SPS 2017 Program SPS 2017 Program - Page 44

18. North Country Healthcare ECHO Provider Experience Colleen Hopkins North Country Healthcare Hepatitis C ECHO- In 2011, North Country HealthCare had over 950 patients with the Hepatitis C diagnosis and limited access to care. Partnering with hepatology specialists Richard Manch, MD and Ann Moore, NP, we joined the cause for the cure through tele mentoring. Weekly video conferences train primary care providers to be experts in treating Hepatitis C. The outcomes are empowering our providers and communi- ties throughout rural northern Arizona. able to be developed all over the state of California with little to no support on grants to continue operating. Conclusions: Arizona legislation and policies will need to be improved in order to maintain teledentistry programs without relying on grant funding. 20. Redesigning the Clinic Visit: Analysis of a Nationwide Asynchronous Virtual Care Program Lisa Ide, MD, MPH 1 , William J. Riley, PhD 2 , Rebecca Hafner- Fogarty, MD 1 , Kevin L. Smith, DNP, FNP, FAANP 1 1 19. Teledentistry in Arizona: Creating Sustainable Programs Through the Im- provement of State Legislation and Policy Scott Howell DMD, MPH, Colleen Trombly MHSA, RDH, Wayne Cottam DMD, MS, Jack Dillenberg DMD, MPH A.T. Still University, Arizona School of Dentistry & Oral Health Background: In 2006, a teledentistry pilot project was devel- oped by the Arizona Office of Oral Health (OOH). It was fund- ed by a Health Resources and Services Administration (HRSA) grant. One finding from this project was that reimbursement for teledentistry services was almost non-existent. Subse- quently, most of the teledentistry programs closed as they were not financially sustainable beyond the grant. In 2015, a teledentistry bill passed in Arizona requiring insurance provid- ers to reimburse for teledentistry services. Also in 2015, the Arizona School of Dentistry & Oral Health received a HRSA grant (#D85HP20045) to develop didactic and clinical teleden- tistry curricula. A primary patient population that would be served by teledentistry is patients with AHCCCS (Arizona Med- icaid). However, current AHCCCS policy does not allow dental providers to be reimbursed for crucial aspects in the delivery of teledentistry, such as exams. This goal of this poster will be to evaluate current Arizona legislation and policy and com- pare it to other states to determine where improvements can be made to allow for sustainable teledentistry programs. Methods: The current Arizona legislation and AHCCCS poli- cies will be compared to other state legislation and Medicaid policies in states with successful teledentistry funding mecha- nisms. Currently, the most robust and sustainable teledentis- try programs are in California. Results: The legislation and policies developed in California are more detailed and comprehensive. These policies, partic- ularly as they relate to reimbursement, have been crafted in a fashion that allow for successful and sustainable teledentistry programs. Subsequently, teledentistry programs have been Zipnosis, Inc., 2 School of Science of Health Care Delivery, Arizona State University Background: The prevailing approach for most episodic, non- emergent patient treatment involves a face to face visit in the clinician's office. Yet, the demand for payment and care deliv- ery reform requires innovative methods to improve health care quality and efficiency. Virtual care is radically transform- ing care delivery; however, its potential impact hasn’t been fully quantified. This study reports the findings of a nation- wide adaptive algorithmic virtual care delivery program for non-emergency conditions. Methods: This study is a five-year longitudinal analysis of a nationwide virtual care program in eleven states used by twenty health care systems. The virtual care platform deploys innovative technology based on a reengineered patient visit. We describe a formative and summative evaluation of key metrics regarding program performance and care quality. Results: We analyzed 49,046 visits for 31 separate clinical conditions treated during the five-year study period. For 2016, the overall average clinician work time was 1.4 minutes, ranging from a low of 59 seconds for epinephrine pen refill to a high of 6.4 minutes for ingrown toenail. The adherence to evidence based practice was 95% for the virtual asynchronous visits. A comparison based on a composite measure using a sensitivity analysis indicated that virtual care visit adherence to clinical guidelines is 61% greater than traditional in-person visits. Further, the efficiency of a virtual setting saved an aver- age of 20.2 minutes per encounter. Conclusions: The findings indicate that in comparison to tra- ditional visits, asynchronous virtual substantially improves clinician efficiency and adherence to evidence based guide- lines for selected conditions. The findings also suggest that virtual care is a key technological innovation to be considered in the pursuit of more convenient access as well as improved efficiency and quality. 44 | Page