Des Moines University
3200 Grand Avenue
Des Moines, Iowa 50312
www.dmu.edu

William Appelgate, PhD
Ph: 515-271-1516
Fax: 515-271-7062
Email: william.appelgate@dmu.edu

Network Partners:
Iowa Health Systems
Mercy Health Network
Onawa Clinic
Des Moines University

Project Purpose: Test the success of telephonic methods for case management of CHF and diabetes patients in the home.

Outcomes Expected: Patient Functionality: Will monitor activities of daily living using home telehealth technologies. Clinical Improvement: Increase the percentage of patients receiving critical elements of self management education while using the telehealth monitors; critical elements include daily weights, activity level, low sodium diet, medication management, follow-up appointments, deteriorating symptoms.Patient Satisfaction: Telephone surveys will be used with all patients in the programs. Physician surveys will be conducted by phone and/or mail to measure physician satisfaction.
Cost-effectiveness: Cost containment related to medical utilization (visits per episode of care, delay onset of readmission to a hospital) pre and post-monitor usage.

Service Area: Current rural and urban sites served by the providers of Mercy Health Network and Iowa Health System.

Services Provided: Intervention: Telemonitoring. Placement of monitors in the home of selected CHF and diabetic patients that have been identified as high risk.

Equipment: Patient monitoring using telephones, scales, BP cuffs, and monitors done through verbal reporting and using the Internet.

Transmission: Plain Old Telephone Service (POTS).

Des Moines University
3200 Grand Avenue
Des Moines, Iowa 50312
www.iowaccc.com

William Appelgate, PhD
Ph: 515-271-1516
Fax: 515-271-7062
Email: william.appelgate@dmu.edu

Network Partners:
Iowa Medicaid Enterprise
Des Moines University
Iowa Health System
Mercy Health Network

Project Purpose: To implement a comprehensive population-based statewide chronic care program, targeting all Iowa Medicaid beneficiaries with a primary or secondary diagnosis of Congestive Heart Failure (CHF) and to deploy a system-wide health risk assessment for all beneficiaries. Care management coordination will be coordinated in collaboration with Iowa Medicaid caseworkers, and a telephonic patient care strategy.

Outcomes Expected: Clinical Improvement: Clinical parameters, (measure) —Telehealth data management technology. Patient Satisfaction: Telephone surveys will be completed with all patients in the program. Providers
will be surveyed as well. Patient Functionality: Will monitor ADL activities-telehealth data management technologies. Also, will utilize Minnesota Living with Heart Failure Assessment. Health Care Utilization: Will evaluate all health claims data on participants.

Service Area: It is anticipated that this project will serve Medicaid beneficiaries within all 99 counties within the stateof Iowa.

Services Provided: Intervention: Internet-based Health Risk Assessment. Telehealth monitoring of CHF patients through telephonic nursing intervention and/or IVR system. Self-management education.

Equipment: Computers: On-line Health risk assessments. Telephones: Patient monitoring through telephonic nursing interventions.

Transmission: Internet and Plain Old Telephone Service (POTS).

Midwest Rural Telemedicine Consortium
Fred Eastman, MS
1111 6th Avenue
Des Moines, IA 50314-2611
www.mrtc-iowa.org

Dale Andres, DO
Ph: 515-643-8750
Fax: 515-643-5350
Email: feastman@mercydesmoines.org

Network Partners: Mercy Medical Center – Des Moines, Mercy Medical Center – North Iowa, and 23 affiliate facilities in Albia, Algona, Ames, Audubon, Belmond, Bloomfield, Britt, Centerville, Charles City, Clarinda, Corydon, Cresco, Emmetsburg, Greenfield, Hampton, Iowa Falls, Leon, Manning, Marshalltown,
Mount Ayr, Nevada, New Hampton and Osage, Iowa.

Project Purpose: Enhance the quality and accessibility of health care services through updated equipment deployment, targeted EMS training, health care career promotion, develop a support mechanism for limited English
proficient (LEP) patients, and increase access for delivery of clinical services.

Outcomes Expected: Outcomes expected include a 10% increase in current network utilization (clinical, educational and administrative); additional staff resources for affiliated entities; improved ability for facilities to address the language needs for LEP patient populations; improved availability of EMS training in rural communities; increased awareness of healthcare career needs and options for high school students (including EMS); and an increased awareness of telemedicine capabilities and opportunities for rural physicians and urban specialists. Monitor outcomes using the OAT GPRA Performance Measures.

Service Area: The service area consists of 24 communities in North-Central, Central and South-Central Iowa, including Adair, Audubon, Wright, Polk, Floyd, Davis, Decatur, Hardin, Franklin, Hancock, Kossuth, Carroll, Marshall, Story, Cerro Gordo, Appanoose, Chickasaw, Mitchell, Page, Palo Alto, Howard,
Ringgold, and Wayne counties.

Services Provided: Since 1995 - Clinical (Echocardiography, Dermatology, Burn Management, Nephrology); Educational (CEU/CME, health care management, community support groups, public health); Administrative. Tele-Interpretation for LEP patients.

Equipment: 8 Polycom Viewstation FX, 24 Polycom Viewstation EX, 7 PictureTel VTC units, POTS videoconferencing systems.

Transmission: Dialable ISDN-PRI over statewide network. Point-to-point and multi-point conferences via dial-up service and state owned videoconference bridge. ISDN-BRI used in Des Moines local area.