supporters to be aware and prepared for potential apprehension and concern. "You have to be prepared for those who are going to disagree with you. You' re going to have to be there with facts and figures. [And show] this has worked before, this is where it has worked and this is how it can work for us."

For assistance scaling up your telehealth program, contact HTRC at 877-643-HTRC. 
University of Missouri mHealth innovations make news

App helps patients with depression, psychiatrists manage mood, activity levels
Developed by University of Missouri researchers, MoodTrek is an app that allows patients struggling with depression to log their moods, sleep patterns, and activity levels. Unlike traditional handwritten mood logs, the app lets patients record their data on their smartphones and share it with psychiatrists in order to track progress between visits. These data then help psychiatrists provide better care. Users are also linked to the National Suicide Prevention Lifeline for patients in crisis. The app is free for download on Android devices. Apple versions will be available in the future.
Many assisted living facilities and hospitals in Missouri and across the nation offer monitoring systems for residents to manage patients' care while also offering peace of mind to family members who may live far away from loved ones. Now a team from University of Missouri's Sinclair School of Nursing and the College of Engineering has created a new wireless sensor system that provides round the clock monitoring of residents' health, and can actually predict health problems or falls before they happen. A series of sensors monitors patients' vital signs and sleep, and movement sensors use patients' silhouettes to evaluate movement and gate. Based on these data, researchers are able to calculate residents' risk of falling, as well as detect other health problems in advance--up to ten days before patients feel themselves falling ill. Currently the sensor system is being piloted in a few private homes and is hoped to expand in the future.


Enhanced nurse licensure compact increases patients' access to care

Telehealth is a tool that helps nurses and other providers reach patients. But regulations can get tricky, especially when care reaches across state lines.  In an effort to improve access and continuity of care, the National Council of State Boards of Nursing (NCSBN) is mounting a renewed effort to eliminate that barrier through their enhanced Nurse Licensure Compact (NLC) and development of an Advanced Practice Registered Nurse (APRN) Compact. The compacts would allow nurses and APRNs to hold one multistate license, permitting them to practice in their home state and other compact states.
The Robert J. Waters Center for Telehealth and E-Health Law (CTeL) recently hosted a webinar to discuss revisions to the Nurse Licensure Compact (NLC). If you missed that webinar, here are six things you need to know:
  1. The 24 states that passed the original version of the NLC will need to pass updated legislation to adopt the enhanced Nurse Licensure Compact.
  2. Nurses who already held a multistate nursing license in their home state will be grandfathered in under most circumstances.
  3. The enhanced NLC has clear requirements for licensure, dispute resolution and termination from the compact.
  4. State licensing boards must have authority to do background checks on applicants. A couple of the states that signed the initial compact were unable to obtain this power through the legislature, so it has been added as a requirement for joining.
  5. The enhanced compact will create the Interstate Commission as a governing body. Rules adopted by the Commission will be legally binding in all member states, a process modeled in more than 100 other interstate compacts, including state drivers' licenses. All proposed rules will be open for public comment.
  6. The NCSBN aligned key provisions of the enhanced NLC and the APRN Compact in order to streamline the approval process for state boards of nursing.
The APRN compact also contains a few provisions that are distinct from the NLC. These distinctions include provisions on prescribing authority for all non-controlled prescription drugs. Since it is itself a new compact, the APRN compact will need ten states to join in order to go into effect. Eligible states must be full practice - meaning there is no requirement for physician supervision.  
State legislatures will begin considering the new compact in January 2016 and states will have about three years to pass the new legislation.
To learn more about the timetable please see the CTeL webinar. For more information and resources on the enhanced nurses licensure compact email the NCSBN at

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