219268 Telehealth in a post-Katrina Gulf Coast - An ethnographic study

Wednesday, November 10, 2010 : 9:10 AM - 9:30 AM

Thomas J. Kim, MD, MPH , Regional Coordinating Center for Hurricane Response- NCPC, Morehouse School of Medicine, Atlanta, GA
Martha I. Arrieta, MD, MPH, PhD , USA Center for Healthy Communities, University of South Alabama, Mobile, AL
Sasha L. Eastburn, JD , Center for Healthy Communities, University of South Alabama, Mobile, AL
Michelle L. Slagle, PhD , Center for Healthy Communities, University of South Alabama, Mobile, AL
Azizeh Nuriddin, MPH , Division of Emergency Operations, OPHPR, Centers for Disease Control and Prevention, Atlanta, GA
Katrina M. Brantley, MPH , Regional Coordinating Center for Hurricane Response, Morehouse School of Medicine, Atlanta, GA
Rachel D. Foreman, BS, MA , 720 Westview Drive SW, Morehouse School of Medicine, Atlanta, GA
Marjorie Icenogle, PhD , Department of Management, University of South Alabama, Mobile, AL
Ayanna Buckner, MD, MPH , Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA
BACKGROUND. Since 2005, the Regional Coordinating Center for Hurricane Response (RCC) has engaged multiple collaborative partners, including the University of South Alabama (USA) towards developing autonomous and sustainable telehealth (TH) delivery models, with a focus on mental health services. To date, these models demonstrate varying levels of maturity and success. OBJECTIVE. This study sought to identify the processes and strategies, which led to successful TH engagement, implementation, and operation. This study also sought to identify barriers impacting TH success. METHODS. This qualitative, ethnographic study identified TH Key Informants (KI) among regulators, advocates, program administrators, technology experts, mental health providers and support personnel. Transcripts of recorded interviews were independently coded by three researchers using qualitative analysis software. Subsequent analyst discussions led to consensus in the interpretation of each transcribed interview. Results were summarized and returned to KI for validation. RESULTS. The 37 KI participants identified eight major elements and 20 key areas critical to TH development, as follows: funding (sources, sustainability), policy and regulation (reimbursement, licensure, liability), organizational workflow (policies, procedures, scheduling), administrator and staff attitudes (“Buy-in”, need for “champions” that convey enthusiasm and interest to staff), staffing (recruitment, training, appropriate time allocation), technology (hardware, connectivity, support), patient issues (comfort with technology, quality of service), and evaluation (metrics, methodology) CONCLUSIONS. Successful implementation of TH programs hinges on administrative commitment, adequate support, effective operational guidelines, appropriate implementation, and buy-in from all stakeholders.

Learning Areas:
Administration, management, leadership
Program planning
Provision of health care to the public

Learning Objectives:
1. Assess eight major elements and related key areas critical to telehealth development 2. Discuss challenges relative to the implementation of telehealth programs

Keywords: Telehealth, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: my role as the Telehealth Project Manager for the Regional Coordinating Center for Hurricane Response at Morehouse School of Medicine...the organization responsible for telehealth model development and assessment in the Gulf Coast since 2005.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
athenahealth Physician Advisor Consultant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.