Transcript The TelAbility Project Using Telecommunications to Improve

Building a
Community of Caring
The WATCH Project
Using Technology to Promote Communication and
Collaboration within the Early Intervention System
Juliellen Simpson-Vos, M.Ed, Joshua J. Alexander, MD
The University of North Carolina at Chapel Hill
School of Medicine
Who Are We?
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Joshua Alexander, MD
Director of Pediatric Rehabilitation and TelAbility Program Director
UNC School of Medicine
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Juliellen Simpson-Vos, M.Ed
TelAbility/WATCH Project Director
Where did we
come from?
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Our TelAbility Center is located in Chapel Hill, NC.
What are we going
to talk about?
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History of our telemedicine programs
Services and Outcomes of the WATCH
Project
Successes, Challenges, Lessons Learned
Definition and Elements of a Successful
Community of Practice
Goals and Possibilities
How could you do it?
Questions and Resources
What is TelAbility?
An Internet-Based
Telehealth Program For
Young Children with Disabilities
http://www.telability/org
Goal #1
Connect people in different locations to
increase access to specialized
healthcare services for families and
decrease professional isolation
Goal #2
Serve as a resource for parents and
professionals seeking credible and
reliable information on topics related to
children with disabilities
Population Served
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Birth – 5 years old
Cerebral Palsy
Spina Bifida
Down Syndrome
Brain Injury
Feeding Difficulties
Developmental
Disabilities
Special Needs
1998
End-user Locations
WATCH
Wake Area
Telehealth Collaborative
Helping Children
with special needs
Building a Community of Practice
“A group of people who share a concern, set of
problems, or passion about a topic and who deepen
their knowledge and expertise in this area by
interaction on an ongoing basis.”
Who does
WATCH Serve?
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There are over 1000 children ages birth-3, who meet the eligibility
criteria, to currently receive early intervention services through the
Raleigh CDSA.
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There are over 1100 children ages three through five, who meet the
eligibility criteria, to currently receive intervention services through
Wake County Preschool Services.
Inclusive Child
Care Centers
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Learning Together
Lucy Daniels Center
Project
Enlightenment
Tammy Lynn Center
White Plains
Children’s Center
Service
Programs
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Community Partnerships for
Children
Learning Together
Pediatric Therapy Associates
Carolina Pediatric Dysphagia
Project Enlightenment
Lucy Daniels Center
Developmental Therapy
Associates
State Agencies
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The Raleigh Children’s
Developmental
Services Agency (ages
birth-3)
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Wake County Preschool
Services (ages 3-5)
The Tammy Lynn Center for
Developmental Disabilities
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TLC employs over 180 people including therapists,
administrators, nurses, psychologists, social workers,
teachers, and residential staff.
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TLC serves a total of 42 residents, 30 in the ICF/MR
residences (10/residence) and 12 in the community
residential group homes (4/home)
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11 children are served in residential services
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45 children are served in the school (including 6
residential children and 14 More @ Four children)
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50+ children are served through Early Intervention
Services
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115 children are served through Respite Services
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Primary serve children with autism (especially within EI
services) and cerebral palsy. The majority of the
children served through the school are
severely/profoundly mentally retarded.
WATCH Current
Programming
Website Content /Expertise Directory
Listserv
Newsletters
Videoconferencing
Other Website Features
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Expertise Directory
Handouts
Links
Calendar
Books
Articles
Videos
More!
Expertise
Directory
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2005 = 60
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2008 = 310
[email protected]
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2005= 29
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2008= (253)
Electronic
Newsletter
Subscribers= 395
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Website Updates
Event Listings
Center Descriptions
Article Reviews
Tips and Topics
Project Updates
Videoconferencing
Videoconsults
Videoclinics
Professional Development
Sessions
Point to point meetings
(administrative, family visits, etc.)
Videoconferences
By Type
December 2005-February 2008
35
30
25
20
15
10
5
0
Vide oclinics
Ne tw ork ing
Cons ults
Adm in/m tgs
Prof.De v.
Videoclinics and
consults
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44 videoclinics and consults have been
held
Involving 358 families, therapists, and
medical personnel
Satisfaction level average =4.81 out of 5.0
Comfort level average = 4.96 out of 5.0
Professional
Development Sessions
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26 Professional Development Session
have been held via videoconference
Involving 943 therapists, EISC, parents,
teachers, EI providers
Satisfaction level average =4.1 out of 5.0
Comfort level average = 4.3 out of 5.0
Professional
Development Data
Continued…
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Sessions were held free of charge to
participants
Infant Toddler Certification credit was offered
for all sessions
Sessions are based on WATCH Member
needs, interests and suggestions
Session cover all EI domains (PT, OTR/L,
SLP. Medical, Mental Health, Developmental,
Education)
Networking Data
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13 Networking sessions have been held
via videoconference
100 people participated
Satisfaction level average= 4.16 out of 5.0
Comfort level average= 4.5 out of 5.0
Administrative
Videoconferences
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11 Administrative meetings have been held
between WATCH Sites and Wake County
Agencies
 Involving 113 participants
 Satisfaction level average = 3.8 out of 5.0
 Comfort level average= 4.45 out of 5.0
Residential Care
Tammy Lynn Center
Videoconference Usage
Since December of 2005…
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26 videoconference session have occurred
 14 Professional Development Sessions
 6 Videoclinics and 2 Videoconsults
 3 Administrative meetings
 1 Networking meeting
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Involving over 625 people
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The average satisfaction rating for video
conference sessions is 4.4 (out of 5)
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The average comfort level for video conference
sessions is 4.6 (out of 5)
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The program has saved 37.5 hours of travel
time and $997.00 in travel mileage.
WATCH Recap
Since December of 2005…
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80 videoconference session have occurred
Involving over 1358 people
The average satisfaction rating for video
conference sessions is 4.4 (out of 5)
The average comfort level for video
conference sessions is 4.6 (out of 5)
Today’s
Travel Data
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We will be driving 396 miles to get here and back home.
Had we conducted this session via videoconference we
would have saved $199.98 and 7 hours of driving
time.
Travel Savings
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April 2007-February 2008
518 participants have participated in
videoconferences
 Miles saved by offering sessions via
videoconference = 31,603
Travel costs saved = $15,959 in gas
(31,603 x .505)
Doesn’t include time out of the office, food,
etc.
WATCH Benefits
for Providers
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Responsive to community’s needs and interests
Increases professional development and education
opportunities
Increases collaboration with other locations and
professionals
Reduces professional isolation
Improves communication and care coordination
efforts
Reduces travel time and costs
WATCH Benefits
for Parents
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Improves communication and care coordination
efforts
Reduces feelings of isolation from their child or the
professionals caring for their child
Reduces travel time and costs
Allows for long term care coordination
No extra charge to use the technology
Challenges
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Lack of technical knowledge and support at sites
Sustainable funds to cover costs of high speed internet
connection
NC won’t reimburse therapists for care offered via
videoconference.
Small monitors of the Tandberg 1500
Buy in/consistent participation from all sites
(turnover, time constraints, etc.)
Establishing a public network/technical support issues
 Modems provided by local services providers are often
incompatible with unit software upgrades
Lessons Learned
 Technical
Support
 Need for a consistent, knowledgeable, easily accessible IT
support person.
 First attempts to establish a public network system was
unreliable.
 Purchase and installation of a border controller has helped to
stabilize the network.
Lessons
Learned cont.
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Programmatic Support
 Fully funded Project director position is necessary to coordinate
communication and activities within the project and be point person for IT
problems.
 Needs assessments of each site and frequent communication with each
site is vital to success.
 The collaborative should consist of sites with specific expertise to help
meet the collective needs of the members.
 Professional development opportunities great opportunities for sites to
network, share expertise, and gain knowledge
 Reimbursement of therapists through grant funding increases the
likelihood of participation in videoclinics and consults..
Quote from WATCH
Service Agency
Director:
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“…Some days things can be very difficult with the day to day
demands of patient care and administration of a practice but
your educational options, along with your organization
communication skills are a very positive exciting thing for a
provider. It is so much easier to participate in these sessions
because:
1.They are on practical topics of interest
2.They are on a Friday, not in the middle of a patient care day.
3.They are well organized and the handouts are sent by you
ahead of the presentations
4. You take care of the registration and curriculum outlines and
the speaker organization
5. The scope of the presentations are well organized for the time
segments allowed
6. They are free, and obviously very appreciated. “
D.I.Y.
OR
How to Establish Your Own
Telemedicine Collaborative
Elements of a
Successful Community
of Practice
Taken from: Meeting the Health Care Needs of
California’s Children: The Role of
Telemedicine
Written by The Children’s Partnership
A Champion for
Your Cause
A respected leader in the community,
committed to investing in and sustaining
the program.
 Can articulate the benefits.
 Has access to resources and can build
infrastructure.
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A Collaborative
Coordinator
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Detail oriented person who can make the
infrastructure work.
Facilitates communication among
collaborative members.
Responds to needs and concerns.
Builds relationships within and among
collaborative members.
Requires support and resources. (personnel
and funding)
Technological
Support
Access to reliable equipment.
 Responsive tech support person with
the ability to problem solve.
 Make the technology easy for your
members to use.
 Provide on-site training and face to face
support.
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Member Buy-in
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Search out the experts in your community.
What are their areas of strength and need?
Where are the gaps?
What are the common goals?
How can you help them meet their goals?
Give them what they need.
Build sustainability.
Question to
Consider…
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What is your need?
How would a telemedicine collaborative help
to meet those needs?
Who would you look to be a part of your
collaborative? (agencies, services)
What services could your agency offer the
collaborative?
Who might be your champions?
What do you see as the initial challenges?
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“Instead of all competing or working as
separate entities, WATCH allows for us
all to come together for the greater good
of the child and family.”
Future Goals
Questions for us?
Joshua Alexander
[email protected]
Juliellen Simpson-Vos
[email protected]
(919) 843.0427
http://www.telability/org
Resources
TelAbility website
http://www.telability.org
The Children’s Partnership Brief: The Role of Telemedicine
http://home.graffiti.net/tcpaccessible/
telemedicine.html
American Telemedicine Association website
http://www.atmeda.org
Information Exchange
http://tie.telemed.org/default.asp
Cultivating Communities of Practice (Hardcover)
by Etienne Wenger (Author), Richard McDermott (Author), William M.
Snyder (Author)