Methods : We identified index claim visits for various care sites that fit the scope of practice for Intermountain Connect Care virtual visits ( i . e . sinusitis , urinary track infection , bronchitis , etc .) that took place between over a year period ( April 1st 2016 to March 30 , 2017 ). The total cost of care included all claims within 21 days after an initial index visit , including provider visit cost , lab , imaging and prescription costs . We excluded patients with a Deyo-Charlson Comorbidity Index ( DCI ) greater than 2 , given the difficulty in associating visits within 21 days with the index visit reason . We also restricted the study to members who joined at least 6 months prior to the index visit and remained at least 3 weeks after the study period .
Results : This study will be completed in July so results are not yet available .
Conclusions : The study will be completed in July so results are not yet available .
24 . Usage Assessment of Interactive Case Simulation Tools in a Statewide Clinical Education Program
David Lukacs , Venkata Sunil Nekkanti , MS , Dongwen Wang , PhD
Arizona State University , Biomedical Informatics
Background : Interactive case simulation tools ( ICSTs ) are important online resources developed by the New York State HIV-HCV-STD Clinical Education Initiative . With healthcare providers as the targeting users , the ICSTs are based on the latest clinical practice guidelines and aim to improve the quality of HIV , HCV and STD patient care . This study reports the usage of ICSTs . The analysis provides important data to identify more effective approaches for dissemination of clinical evidence .
Methods : We collected the usage data of 12 ICSTs for a period of 25 months from October 2013 to November 2015 . All user activities , such as click of buttons , check of decision branches , and selection of specific patient conditions , were captured and stored for analyses . For each ICST , we measured the usage based on episodes of use and frequency of visits to specific part of ICST , and differentiated the use through web vs . native apps .
Results : We recorded a total of 5,321 episodes of use during the study period , with 1,889 ( 35.50 %) from web and the remaining 3,432 ( 64.50 %) from native apps . We recorded a total of 59,450 visits to specific ICST functions , with 21,530 ( 36.22 %) from the web and the remaining 37,920 ( 63.78 %) from native apps . The top usage of ICST was recorded for HIV Testing , followed by Anal Dysplasia & Cancer and HIV / HBV / HCV Prophylaxis Following Occupational Exposure .
Conclusions : We recorded intensive use of ICSTs by a large number of clinicians . Native apps have become a preferred platform for using ICSTs . ICST usage is unevenly distributed .
Further study is required to perform correlation analyses on ICST usage , clinical topics , users , and use contexts , such as to identify the most effective approaches to disseminating clinical evidence through ICSTs .
25 . Behavioral Health Telehealth : Making a Difference
Richard Maas , MA , LPCS , and Nancy Brandon Novant Health
Background : It is a widely known fact that there is a psychiatry shortage across the nation due to various reasons . To combat this shortage , Novant Health leveraged their “ Remarkable Patient Experience ” campaign to include telepsychiatry and teleassessment services in combination to meet the needs of patients in all of our hospital ED ’ s and one community hospital with limited psychiatric resources .
Methods : Novant Health Psychiatric Medicine partnered with the North Carolina Statewide Telepsychiatry Program ( NCSTeP ), a state funded initiative to bring psychiatry resources to areas that were unable to serve patients in a timely manner . NH psychiatrists and therapists work together to provide comprehensive evaluations for each patient in these Emergency Departments . NCSTeP provided each hospital with equipment and IT support to help see patients in these areas . Psychiatrists were credentialed by each hospital with consulting privileges so that they can help the ED providers serve these patients in a timelier manner .
Results : A dedicated team of therapists and psychiatrists working together promotes faster placement in an appropriate setting for the patient ’ s particular needs . This structure decreases length of stay for the patients in the ED setting and helps facilitate the patient receiving treatment faster . The average LOS in NC ED ’ s is 60 hours . Our service LOS is 17 hours . This service also provides ED staff access to trained therapists .
Conclusions : Telemedicine may never replace face-to-face interaction with a patient ; it is a better option to those needing faster placement and treatment to help alleviate the strain on the EDs across the state . Novant Health is committed to putting the patient first as the right thing to do and will continue to foster this mission to all areas across the state with which we are so privileged to come in contact .
26 . Rural Stabilization Grant / Partnership Fills MFM Gap via Telemedicine
Tanya Mack , BSN 1 , C . Anne Patterson , MD 1 , Sallie Barker 2 1 Women ’ s Telehealth , 2 Upson Regional Medical Center
Background : The obstetric healthcare system is often fragile in rural areas . OB access can be limited and maternal fetal medicine care is rare . Studies show that patients with pre-
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