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The creation of a Tele-Observation Unit: Implementation of Telemedicine in…
The creation of a Tele-Observation Unit: Implementation of Telemedicine in the Observation Unit
Benefits of an Observation Unit
Quality care for patients
Patient satisfaction
Safety
Cost reducing measures
Elimination of unnecessary hospital admissions
CMS Reimbursement Policy
MD Policy Supervision for APP
MD is not required for in person examination of patient
APP and MD reimbursement rates
Tele-Observation Model and Structure
Provider to Provider Consult Model
One Service Model
Staffed by ED MD and Obs unit APP
Two Service Model
Sraffed by HMS Attending and Obs unit APP
Create Tele-Obs Standards of Operation and Workflow
Establish MD and APP AM and PM rounding tines via tele-video
Establish MD and APP staffing schedule
Tele-Observation Outcome measurements
Observation Unit performance
LOS (Length of Stay), Admission Rate, Total direct cost
Satisfaction
Patient Satisfaction
Retrospective analysis (Press Ganey Survey)
Provider (APP/MD) Satisfaction
Real time Survey
Safety
Death, cardio-respiratory arrest in the unit, ICU admits, Return to ED or hospital within 14 days of CDU discharge
Quality
Length of stay over 36 hours, physician contact outside of Tele-CDU rounds
Benefits of Telemedicine
Cost/ROI
Convenience
Access
Quality and Safety
Current issues with observation units
Their is a need for more observation Units
Financial issues