SPS 2018 Program SPS 2018 Program | Page 46

Conclusions: This connectivity helps the patient and provider to overcome obstacles in healthcare. Geographic, financial, and time constraints are just a few obstacles as well as lessening the added stress of travel and missing work for the patient. The healthcare provider is offered added support as well from a highly trained specialist that they may not be able to access in the smaller rural setting. An extra set of eyes and ears is on the scene to assess and consult within real time situations. 21) Comparison of Pharmacist Managed In-Person and Telehealth Warfarin Clinic Outcomes Michael Pham, PharmD and Laura Moore, PharmD North Country HealthCare Background: Warfarin is an oral anticoagulant used for the prevention of thromboembolism and requires frequent monitoring due to a narrow therapeutic window. The use of warfarin in rural communities has been complicated by a lack of access to consistent and timely monitoring. Through telehealth anticoagulation appointments, patients from rural communities are able to have more frequent monitoring by pharmacists. Methods: The electronic medical records (EMR) of patients on warfarin enrolled at the NCHC on-site anticoagulation clinic in Flagstaff, AZ was compared to the EMRs of pharmacist managed telehealth patients on warfarin at NCHC satellite clinics. The primary outcome measured the time-in-therapeutic-range (TTR) using the Rosendaal method. The secondary outcome compared the TTR of physician-managed pa tients at NCHC Williams satellite clinic versus TTR of pharmacists managed telehealth patients at NCHC Williams satellite clinic. Results: The average TTR for patients managed by pharmacist in-person at Flagstaff was 70.55% (N=82) while the average TTR for patients managed by pharmacist through telehealth was 58.98% (N=35, Williams), 63.04% (N=4, Winslow), 63.09% (N=6, Ashfork), and 50.60% (N=7, Seligman). Patients who were managed by their providers had an average TTR of 51.99% (N=27, Williams). Patients who were seen in-person (Flagstaff) had a statistically significant higher time in therapeutic range than patients who were seen through telehealth at the Williams clinic (p-value 0.0091). However, there was no statistically significant difference of TTR seen between in- person appointments (Flagstaff) with telehealth patients from other clinics. There was also no significant difference between TTR of physician managed patients compared with pharmacist managed telehealth patients at the Williams clinic. Conclusions: Patients who were managed in-person by a pharmacist had a higher TTR than patients who were managed by pharmacist through telehealth. Also patients managed by pharmacists via Telehealth at Flagstaff, Williams, Winslow, and Ashfork had a higher average TTR than patients managed in person by their providers. 46 | Telemedicine Telehealth Service Provider Summit 22) Optimizing Behavioral Health Services in Long-Term Care with Scalable Telemedicine Christopher Pick Deer Oaks – a behavioral health company Specialty medical services can be challenging to deliver in institutional settings. A study in the American Journal of Preventive Medicine finds that a majority of non-metropolitan counties (65%) do not have a psychiatrist and almost half of non-metropolitan counties (47%) do not have a psychologist. Based on current CDC statistics for nursing home residents, over two-thirds suffer from behavioral and mental health disorders, 37% suffer from depression which can lead to suicide, and over 50% from Alzheimer’s or other dementias. Behavioral health conditions influence many comorbid conditions, immune and cardiac functions, susceptibility to infection, asthma and recovery time. Integrated, or partial behavioral health services for residents are scarce with more than 30% of nursing homes in non-metropolitan areas. As the nation’s leading provider of behavioral health services to long-term care communities, Deer Oaks serves over 1,400 long term care facilities across 27 states, serving over 10,000 senior adults. Known for consistency, clinical efficacy and Sponsor