Dept. of Veterans Affairs Medical Center, 10000 Brecksville Road, Brecksville, OH 44141

U -- SOURCES SOUGHT FOR TELEMEDICINE CURRICULUM SOL EESSources2 DUE 030100 POC Karen Lebo (440)526-3030 X7444 The Employee Education System (EES) of the Veterans Health Administration (VHA) is performing a market research by seeking out information, including cost, from universities that may already have curriculum already established to satisfy our needs. The Scope of this research is to seek information on advanced telemedicine training for our staff. EES is currently working on introductory telemedicine class 101, and requires outside assistance for the advanced telemedicine training. Training shall include course material to build skills and competencies in: a) Initiating a telemedicine program in the VHA, b) The management of a telemedicine program, c) Clinical practice development, and d) Maintenance of the technical infrastructure associated with telemedicine in the VHA. Background: In order to maximize the benefit from its investment in telemedicine technologies, the VHA plans to incorporate telemedicine into routine service delivery and this requires a telemedicine competent workforce. There is currently no formalized system for telemedicine training in the VHA. The workforce is currently concentrated on delivering routine health care services from170 Veterans Administration Medical Centers (VAMC's), and Over 200 Community Based Outpatient Clinics (CBOC's). These facilities are managed nationally through a network of 22 offices called Veteran's Integrated Service Networks (VISN's). Many VAMC's have a designated telemedicine coordinator to oversee telemedicine development and training, and many of the VISN's have also appointed a telemedicine coordinator to plan the strategic development of telemedicine in their VAMC's and CBOC's. The VHA is a major provider of telemedicine services and delivers over 250,000 teleconsultations per year. These consultations take place in 110 of the VAMC's in 18 VISN's. The majority of this activity is in teleradiology, teledermatology and telemental health. Additionally 29 clinical specialties are routinely undertaking telemedicine in the VHA and we expect this number will increase in the near future. ObjectivesIt is the expectation of the VHA that this advanced telemedicine training will be predominantly aimed at developing the skills and competencies of staff within the VAMC's. This advanced telemedicine training will be predominantly aimed at developing the skills and competencies of staff within the VAMC's including the VAMC telemedicine coordinators who are responsible for the primary development of the VHA's telemedicine services. It may also involve other key personnel in the VAMC such as senior Information Technology (IT) staff, the Chief of Staff and the Associate Facility Director. Expectations: a) Provide participants with advanced customized training in telemedicine specific to the needs of the VHA, b) Provide CME credit or joint CME credit (with the Employee Education System (EES), c) Provide the VHA with a telemedicine competent workforce to ensure its telemedicine services are sustainable, d) Help to provide a uniformity of telemedicine practice within the VHA based on practice guidelines and protocols that are "evidence based", e) Lead to improved services to veterans through better integration of inpatient and outpatient resources as a direct benefit of the VHA increasingly functioning as a "virtual" health care delivery organization, f) Improve services to veterans through better integration of inpatient and outpatient resources as direct benefits of the VHA functioning as a "virtual organization". Current Content of VHA Telemedicine 101 Course: a)Knowledge of available resources (clinical, technical, administrative); b) Knowledge of current practices (both VA and non-VA); c) Choosing which specialties to include in a Telemedicine program; d)Obvious differences in practice, How to choose and purchase equipment?; e)White paper for equipment and vendors current and past; f)Knowledge base needs for personnel Core Competencies; g)Security, confidentiality, medical, legal, ethical issues: Organizational options different models; h)Establishing Telemedicine standards; j)Integrating VA Information Systems; k)Needs Assessment models; l)Infrastructure and resource needs; m)Marketing; n)Informational Technology for patient education as well as staff; p)Planning for system failures. Course Content for Advanced Training to build and maintain a Telemedicine Program is as follows, but any other additions are willingly accepted: a) How to best train new clinicians in telemedicine; b)Skills in using the various technologies; c)Clinical skills and change management strategies; d)Adopting a multidisciplinary approach to care delivery; e)Teambuilding communication skills/multi-site teams; f)Quality control informatics and questionnaire construction; g)Long-term project planning; h)Project evaluation including rudimentary cost benefit analysis; j)Outcome measures; k)Assessing customer satisfaction; l)Negotiating service contracts; m)Coding and reimbursement e.g. CPT codes; n)On-going resource management of bandwidth and networking; p)System expansion e.g. expanding point-to-point systems to become multi-point; q)bridges what is the scalability?; r)Available outside educational resources for continuing Telemedicine education; s)Integrating Telemedicine into the VHA information technology infrastructure; t)Avoiding obsolescence and efficiently upgrading technology; u)Adaptation strategies; v)Clinical guidelines; w)Outside funding mechanisms; x)Maintaining security, privacy and confidentiality. Interested parties shall provide detailed information regarding the course curriculum, the cost of customizing their course or classes to meet VHA needs. Any descriptive literature, CDROMs, Videos, web based instruction, and video conferencing examples will be helpful. Please send all documents to the address above to the attention of Karen Lebo Code 90(c). Posted 02/09/00 (W-SN423726). (0040)

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