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Telepathology at the University of Minnesota Veterinary Diag

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Sabina Ponicki

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Transcript of Telepathology at the University of Minnesota Veterinary Diag

Telepathology at the University of Minnesota's Veterinary Diagnostic Laboratory
Dr. James E Collins, DVM, PhD, Diplomate ACVP
The VDL Welcomes You!
Take a journey with me through the labs before we start our expedition.
Choose the Right Telemedicine Partner
Design & Customizations
User-friendly
Customizations
Equipment needed
Security

Features & Workflow
Built-in billing
Pet Insurance?
Tool integration
Documentation
Outline Your Telemedicine Use Case
Factors to consider:

Type of telemedicine
Live video
Store-and-forward
Remote monitoring

Target client population for telemedicine
Rural or far away?
Chronic conditions?
Companion animal, Livestock, Poultry
Exotic Animals, Wildlife, Aquaculture

Animal Medical Services
Lab results review?
Urgent issues
Simple follow-ups or check-ins?
Off-hours coverage?

Create Your Implementation Plan
Gather your team
Learn the telemedicine policy for your state
Decide on your billing policy
Establish your telemedicine workflow
Create a timeline with concrete tasks

"Pet emergencies can happen at ANY time!"
Ability to contact “an expert veterinarian via phone, email or chat 24/7”

Help with behavioral problems
Ex: Cat no longer uses litter box
Ex: Introducing new animals

Various plans available
One call: $39.95
Six months unlimited: $89.95
One year unlimited: $149.95

https://www.whiskerdocs.com/
Tele-Veterinary
Medicine
The Veterinary Diagnostic Lab!
Polymerase Chain Reaction Lab
Electron Microscope Lab
Necropsy Floor
College of Veterinary Medicine Research
And more...
TeleRadiology
“Board-certified veterinary radiologists available 24/7”
American College of Veterinary Radiology

“Provide fast, accurate radiology consultations”
“Routine turnaround time averages 3 hours”
“STAT radiology reports delivered within 30-60 minutes or less”
“Average 30 minute STAT turnaround time is 14 minutes”

“Interpret a full complement of imaging exams, including:”
X-rays
Ultrasound
CT scans
MRI scans

“Obtaining a second opinion from a PetRay’s veterinary radiologist increases the” accuracy of the results and diagnosis.

©2013 PetRays, all rights reserved
http://petrays.com/services/radiology/
VDL's Technology
Old Faxitron
New Faxitron
Radiographs
Gray Squirrel
Canine Nasal Carcinoma
Eko Digital Stethoscope
“Live stream sounds from the stethoscope to clinicians worldwide”

“Enable real-time telemedicine with no computer required”
Utilizes Bluetooth
Partnered with the Eko Stethoscope App
Simple attachment to stethoscope

Respiratory and Heart rhythms monitored
Recordings:
Send via email
Save in library as a reference

Importance:
Education
Cardiology
TeleMedicine
Primary Care

“FDA cleared and fully HIPAA compliant”
https://ekodevices.com/
Stage 1:
Strategy
Stage 2:
Purchasing
Stage 3:
Planning
Set Up Your Workspace
Space should be:
Private!
Neat & organized
Well-lit
Quiet
Properly equipped

For Example:
Informed client consent form
Telemedicine waiver/billing policy form
Tip/workflow sheets for staff
Client visit documentation

Create Any Needed
Program Materials
Get trained on
the Technology!
Involve all staff
Block off time in your calendar
Commit to it!
Always
do a dry-run
Do a “family & friends” test run
From very first step to billing
Have staff review technical tips

Build and Launch Your
Marketing Plan
2 parts:
Letting clients know about telemedicine visits
Getting them set-up for a visit

Get clients on board!
Stage 4:
Implement
Build and Launch Your
Marketing Plan
Decide on your strategies:
In-office brochures, posters, cards
Update your practice website
Phone message and staff scripts
Email marketing
Social Media Campaign
Direct mail campaign
Open House event

In-office materials & staff prompts are the minimum!
Update your website will
Helps marketing
Gives patients an easy portal to the telemed platform
Email campaigns are a great
Affordable option to spread news
Social media
Easy and cheap
Direct mail
Simple letter shares the news
Tells clients how to get started with their first telemed appointment
Offer an incentive for the first appointment

Order Equipment & Get Set-up
Is the platform cloud-based or does the software need to be installed?
Help with installation
Secure data server space

Is your internet connection good enough?
3 mbps is minimum for good video quality
Speedtest.net

Build and Launch Your
Patient Marketing Plan
Points to include:
Benefits of telemedicine appointments to patients
What conditions/services appointments are for
Availability
Cost
Instructions on how to get started!

Stage 5:
Evaluate & Expand
Build Your Internal Team
Include:
Staff in the purchase process
At least inform them once you buy
Practice managers & providers in workflow/billing/policy discussions
Any staff who will be involved in the telemedicine program
Get team buy-in

Call a meeting and share:
The use case
The goal
Steps needed
Learn the Telemedicine
Policy in Your State
What does your state law say about telemedicine?

Telemedicine parity laws
Client informed consent (telemedicine specific)
Prescriptions based on telemedicine appts
Using telemedicine with established vs. new patients
Location of the client during the telemedicine visit, and interstate licensing
How to research this for your state?

American Veterinary Medical Association (AVMA.org)
Minnesota Veterinary Medical Association (MVMA.org)
Minnesota Board of Veterinary Medicine https://mn.gov/boards/veterinary-medicine/
American Telemedicine Association State Policy Center (human patients)
Decide on your billing policy
Questions to ask yourself:
Will you charge clients for telemedicine appts?
Will you be doing a self-pay model or billing pet insurance?
How will you bill (in platform, in EMR, standard paper)?
How much will you charge patients?

Figure out how you’ll Provide
Tech Support
Have a technical troubleshooting/tip sheet for clients
Train staff to field basic technical questions
Ask if your vendor has an online support resource database
Patients can solve problems themselves
Have a
back-up plan
in case you get disconnected
Pick-up phone if audio isn’t working
Have vendor support team contact info
Have system in place to handle any off-hours issues

Tell your clients about your new telemedicine visit option.
Gross & microscopic pathology at a distance
Real-time dynamic systems
Static (eg. whole slide scanning)

21st century approach to veterinary pathology
Real-time web-based consultation and information sharing
Distance pathology training
Academic-public-private partnership opportunity

Telepathology
Active Learning Commons

Cost
Pricing
Equipment & set-up needed



Services: Support & Implementation
Tech support
Customer implementation
Client marketing
Good support & implementation is
key
!
Key
Things to Consider:
1. Design
2. Features & Workflow
3. Cost
4. Support & Implementation Services

Telehealth Software Purchasing Guide
15 Barrington Place
Melville, NY 11747
T: 631-491-6614
F: 631-491-5180
www.rmtcentral.com
Think about the on-going relationship!
Telepathology Addressing Needs Across University Missions
Education
DVM students
Continuing Education
Training
Research
Service

International Telepathology Partnership to Improve Pathology Training for Swine Diagnostics in China –IVCC 2014-15 partially supported the initiation of this program
Current Uses and Expansion
Collaboration
Swine pathology & diagnostic consultation with IVCC partners
Aquaculture
Veterinary Dermatology
Teaching
Pathology cases reports (active learning classroom)
Connecting clinical path lab with others
UMN’s Cancer Center
Veterinary-Human pathology collaboration

VDL Telepathology Equipment:
Remote Medical Technologies
Micro Unit Host Interface
Live Demo
https://imed1.rmtcentral.net/q/umncvm/
ChromaCal
Technology
TM
Allows for highly accurate color calibration
“Maintains image and scientific integrity of digital data”

Incorporates Computer Monitor and Microscope calibration.
Monitor: “Uses precision color sensor, ensuring consistent color profile on any computer display”
Images look exactly the same, whether seen on a laptop, desktop, or on a friend’s computer

Microscope: “Use brightfield calibration slide with microscope and Datacolor calibration system”
Establishes “a baseline color profile unique to the imaging system”

Utilized in TelePathology: Grossing and Microscopy
Ensures no specimen sample is discolored, allowing for more accurate analysis
Everyone in the scientific community can see same color images

U of MN is a
CENTER FOR EXCELLENCE
concerning ChromaCal technology usage

http://scientific.datacolor.com/
https://www.emsdiasum.com/microscopy/products/brochures/2013/EMS_ChromaCal_Brochure_HR.pdf

Define Your Telemedicine Goals

Better animal care
Higher customer satisfaction
Increase in revenue
Attract new patients

Make specific, measurable goals
# new patients in 90 days
$$$ in revenue from virtual visits
Measuring
How will you use telemedicine?
BEFORE AFTER
ChromaCal
TM
Why do you want to add telehealth services?
What outcome do you want to achieve?
WELCOME TO
YOUR NEW TELEMEDICINE PROGRAM!
Did You Hit Your Goals?
At the 90-day mark, evaluate your program.
Have you hit your goals?
Do you need to change workflows?
Is it time to expand?
Have you asked for feedback from patients & providers?

Private sector – telepathology
fee for service
model
Teaching and training
partnerships (US and international)
USDA Plum Island Animal Disease Center (FADDL)
Wildlife pathology
networks
(Uganda)
Future Plans
Questions?
James E Collins, DVM, PhD, Diplomate ACVP
Professor
College of Veterinary Medicine
University of Minnesota
Saint Paul, MN 55108
612-625-9289 (office)
612-625-8787 (main office)
colli002@umn.edu
Acknowledgements
MN VDL Telepathology Initiative
Jim Collins
, Former VDL Director
Mac Farnham
, telepathology lead
Fabio Vannucci
, VDL Food Animal Pathologist
Arno Wunschmann
, VDL Pathologist
Frank Liu
, Program Director, Chinese Partners
Ann Fitzpatrick
, training coordinator
Tom Molitor
, Chair of VPM
Trevor Ames
, Dean of CVM
Sabina Ponicki,
Undergraduate Student
THANK YOU
iMedHD-Pro Grossing and Micro Systems
1080p HD
Web-based / Real-time
Full transcript