Ingrid Zimmer-Galler MD, Professor of Ophthalmology at Johns Hopkins Wilmer Eye Institute, and Clinical Director of the John Hopkins Office of Telemedicine, https://hopkinsmedicine.org/telemedicine presented testimony before the recent House Small Business Committee Hearing on “Upskilling the Medical Workforce”.
She presented details on how the Johns Hopkins Office of Telemedicine oversees the building of required technology infrastructure and the integration with EMRs. The office coordinates clinical activities evaluates and advises on relevant research by studying clinical outcomes and the efficiency of telemedicine.
The office staff also works closely with legal, payer, and compliance teams to ensure a coordinated approach to telehealth across John Hopkins Medicine. Another important role for the office is to participate with government affairs at national and state levels to develop policy for telemedicine. Johns Hopkin’s approach to virtual care is to use standardized and scalable methods to create solutions and alternative options to deliver healthcare to the patients.
Telemedicine programs have included over 18,000 total telemedicine encounters and include asynchronous or store-and-forward projects plus live interactive video visits between providers or between a patient and a provider.
Often video visits for specialty care is provided in rural areas. For example patients with hepatitis C living in areas without access to specialists can now receive care in communities in Western Maryland. Also, pediatric specialty care including endocrinology and rheumatology, is now available via video visits to communities on the eastern shore of Maryland.
Dr, Galler discussed examples of other successful telemedicine programs such as programs involving diabetic retinopathy screening. Also, telemedicine is used to do remote screening for Retinopathy of Prematurity (ROP) since there is a lack of available physicians who are able and willing to diagnose and manage the disease.
Addressing the medical workforce issue, the growing successful typical telemedicine medical workforce will need to include several positions:
- Physician Medical Director to act as a liaison for the staff
- Administrative Director to guide the telemedicine team
- Program Coordinator with clinical experience to lead project managers on all aspects of telehealth clinical services
- Project Managers to work with clinical departments to develop workflows and provide support
- Site coordinators at the originating site where the patient is located to serve as the main point of contact and distributor for telemedicine information
- Technology coordinator to serve as the primary contact for hardware and software issues
- Nurse or a staff presenter at the originating site who facilitates the virtual clinic visit and interacts with the remote provider if needed
- Clinical champions in various specialty departments to encourage and support providers new to telemedicine technology
Go to https://smallbusiness.house.gov/calendar/eventsingle.aspx?EventID-2977 to view the transcript from the hearing held November 13, 2019.