Page 13 - Delaware Medical Journal - July 2017
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TELEHEALTH
FIGURE 1
Telehealth became a potential solution.
Members of the PD community approached then-Secretary of Health and Social Services, Rita Landgraf, to appeal for assistance in bringing MDS telemedicine services to Delaware. In response to this appeal, a group of about a dozen representatives from the Delaware Department of Health and Social Services (DHSS), the PD community convened in March 2011 to explore how to further the use of telehealth in the state. Barriers to implementing discussed. For example, it was immediately evident that Delaware Medicaid did not reimburse for telehealth, Medicare reimbursed for services delivered via telemedicine only under certain narrow criteria, and questions around private insurance reimbursement in Delaware needed answering. Many issues needed to be resolved; thus, the Delaware Telehealth Coalition was formed.
PARKINSON’S SPECIALTY SERVICES
Concurrent to the formation of the Delaware Telehealth Coalition, leaders in the PD community approached associate professor Dr. Ingrid Pretzer-Aboff, at the UD School of Nursing, to help recruit the services of PD specialists to the state. Seeking to understand the need and scope of the problem, a survey was conducted
that approximately 50 percent of support group members with PD drove out of the state for specialty care, with the majority traveling to Baltimore and Philadelphia Movement Disorder Centers. The remaining group members did not make the trip out of state as it was “too burdensome.” With the estimated 3,000-plus people on the Delmarva Peninsula diagnosed with Parkinson’s disease, there was a clear need to import PD specialists into the state. A feasible solution to the problem was to utilize telehealth technology to access a movement disorder specialist and a clinical psychologist.
In 2013, the process of developing the clinic model began. Efforts were made to identify local nurse practitioners, physical therapists, speech and language pathologists, occupational therapists, nutritionists, exercise physiologists with expertise in PD, and to identify an out of state movement disorder specialist (MDS) and a clinical psychologist with expertise in PD and telehealth. The out of state specialists needed to obtain professional licenses in the state of Delaware, and the institutions they worked in needed to develop a working contract with UD, a process that took more than one year to execute. The videoconferencing equipment was purchased Science, Delaware Health and Social Services Division of Services for Aging and Adults with Physical Disabilities (DSAAPD), and The Parkinson Council. The Director of the UD Nurse Managed Primary Care Clinic (NMPCC) agreed to host this new clinic twice
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