1. ... A wide-scale, international program that includes every insurance company and all American health organizations; and eventually, an entirely new branch to our modern day health care system.
2. References
3. The quadruple aim
3.1. (1) Improve population health
3.1.1. Increasing access at lower costs allows more low-income patients the ability to seek and receive care with their time and financial constraints.
3.2. (2) Improve experience of patients
3.2.1. Patients wait an average of two hours in emergency rooms every time they need to visit (Esposito, 2015).
3.2.1.1. Initial prototypes of telemedicine like eVisit are able to provide care in an average of 20 minutes (Calfilsh, 2017).
3.3. (3) Reduce per capita cost for care
3.3.1. Per capita cost for healthcare in the US today is $10,348. The traditional healthcare system is expensive, cumbersome, and clearly slow (Sawyer & Cox, 2018).
3.3.1.1. With telehealth, we're able to massively reduce wait times as well as cost to provide care, correspondingly reducing per capita cost of care.
3.4. (4) Job satisfaction for health care professionals
3.4.1. When waiting rooms are consistently full and patients are persistently upset over the cost they are paying, the enjoyment for their jobs and joy in the act of providing care gets overshadowed.
4. The importance
4.1. Wait times in emergency rooms
4.2. Cost effective method to reducing per capital cost of health care within our current system
4.3. Quicker access to care for remote patients
4.4. Current system of telemedicine is inadequate, disjointed, and mismanaged
4.4.1. Some insurance companies recognize the legitimacy of this form of health provision, but still many do not, leading to an inadequate use of the resource.
4.4.1.1. By bringing us all together into a new branch of the modern health care system, we can use this resource effectively for all the potential it has.
4.4.2. Many refer to it as a "spoke model" with no efficient connection between all parties involved (insurance companies, telehealth providers, and the federal government) (Cranford, 2017).
5. Operationalization
5.1. Techonlogy
5.1.1. The bulk of the investment will occur upfront with the purchasing of equipment to make telecommunications possible.
5.1.2. Ongoing maintenance costs will require full time technology professionals in an IT department. Without technology, we cannot operationalize.
5.2. Clinicians and physicians
5.2.1. We need professionals to speak with patients and legally prescribe treatments. Through credentialing unique to telecommunications, we provide our doctors with care privileges (Providence, 2018).
5.3. Quality control of care managers
5.3.1. Important to the maintenance of our credibility for quality of care and federal support (Providence, 2018).
5.4. Funding
5.4.1. Through the US Department of Health and Human services, we will attain federal funding and support, as well as support from other US health organizations like the National Institute of Health, etc.
6. Expected outcomes (Institute of Medicine Committee on Evaluating Clinical Applications of Telemedicine, 1996).
6.1. Improving work satisfaction and healthy work environment for physicians and nurses
6.1.1. Healthy decision-making
6.1.2. Allows more time to set aside for professional development of standards and procedures
6.1.3. Less stressful work life
6.2. Better physiological and cognitive status of the majority of the population
6.2.1. Through the increasing of access to care
6.3. Better vitality and functional capacity with access and financially feasible use of care
6.3.1. Less financial strain
7. Measuring outcomes
7.1. Why?
7.1.1. Provide feedback to investors
7.1.1.1. Initial operationalization costs will be expensive. Investors are an important key
7.1.2. Determine success rates
7.2. Ways?
7.2.1. Keep records of profits over regular periods of time
7.2.2. Keep records of numbers of patients who are utilizing our services
7.2.2.1. Helps determine when we might need to expand and/or adjust our growth plan
7.2.3. Keep records of return patients
7.2.3.1. Helps us tell who is happy with the care and method of care received
7.2.3.2. Tells us how much care is so effective/efficient that patients will come back for more
7.2.4. Voluntary questionnaires for patients at the end of their care
7.2.4.1. Gives them the opportunity to speak about their experience
7.2.5. Keep track of overall health outcomes in areas of service over times
7.2.5.1. Health statistics
8. The team
8.1. Building a team of individuals who are humble, hungry, and smart (Lencioni, 2016, p. 159)
8.1.1. They communicate, focus on goals, do their fair share within groups, support others, have diverse backdrops, are organized, and practice leadership.
8.2. Doctors, innovators (from various fields; individuals who think outside the box), hospitals, doctor's offices, nurses, and lawyers
8.3. Spearheads of the first versions of telehealth and telecommunications who already have vision and knowledge of what to expect in this area
8.3.1. We can learn from those who came before us in this field; their mistake, successes, and thoughts
8.4. US Department of Health and Human Services, lawyers, federal healthcare organizations.
8.4.1. Any and all national health organizations that wish to participate are a glad addition to the team and will help with our relationship with the federal government and funding.
9. Innovative project facilitation // Positive deviance
9.1. Utilize and employ individuals who have devoted their work to positive deviance already in the healthcare field
9.2. Purposfully pursue individuals who actively pursue different avenues in their own unique health care areas
9.2.1. For example, nurses reacting creatively to the needs of their patients that may be against standard, yet beneficial to the overall outcome of their patient
9.3. Growth, change-oriented mindset
9.4. A form of telehealth already exists today...
9.4.1. We need to take this pre-existing framework for telehealth and expand to a growth mindset
9.4.2. Pursue the massive goal of being Incorporated into the federal healthcare system
9.4.2.1. Employ legally competent individuals who can help us realistically achieve this outcome goal
9.4.3. Today, the term telehealth is used loosely to refer to the provision of care over the phone.
9.4.3.1. A physical and nationally reaching branch of health care provision needs to be in place to regulate and standardize telehealth
9.4.3.2. The greater the involvement with the system, the greater the credibility we will get initially.
10. Leadership
10.1. Development
10.1.1. Innovator mindset
10.1.1.1. Believe that we can always get better, learn more, and better serve our population
10.1.2. Beginning with a team charter
10.1.2.1. Continue to go back to this team charter during challenging times to ensure our main focus is kept up
10.1.3. Setting and checking on growth by setting outcome goals
10.2. Implementation
10.2.1. Begin with the quadruple aim in mind
10.3. Sustainability
10.3.1. Never settle for the status quo