SPS 2017 Program SPS 2017 Program - Page 43

venience with subthemes of i. “less travel time and mileage” with references to significant travel reduction (n= 36), ii. “prompt care” (n=7), iii. “easy-to-use” (n= 6); 3) Confidence with subthemes of i. “complete, comprehensive care” (n= 13), ii. “highly qualified and professional service” (n= 9); and 4) Connection with subthemes i. “my cardiology team” (n= 13), ii. “very personable” (n= 10), and iii. “things were clearly explained to me” (n= 9). Negative commentary was not provided. Conclusions: Veterans using telecardiology found the service substantially satisfactory. The most commonly reported bene- fit was that telecardiology was highly convenient, saving sig- nificant travel time while providing an easy-to-use and prompt service. Confidence in the cardiology medical service accuracy and treatment was expressed. Telecardiology was perceived as professional, personal, and educationally in- formative and Veterans appreciated seeing consistent provid- er teams. Overall, this research provides a conceptual founda- tion for future VA telecardiology patient satisfaction research. 16. General Surgery Consults Via Telemedicine Katie L. George, DNP, MSN, ACNP, RN, CCRN University Physicians Group, University of Virginia Health System Background: There is a lack of surgical care, especially for complex cases, in remote areas. Surgical candidacy can often be determined through complete history taking in combina- tion with imaging, thus avoiding the need for a face to face encounter. Not all patients are surgical candidates, which can be frustrating for patients to hear after extended travel for surgical evaluation. Additionally, telemedicine has repeatedly resulted in high patient satisfaction ratings. Methods: A Telemedicine Surgery Consult pilot protocol was created to offer a telemedicine visit to all patients who lived greater than 60 miles away. The patient was evaluated via telemedicine by either an attending surgeon or the surgery nurse practitioner. To reduce the risk of surgical complica- tions, relative contraindications to surgery included BMI > 35, active smoking, and/or had a HBA1C > 8. In these cases, sur- gery was deferred and resources were provided to help the patient improve his/her health prior to surgery. In mid-2017 provider access to telemedicine was increased through iPad distribution and installation of telemedicine equipment within the surgery clinic. Results: From January 2015 to June 2017 twenty-five general surgery consult patients were seen. A total of 6,174 miles driven were saved. A significant number of patients were una- ble to enroll, as a large telemedicine satellite station was tem- porarily non-operational. 43 | Page Conclusions: This pilot protocol increased access to care for general surgery patients, and anecdotally increased other surgeons’ acceptance of telemedicine. The program continues to expand as additional surgeons, including other surgical specialties, now have easy access to telemedicine capabilities. We expect our telemedicine patient encounters to increase exponentially as provider comfort with the technology in- creases, additional telemedicine satellite locations are estab- lished, and follow-up visits are transitioned to telemedicine. 17. CEP On Duty ® Telepsychiatry Herbert Harman, MD, Richard Newell, MD, Emily Rosendahl, Lauren Sweeney, Tami Longo, Lindsay Kriger, Andrew Smith CEP America Background: The U.S. is currently facing a mental health cov- erage crisis; nowhere is this crisis more pronounced than in hospital Emergency Departments (EDs) where patients regu- larly board for hours or even days before being seen by the appropriate level of care. Often the patient is transferred to an inpatient unit in another facility. Telepsychiatry is a meth- od to increase timely access to care, and promote better out- comes at an affordable price. Methods: CEP America’s Telepsychiatry program provides 24/7 access to board-certified psychiatrists. When a patient comes to the hospital with a mental health crisis, a consult can be ordered on-demand by the ED physician. An experi- enced emergency-trained psychiatrist will then review patient records, and connect with the patient via high-quality, HIPAA secure video. Thorough documentation including medical history, diagnosis, disposition recommendations and plan/ care instructions are made available to the referring physi- cian. Results: From January to May 2017, over 250 patients were seen via the On Duty Telepsychiatry platform from three different hospital locations. Average wait time to see a psychi- atrist is less than 1 hour, and consults last an average of 30 minutes. Only 18% of patients seen via On Duty Telepsychia- try were recommended for inpatient psychiatric care, while 42% were recommended for discharge – much higher than the national average. For those seen while on an involuntary hold, 57% of holds were recommended to be dropped. Conclusions: CEP’s Telepsychiatry program has resulted in faster than average treatment and disposition of mental health patients. As time goes on, we expect this program will show improvement in patient experience, patient throughput, and cost savings.