The Medical University of South Carolina (MUSC) is widely regarded as an industry leader in telehealth with a robust, high-volume telehealth program that touches not only the local community, but also impacts patients throughout the state.
In October 2017, MUSC was named one of only two national Telehealth Centers of Excellence through a landmark grant awarded by the Health Resources and Services Administration (HRSA).
Principal investigators Dee Ford, M.D., and Katie Cristaldi, M.D., who will serve as the Center of Excellence’s (COE) Director and Associate Director respectively, were responsible for leading the effort to pull together the federal grant application. Their painstaking efforts paid off: the grant awarded $600,000 the first year and $2 million in year two.
The COE team will work hand in hand with the existing MUSC Center for Telehealth as it expands the scope and delivery of clinical care throughout the state. The primary COE objectives are to expand MUSC’s telehealth scope beyond a regional focus, to a national level.
Furthermore, in a collaborative multidisciplinary team approach, the COE, applying rigorous scientific evaluation, will assess the effectiveness of MUSC’s telehealth services in rural and urban areas in an effort to achieve “next level” telehealth.
Telehealth is an innovative, convenient, and effective way for health care providers to deliver acute, primary, and specialty medical care and support to patients located in all areas of the state, with a particular focus on rural and/or underserved areas. Through the use of high-tech videoconferencing equipment, telehealth can enable doctors many miles away to care for patients with any condition ranging from life-threatening (e.g., cardiac arrest, ischemic stroke) to basic (e.g., routine asthma care for school children).
MUSC’s first telehealth program launched in 2005 with a maternal-fetal medicine program that treated women with high-risk pregnancies in underserved communities. Building on its success, MUSC opened a telestroke program in 2008.
“The inception of telehealth at MUSC was grassroots-driven. Individual clinicians who saw a need tried to meet those needs with telehealth technology. Early on, we didn't have the institutional support to develop a comprehensive program." - Dee Ford, M.D.
“The inception of telehealth at MUSC was grassroots-driven. Individual clinicians who saw a need tried to meet those needs with telehealth technology,” says Ford. “Early on, we didn’t have the institutional support to develop a comprehensive program.”
But MUSC’s improved outcomes and demonstrated benefit to the communities MUSC serves captured the attention of the state legislature. As a result, in 2013, MUSC received $12.4 million in state appropriated funds to advance telehealth initiatives throughout the state. The legislature has appropriated funds each year since.
“That was a huge catalyst for us,” says Ford. “Our ability to demonstrate innovation in the telehealth arena garnered support from the state.”
Since the program’s humble beginnings, it has flourished in ways the teams could not have predicted. For instance, MUSC’s number of annual telehealth interactions has grown from 1,078 in 2013 to over 300,000 projected in 2018. Today, MUSC provides telehealth services to more than 200 sites in 27 counties at 28 hospitals, more than 100 community clinics and 50 schools, as well as alternative sites such as nursing facilities, prisons, and patients’ homes. Seventy-eight percent of sites are located in completely or partially medically underserved areas of the state.
COE - The Brass Ring
The Health Resources and Services Administration was looking for high-volume telehealth programs that were focused on the medically–underserved in rural areas and could demonstrate financially sustainable telehealth business models. MUSC hit the telehealth trifecta.
"HRSA now wants to see how telehealth can be embedded in traditional clinical practice – not an add-on." Ford says. "They want it interwoven and integrated, and they want to see financial feasibility.”
Ford explains MUSC has a lived experience of telehealth successes and failures and part of what our federal partners want to understand is how to evaluate and disseminate telehealth best practices.
The MUSC Center for Telehealth will continue its clinical efforts under the leadership of James McElligott, M.D., Medical Director, and Shawn Valenta, Administrator of the Center. Moving forward, the COE will fill important gaps in the national telehealth landscape, focusing on three priority areas: the impact of telehealth on federal and local health care spending, provider and patient engagement in telehealth, and open access network evaluation and best practice dissemination. MUSC will also develop and offer at a national level teams devoted to evaluation, dissemination, and consultation.
Valenta credits the efforts of Ford and Cristaldi for leading the robust team to the win. “As co-principal investigators on the award, Dr. Ford and Dr. Cristaldi will leverage the amazing work of our Center for Telehealth’s programs and MUSC’s scientific resources to focus on recommendations and solutions to universally complex telehealth barriers.
We are extremely excited to partner with this formidable team to serve the patients throughout South Carolina and nationally to the best of our abilities.”
Ford believes that critical to MUSC’s success is the people working within the telehealth programs who are fiercely committed to its mission of better meeting the health care needs of South Carolina residents.
“It’s a very high-quality, high-performing, committed team. There are all different kinds of roles and ways in which people contribute to the whole program. All of this is only achievable because we have the right people to get the work done. It’s really the team that has gotten us this far,” says Ford.
Original article by Mikie Hayes, MUSC Catalyst News