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March 16, 2012
Heather M. Linn, MD
Board Certified Neurologist
University of Texas Medical Branch
Clinical Neurophysiology Fellow, Baylor College of Medicine

Currently a full time Teleneurologist for Specialists On Call
•   Provide 24/7 neurology on-call, now psychiatry on-demand to more than 180
    hospitals in 21 states
•   Support emergency departments, hospitalists, ICU’s
•   Heavy emphasis on quality:
               – Doctors - over 55 neurologists
               – Practices, processes & protocols – 15 minute guaranteed response
               – Technology – FDA approved, encrypted and HIPAA Compliant
               – Joint Commission Accredited - since May 2006
•   Unique business offering and pricing model for hospital clients
•   3 of the top ten university neurology departments in U.S. collaborate with & take call
    for SOC

•   More emergency neurology consultations than any traditional provider, >40K

•   More acute stroke consultations than any tertiary institution

•   More tPA administered than any institution worldwide (2X)

•
Cost, quality, patient satisfaction all suffer in the absence of effective
on-call coverage

                                                       Stipends are growing as a
                                                       burden to systems

                                         Underserved no longer
                                         means just ‘rural’


                    Demand for specialty
                    consults is increasing


          Specialty physician shortage
          is increasing


 Call coverage is increasingly
 punitive & undesirable
Teleneurology is the delivery of remote consultative services
for any neurologic emergency via a telemedicine platform that
includes the following:

•   100% Secure Network with Dual Redundancy
•   High Definition Video End Points with Stereo Audio
•   PACS
•   EMR
•   24/7/365 Live Technical Support
•   Operational Support (scheduling, licensing & credentialing)
•   Strict Clinical Protocols
•   Dedicated Team of Neurologists
•   Attractive Physician Compensation
Teleneurology is clinically effective and viable as a service
because it’s comprehensive.

Telestroke is an empty proposition due to its limitations.

•   It doesn’t answer the question “Is this a stroke?” and telestroke
    protocols are typically for established stroke patients.

•   It fails to relieve the need for local neurology on-call coverage.

•   It’s employed primarily as a referral-grabbing tool.
Annual Clinical Recommendation Profile
Non Stroke Neurologic        Non-tPA Stroke or TIA
tPA Recommendation           ICH Recommendation
                6%      3%

                                  32%




         59%
•   Anoxic Brain Injury           •   SAH
•   Bell Palsy                    •   Seizure
•   Demylenating Disease          •   Syncope
•   Encephalopathy                •   Transient Global Amnesia
•   Hypertensive Encephalopathy   •   Trauma/TBI
•   Migraine/Headache             •   Tumor
•   Other                         •   Vestibulopathy
•   Psychogenic
•   Allows hospitals to treat stroke patients with confidence & clinical
    consistency
•   Eliminates EMS diversions
•   Reduces unnecessary patient transfers
•   Satisfies staffing requirement for Primary Stroke Center
    certification
•   Supports ER staff & improves department efficiency
•   Provides a competitive advantage in local marketplace
•   Relieves the burden of on-call coverage for local neurologists
•   Serves as a recruiting advantage for physicians
Why Georgia remains a member of the “Stroke Belt”
•     9,829,000 total state population
•     21% of state population is over 55 years old
•     29% of state population have known stroke risk factors
•     53% stroke mortality rate
•     22 Primary Stroke Centers
•     343 neurologists in state
•     28,656 to 1 ratio of patients to neurologists



* Figures provided by US Census Bureau, Robert Wood Johnson Foundation Obesity Report, American
    Stroke Association, SK&A Specialty report
How to implement a successful Teleneurology program:
•   Don’t get caught up in the technology – the equipment is
    secondary to the clinical care being imported

•   It’s not a “Do It Yourself” project – a successful teleneurology
    program takes resources, infrastructure and dedicated physicians

•   Establish your goals & communicate them to all stakeholders

•   Make sure local neurologists are on board with the program

•   Market your new teleneurology capabilities in your community
•   Opportunity to treat the patients who need help the most
•   Part of an innovative company that’s expanding medicine’s
    overall reach & effectiveness
•   Member of an exceptional physician team that is defining
    the very highest clinical standards possible for
    teleneurology
•   Enjoy work/home balance
Teleneurology Today

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Teleneurology Today

  • 2. Heather M. Linn, MD Board Certified Neurologist University of Texas Medical Branch Clinical Neurophysiology Fellow, Baylor College of Medicine Currently a full time Teleneurologist for Specialists On Call
  • 3. Provide 24/7 neurology on-call, now psychiatry on-demand to more than 180 hospitals in 21 states • Support emergency departments, hospitalists, ICU’s • Heavy emphasis on quality: – Doctors - over 55 neurologists – Practices, processes & protocols – 15 minute guaranteed response – Technology – FDA approved, encrypted and HIPAA Compliant – Joint Commission Accredited - since May 2006 • Unique business offering and pricing model for hospital clients • 3 of the top ten university neurology departments in U.S. collaborate with & take call for SOC • More emergency neurology consultations than any traditional provider, >40K • More acute stroke consultations than any tertiary institution • More tPA administered than any institution worldwide (2X) •
  • 4. Cost, quality, patient satisfaction all suffer in the absence of effective on-call coverage Stipends are growing as a burden to systems Underserved no longer means just ‘rural’ Demand for specialty consults is increasing Specialty physician shortage is increasing Call coverage is increasingly punitive & undesirable
  • 5. Teleneurology is the delivery of remote consultative services for any neurologic emergency via a telemedicine platform that includes the following: • 100% Secure Network with Dual Redundancy • High Definition Video End Points with Stereo Audio • PACS • EMR • 24/7/365 Live Technical Support • Operational Support (scheduling, licensing & credentialing) • Strict Clinical Protocols • Dedicated Team of Neurologists • Attractive Physician Compensation
  • 6.
  • 7. Teleneurology is clinically effective and viable as a service because it’s comprehensive. Telestroke is an empty proposition due to its limitations. • It doesn’t answer the question “Is this a stroke?” and telestroke protocols are typically for established stroke patients. • It fails to relieve the need for local neurology on-call coverage. • It’s employed primarily as a referral-grabbing tool.
  • 8. Annual Clinical Recommendation Profile Non Stroke Neurologic Non-tPA Stroke or TIA tPA Recommendation ICH Recommendation 6% 3% 32% 59%
  • 9. Anoxic Brain Injury • SAH • Bell Palsy • Seizure • Demylenating Disease • Syncope • Encephalopathy • Transient Global Amnesia • Hypertensive Encephalopathy • Trauma/TBI • Migraine/Headache • Tumor • Other • Vestibulopathy • Psychogenic
  • 10. Allows hospitals to treat stroke patients with confidence & clinical consistency • Eliminates EMS diversions • Reduces unnecessary patient transfers • Satisfies staffing requirement for Primary Stroke Center certification • Supports ER staff & improves department efficiency • Provides a competitive advantage in local marketplace • Relieves the burden of on-call coverage for local neurologists • Serves as a recruiting advantage for physicians
  • 11. Why Georgia remains a member of the “Stroke Belt” • 9,829,000 total state population • 21% of state population is over 55 years old • 29% of state population have known stroke risk factors • 53% stroke mortality rate • 22 Primary Stroke Centers • 343 neurologists in state • 28,656 to 1 ratio of patients to neurologists * Figures provided by US Census Bureau, Robert Wood Johnson Foundation Obesity Report, American Stroke Association, SK&A Specialty report
  • 12. How to implement a successful Teleneurology program: • Don’t get caught up in the technology – the equipment is secondary to the clinical care being imported • It’s not a “Do It Yourself” project – a successful teleneurology program takes resources, infrastructure and dedicated physicians • Establish your goals & communicate them to all stakeholders • Make sure local neurologists are on board with the program • Market your new teleneurology capabilities in your community
  • 13. Opportunity to treat the patients who need help the most • Part of an innovative company that’s expanding medicine’s overall reach & effectiveness • Member of an exceptional physician team that is defining the very highest clinical standards possible for teleneurology • Enjoy work/home balance

Notas del editor

  1. From Joe: SLIDE 1   What we’ll cover today   The world we likely share with you   Who are we & what we do   Benefits of our service   How we deliver quality care with teleneurology   Our client experience   How we cost you nothing   Next steps & moving forward From Elliott – Remove Our Mission. Remove the small brain symbols. Use bullets. Add “What do we do” under Who are we Replace How we ….with “The Process of Delivering Quality Care Through Tele-Neurology” Add “Our Clients Experience: after “how we…” BUILD EACH POINT.
  2. Summary of Discussion – Sample Graphic