As the CMIO of Cherokee Nation Health Services, James Stallcup, M.D., is always looking for ways to implement technology at low costs.
"If you are a CMIO who does not want to consume expensive products, you will be very popular at your organization," he quipped to the audience during a talk at WEDI-Con on Tuesday in Reston, Virginia.
The Oklahoma integrated health system wanted to implement telemedicine, but Stallcup said he wanted something that would be "ubiquitous."
At the time, Cherokee Nation was awarded telemedicine equipment, however, the systems were big and cumbersome, he said. So instead, the facility went with a cheaper, simpler option--a camera and microphone that can be hooked up to a computer through a USB cord.
The health system used the devices to connect and communicate in many different ways. One of those ways that Stallcup highlighted was the devices' ability to help patients see a psychiatrist.
It was difficult for the system to get a psychiatrist to work at the facility, because of a combination of factors such as location of the facility and number of available psychiatrists. However, there was one psychiatrist in Iowa who really wanted to work for Cherokee Nation but didn't want to move, Stallcup said.
The solution: Telemedicine.
"It was a huge leap of faith for a system to embark on this kind of thing. He sees patients exclusively through telemedicine. This is true distance telemedicine," he said.
However, the road to success was not without some hiccups. Stallcup says before embarking on a similar effort, organizations should keep the following in mind:
- Prescription handling is difficult, so get a a plan in place ahead of time. Use e-prescription of controlled substances before implementing your program, he said.
- Create an outline of what to say to the patient once he or she arrives in the room with the telemedicine equipment.
- Establish a "very clear downtime process" in the event the system goes down, he said.
- Don't automatically assume that elderly patients aren't willing to obtain treatment via telehealth, he said. "The elders who do this, they rank it just as high as everybody else, there's not that digital divide."
- Make sure any provider who's working with you remotely feels involved and a part of the team. "You can kind of alienate them and just say 'oh we made this change' and 'oh we did this' but people need to be involved."