南卡罗来纳州的虚拟解决方案状况.pdf

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1、Marc Heincelman,MD,MPHAssociate Professor of Medicine,MUSC Charleston Division Chief of Hospital Medicine(Panelist)Shay McLeod,MSN,RNNurse Manager,Acute Services,MUSC Center for Telehealth(Panelist)Melanie Waggener,BSN,RNChief Nursing Officer,Hampton Regional Medical Center(Panelist)Dunc Williams,PH

2、D,MHA Associate Professor,MUSC College of Health Professions(Moderator)This presentation was made possible by the Health Resources and Services Administration(HRSA)of the US Department of Health and Human Services(HHS)as part of the National Telehealth Centers of Excellence Award(U66RH31458)Vision i

3、s to preserve and optimize human life in South Carolina and beyondMUSC Health Charleston is the states only comprehensive academic medical center32%of South Carolina residents(1.6 million)live in rural areas11 hospital located in Charleston,SC800-bed academic medical center6 formal affiliates If we

4、are truly the Medical University of South Carolina,as opposed to Charleston,growth is absolutely needed to achieve our visionMUSC Health:9 hospitals within 4 regional health networksMultiple additional formal affiliates Rural hospitals are closing Rural hospitals make up 35%of all hospitals in the U

5、S2 192 rural hospitals closed between 2005-20232 4 hospital closures in South Carolina 10%of physicians practice in rural areas2 Outmigration and/or bypassing of the local rural hospitals to bystander hospitals remains problematic and impacts a communitys access to healthcare and the long-term busin

6、ess viability of the city3 Rural hospitals supported 1 in 12 rural jobs in the US in 2020230-bed rural,community hospital in Varnville,SC that opened in 1950New building developed in 20084Primarily serves patients of Hampton and Allendale Counties,ranked 43rd and 46th out of 46 counties respectively

7、 in SCs County Health Outcomes report5HRMC located in close proximity to 2 SC counties that experienced hospital closures over last decadeHRMC is one of the largest employers in the region resulting in a significant economical impact to the region if closed85%of its residents receive inpatient medic

8、al care outside their home facility resulting in 30-40%occupancy rate4ADC 8 patients2019-HRMC loses its hospitalist providerGoal:Concerted partnership between HRMC and MUSC to provide a sustainable care delivery model for HRMC and ensure important healthcare is delivered within the communitySC Dept

9、of Health and Human Services FundingMUSC hospital medicine physicians partnering with onsite HRMC APPs to provide coverage of all admitted patientsTele-hospitalist requirements:Daily videoconferencing on all new admissions and ICU patients Additional videoconferencing available prn based on clinical

10、 scenario24/7 pager coverage for any acute issuesProviding MUSC physician coverage reassures local community they are receiving high-quality evidence-based medicine and instills confidence to stay locally at HRMCTele-consultation services:infectious disease,neurology,nephrology,psychiatry,and critic

11、al careHRMC EHR:MeditechVideo Conferencing Platform:TeladocVideo Conference Vehicle:Telehealth Cart Center for Telehealth Over 100 unique telehealth services Nearly 350 sites across South Carolina 40+hospitals,90+schools,100+community clinics and other facilities Most sites are in partially or fully

12、 medically underserved areas National Telehealth Center of Excellence(COE)HRSA designated MUSC as one of two COEs in 2017 Goal of COE is to fill important gaps in the national telehealth landscape through a combination of ongoing regional and national collaborations,as well as proactive disseminatio

13、n of telehealth resources South Carolina Telehealth Alliance(SCTA)MUSC oversees the statewide strategy and aligned funding for telehealth expansion in SC 4%reduction in outmigration Increase in emergency department admissions to HRMC 24%increase in average daily census Ability to keep sicker patient

14、s locally;increase in case mix index Decrease in 30-day readmissions Ability to support HRMC and community during COVID-19 pandemic1.State-level Urban and Rural Information for the 2020 Census and 2010 Census.2.The Cecil G.Sheps Center for Health Services Research(https:/www.shepscenter.unc.edu/prog

15、rams-projects/rural-health/rural-hospital-closures/).3.Ramedani S,George DR,Leslie DL,Kraschnewski J.The bystander effect:Impact of rural hospital closures on the operations and financial wellbeing of surrounding healthcare institutions.J Hosp Med.2022;17:901906.doi:10.1002/jhm.129614.MUSC Health an

16、d Hampton Regional Medical Center:Hospital transformation and Sustainability Plan.White Paper.June 20195.University of Wisconsin Population Health Institute,School of Medicine and Public Health;Robert Wood Johnson Foundation.(2018).Retrieved from http:/www.countyhealthrankings.org/app/southcarolina/2018/rankings/allendale/county/outc omes/overall/snapshot