Community Health Care Services Foundation, Inc. (CHC)
99 Troy Road, Suite 200
East Greenbush, NY 12061
www.chcforum.org/

Charissa Ashman, RN, BSN, MBA
Ph: 518-463-1118 Ext. 816
Fax: 518-463-1606
Email: Ashman@nyshcp.org

Network Partners: Essex County Public Health Department, North Country Home Services, Inc., and the Visiting Nurse Association of Albany, Saratoga, Rennelaer, Inc.

Project Purpose: Demonstrate whether the use of home telehealth: leads to better utilization of scare home care personnel (nurses and home health aides); has an impact on job satisfaction among home care personnel; improves access to care for patients in rural areas; enhances overall patient satisfaction and quality of life; and presents an economic benefit to the health care system by reducing the frequency of home care, physician, and emergency room visits as well as hospitalizations. The secondary purpose of this project is to study the effects of telehealth for Congestive Heart Failure (CHF) patients during an 8- month pilot.

Outcomes Expected: (1) Patient acceptance and satisfaction with telehealth technologies pre- and post-Likert survey instrument; (2) Staff acceptance and satisfaction with telehealth technologies pre- and post-Likert survey instrument; and (3) Reduction in the number of “physical” home care visits, unplanned
physician visits; Emergency Department visits and hospitalizations-a utilization tracking tool will compare historical visit rates for CHF patients. At the conclusion of the pilot, CHC and its partners will raise awareness of telehealth and its potential benefits to patients; caregivers; payers; and policymakers across New York State.

Service Area: Essex County, 5 dental HPSAs, 1 mental health HPSA, 8 primary care HPSAs and 3 MUAs; portions of Rennselaer County: 3 MUAs; and portions of Saratoga County, 6 dental HPSAs.

Services Provided: Community Health Care Services Foundation, Inc. (CHC) is partnering with three home care agencies for a home telehealth project that began November 1, 2005. Home telehealth units will be placed in the homes of 14 Congestive Heart Failure (CHF) patients to monitor blood pressure, heart rate, weight, and oxygen saturation on a daily basis as well as obtain answers to health-related questions that ask patients about their illness, diet, symptoms and activity levels. It is expected that patients will receive remote
patient monitoring in their homes for a 60-day period (a typical episode of care for a certified home care agency) or discharge, whichever comes first.

Equipment: Fourteen Viterion 100 home monitoring units with heart rate, blood pressure, weight scale, and oxygen saturation peripherals. Viterion server and network for ongoing data transmission and collection for home care personnel.

Transmission: POTS lines in patients home to transmit daily monitoring data. Home care agencies retrieve patient data using the Internet.

Genesee Gateway Local Development Corporation, Inc.
One Mill Street
Batavia, NY 14020
Ph: 585-344-1022
www.gcedc.com

Fax: 585-345-7452
Email: mshilling@r-ahec.org

Network Partners: Lake Plains Community Care Network, Medina Memorial Health Care System, Noyes Memorial Hospital, Oak Orchard Community Health System, State University of New York at Buffalo, United Memorial Medical Center, Western New York Rural Area Health Education Center, Wyoming County Community Health System, Erie County Medical Center.

Project Purpose: To develop a rural collaborative telehealth network connecting seven rural health care and education facilities with major urban hospital, that will increase clinical collaborative efforts in providing the rural communities affordable access across the spectrum of health services, as well as improving the quality of rural health education and training. Each rural telehealth end-point will develop the clinical and technical competence and capability to evolve into a telehealth hub that can reach further into the rural communities with access to quality health services and education. The rural collaborative telehealth network will also provide the framework to enhance the ability of the regional health
infrastructure to respond to bioterrorism and other public health threats in a timely and effective manner.

Outcomes Expected: Enhancing the ability of rural health service providers to increase access to quality health care and improve patient safety in rural communities by collaborating with urban hospitals and other partners
through telehealth treatment applications. Measure success in adoption of telehealth services and systems by tracking 1) numbers of clinical encounters and visits; 2) patient acceptance and satisfaction; 3) adoption by providers for consultative and educational activity; 4) recruitment and retention of
professionals in rural communities; and 5) adoption of health information systems. Measurement tools: self-report of patient acceptance and satisfaction, OAT GPRA Performance measures, periodic selfreport of utilization data, key informants, focus groups, and public health data, and Likert surveys.

Service Area: Counties of Genesee, Livingston, Orleans, Wyoming (NY) serving 2 PC-HPSAs, 4 MH-HPSAs, 5 MUAs.

Services Provided: All pertinent clinical and healthcare education/training services will be offered (to be further updated upon completion of needs assessment with partner healthcare facilities).

Equipment: Telemedicine carts with dual screens for video and data collaboration, Consultation systems, Secure IP Network connectivity, Routers.

Transmission: Full T1 connections with IP transmission MPLS network protocol.

Integrated Community Alternatives Network, Inc.
1500 Genesee Street
Utica, NY 13502
www.kidsoneida.org

J. Michael Daly, LCSW
Ph: 315-792-9039, Ext. #211
Fax: 315-792-9578
Email: mdaly@kidsoneida.org

Network Partners: Integrated Community Alternatives Network, Inc., Oneida County Department of Social Services, Capraro Technologies, Inc.

Project Purpose: ICAN works under contract with Oneida County Department of Social Services (OCDSS), part of our mission is to assist OCDSS in returning children from out of home foster care placements. Our software automates case records, including critical case information, diagnosis information, allowing for timely and accurate assessment of a child and their family’s ability to be reunited. In additional to ICAN benefiting, OCDSS will also benefit from this technology as it will assist Oneida County in streamlining information on children who are living in the foster care system enabling to prepare for
appropriate service provisions and timely discharges.

Outcomes Expected: Provide increased assessment capabilities by tracking key demographic data, diagnosis information, placement histories, educational histories, and a child and family readiness assessment. To address needs more timely, remove barriers to successful discharges, understand the unique characteristics of the foster care population more effectively, and plan to utilize resources more effectively in the future. This project will save time as well as valuable human resources.

Service Area: The geographic location for this project is Oneida County. Approximately 335 of the 400 children tracked by this software project are currently living in foster care situations. There are 65 children residing in foster care levels of care throughout Upstate New York that will be tracked with a handful of children residing in other states via contract with OCDSS.

Services Provided: Currently, ICAN is a Not For Profit Corporation whose mission is to serve children with serious emotional, psychiatric, and behavioral disorders. Future services would utilize effective technology software to have key information at our fingertips and utilize this information in the best interest of our children and their families that we serve.

Equipment: Integrated Community Alternatives Network, Inc. is currently using the existing network. ICAN has purchased a new File Server to store data associated with the project.

Transmission: Integrated Community Alternatives Network, Inc. is currently using a Fractional T1.

Millennium Center for Convergent Technologies
300 Broadhollow Road
Melville, NY 11747
www.longislandassociation.org

Robert Kelly, PhD
Mitchell H. Pally
Ph: 631-493-3002
Fax: 631-499-2194
Email: mpally@longislandassociation.org

Network Partners: Stony Brook University, Stony Brook University Hospital, LifeTree Technology, North Shore-Long Island Jewish Health System, New York Institute of Technology.

Project Purpose: The overarching purpose of this project is to develop and test the application of new technologies for the healthcare industry to help reduce its spiraling costs. The first goal is to add an enhancement to an already-developed clinical trial system to reduce the time to capture and process clinical trial data, while improving the accuracy of data collected. The second goal seeks to address the inability to recruit patients that is the single biggest cause of clinical trial delays, which thereby increases clinical period development costs, by developing a prototype patient eligibility system to identify potential clinical trial subjects when they arrive for Emergency Room treatment.

Outcomes Expected: The project will measure the time savings and the improvement in data quality, achieved by use of the software enhancement, which will permit electronic data exchange between the clinical site and the
trial manager, in a realistic clinical environment, expecting at least 30% time savings and over 99% accuracy. The prototype eligibility system will investigate the use of portable XML documents and a rule-based system to identify candidates for a clinical trial from among patients in a typical ER setting,
seeking to identify at least 10 eligible patients.

Service Area: Not Applicable.

Services Provided: Not Applicable.

Equipment: Computers and related equipment as follows: HP Desktop PC, IBM Thinkpad Notebook, Elo Intuitive Touchscreen Monitor (2), HP Deskjet printer, SIIG Fiber Optic Switch, and Com SS3 Baseline Hub. Substitutions may be made if appropriate as the project moves forward.

Transmission: Internet and T-3 highspeed broadband.

Comprehensive Health Care Center (FQHC)
Montefiore Medical Center
111 East 210th Street
Bronx, NY 10467
www.montefiore.org

Jack Wolf, VP, CIO
Rocco Mitaratonda, CFO
Ph: 914-457-6311
Fax: 914-457-6064
jwolf@montefiore.org

Network Partners: Community Health Centers in The Bronx, CFCC (FQHC), Montefiore Medical Center.

Project Purpose: Implement an Ambulatory Electronic Medical Record which is fully integrated with the Hospitals Electronic Medical Record with remote access to all aspects of the Patients Care, including but not limited to lab results, radiology reports, medication history, electronic orders, Rx pad, PACs Radiology Images, etc. with a unique identifier for each patient. The EMR will be available at any time from any location in Montefiore’s delivery network for all authorized clinicians.

Outcomes Expected: Improved patient care resulting from immediate access to all episodes of care for the patient from any care location throughout Montefiore’s delivery network. Access to a longitudinal view of lab and
radiology results, problem list, medication history, allergies, all demographic information including insurance information to improve patient throughput and inpatient care. Insure continuity of care when patients travel between clinics and other delivery settings within the Montefiore Network.

Service Area: All parts of The Bronx New York, Lower Westchester County and Northern Manhattan.

Services Provided: Patient Registration, Laboratory and Radiology Results, Electronic Rx Pad, Radiology PACs images access, Online Order Entry, Patient Insurance and demographic information, Problem List, and Internet
access.

Equipment: The equipment needed for this project is Okidata and Rx Pad printers, PC Workstations, wireless devices, cables, Nortel equipment and IDX Software.

Transmission: The Comprehensive Health Care Center CHCC site is connected to the Main MontefioreCommunication Network via a T1 connection provided by Verizon Services. The T1 connects into a communication hub consisting of Nortel switches and routers which in turn links via category 5 cabling to workstations located throughout the facility.

State University of New York (SUNY) at Buffalo
C/o David Ellis, MD
ECMC, Dept. Emergency Medicine
462 Grider Street
Buffalo, NY 14215
www.telehealth.buffalo.edu

David Ellis, MD, FACEP
Ph: 716-898-4957
Fax: 716-898-4432
Email: dellis@ecmc.edu

Network Partners: Erie County Medical Center, Comprehensive Psychiatric Evaluation Program; The TLC Healthcare Network, 100 Memorial Dr., Gowanda, NY 14070 (Chautauqua and Cattaraugus counties); Wyoming County Community Health System, 400 N. Main St., Warsaw, NY 14569; Erie County Medical Center, Regional Resource Center & Healthcare Preparedness.

Project Purpose: This project builds on a successful, statewide correctional emergency telemedicine network (Y2003, >3000 patients, with 41% ER trip avoidance) to develop clinical services, distance learning (Grand Rounds) & informatics through rural and tertiary care hospital ER linkages. The project will improve health outcomes for victims of rural trauma (teletrauma) through rural EMS telehealth coordination and a virtual-onsite trauma care partnership using wireless roll-abouts IP- based multi-protocol label switched (MPLS) network protocol videoconferencing units.This will provide a flexible, scalable model for rural access and 24/7 mental health, serving children & adolescents, as well as adults.

Outcomes Expected: Rural Trauma Care: Resuscitation times (arrival – transfer), mode of transfer, patients intubated – GCS < 12, blood administration when hypotensive, FAST ultrasound performed, length of admission/stay (LOS) ED trauma center, LOS in trauma center, time to OR, physiologic outcomes for
trauma based on injury severity scores specific locations head/spinal injury, chest, abdominal, extremity injury. General indicators: patient/provider satisfaction—Likert surveys, quantifying patient usage of services provided through OAT GPRA, performance measures.

Service Area: Chautauqua Co. (HPSA) 3 full, full mental, 27/30 cities full dental; MUAs #2401, #5034. Cattaraugus Co. (HPSA) 5 full, full mental, full dental; MUAs #2409, #2410. Wyoming Co. (HPSA) 3 full, full dental, MUAs #2396, #2408.

Services Provided: Emergency / Trauma (Tele-trauma), Mental Health, Emergency Mental Health, Child /Adolescent Psychiatry, Hand, Maxillo-Facial, Infectious Disease / HIV, Gastroenterology. Planned Services (2005-6): Pediatric Emergency / Trauma, Pediatric Cardiology, Pediatric Specialties, Dental.

Equipment: Three (3) Wireless IP roll-about videoconferencing units, Polycom codecs, Dual-screen consultation systems, networking hubs, Cisco routers.

Transmission: Full T1 connections with IP transmission MPSL network protocols.

The Rosalind and Joseph Gurwin Jewish Geriatric Center of Long Island
Department of Medicine
68 Hauppauge Road
Commack, NY 11725
www.gurwin.org

Suzanne Fields, MD/Jean-Marie Kineiko
Sunni Herman
Ph: 631-715-2600
Fax: 631-715-2908
Email: dellis@ecmc.edu

Network Partners: St. Catherine of Siena Medical Center (Smithtown, NY), Huntington Hospital (Huntington, NY), University Hospital at SUNY Stony Brook (Stony Brook, NY).

Project Purpose: Engage in a pilot demonstration project for an interoperable electronic medical record program including computerized physician-order entry suitable for post-acute care and long-term care. This program will be designed with the potential to exchange critical health information with other clinical settings, particularly acute care hospitals, off-site physicians’ home or office and emergency rooms and ultimately with federal, state, regional and local health information infrastructures and systems.

Outcomes Expected: Provider satisfaction, enhanced communication, improved compliance with required documentation, decreased time to document history and physical examination (measures)-Survey of medical staff (tool); Reduction of medial errors that occur during transitional care, decreased rate of illegible or incomplete orders, better reconciliation of medications (measure)-Review of medical records of medication errors (tool).

Service Area: Suffolk County, including 3 acute care hospitals.

Services Provided: Opened in November 1988. Provides long term care services, assisted living, home care, ventilator dependent care, subacute care, adult day care, hospice services. Dialysis services will begin in summer of 2006.

Equipment: Laptops, printers.

Transmission: Internet, T1 lines.