Kristine Erps

Governance of a telemedicine program can influence the sustainability of a state-wide telemedicine program. Concerns of the founding ATP director regarding governance at the University of Arizona’s College of Medicine, in Tucson, 115 miles from the State Capitol in Phoenix, AZ, were addressed by legislative leaders through their creation of the Arizona Telemedicine Council (ATC). This blue-ribbon “non-statutory overarching authority” holds its quarterly 2-hour luncheon meetings in the Board Room of the Joint Legislative Budget Committee on the Arizona State Capitol Campus, in Phoenix. The ATP director creates the ATC meeting agendas. He has moderated all 92 ATC meetings, dating back to October 1996. Chairs of Appropriations Committees in the AZ House of Representatives and AZ State Senate have chaired the meetings. ATC’s meetings provide the opportunity for direct communication between AZ State Legislators, the ATP, and other Arizona stakeholders. This highly visible interest in tel...

As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled "Telemedicine & Telehealth Service Provider Showcase" (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues. This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2-3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiati...

A medical school general pathology course has been reformatted into a K-12 general pathology course. This new course has been implemented at a series of 7 to 12 grade levels and the student outcomes compared. Typically, topics covered mirrored those in a medical school general pathology course serving as an introduction to the mechanisms of diseases. Assessment of student performance was based on their score on a multiple-choice final examination modeled after an examination given to medical students. Two Tucson area schools, in a charter school network, participated in the study. Statistical analysis of examination performances showed that there were no significant differences as a function of school ( F = 0.258, P = .6128), with students at school A having an average test scores of 87.03 (standard deviation = 8.99) and school B 86.00 (standard deviation = 8.18; F = 0.258, P = .6128). Analysis of variance was also conducted on the test scores as a function of gender and class grade...

Starting in 1910, the "Flexner Revolution" in medical education catalyzed the transformation of the US medical education enterprise from a proprietary medical school dominated system into a university-based medical school system. In the 21st century, what we refer to as the "Second Flexner Century" shifts focus from the education of medical students to the education of the general population in the "4 health literacies." Compared with the remarkable success of the first Flexner Revolution, retrofitting medical science education into the US general population today, starting with K-12 students, is a more daunting task. The stakes are high. The emergence of the patient-centered medical home as a health-care delivery model and the revelation that medical errors are the third leading cause of adult deaths in the United States are drivers of population education reform. In this century, patients will be expected to assume far greater responsibility for their...

Faculty members from the Department of Pathology at The University of Arizona College of Medicine-Tucson have offered a 4-credit course on enhanced general pathology for graduate students since 1996. The course is titled, "Mechanisms of Human Disease." Between 1997 and 2016, 270 graduate students completed Mechanisms of Human Disease. The students came from 21 programs of study. Analysis of Variance, using course grade as the dependent and degree, program, gender, and year (1997-2016) as independent variables, indicated that there was no significant difference in final grade (F = 0.112; P = .8856) as a function of degree (doctorate: mean = 89.60, standard deviation = 5.75; master's: mean = 89.34, standard deviation = 6.00; certificate program: mean = 88.64, standard deviation = 8.25), specific type of degree program (F = 2.066, P = .1316; life sciences: mean = 89.95, standard deviation = 6.40; pharmaceutical sciences: mean = 90.71, standard deviation = 4.57; physical s...

Communications strategies are central to the planning and execution of interprofessional education (IPE) programs. The diversity of telecommunications-based tools and platforms available for IPE is rapidly expanding. Each tool and platform has a potentially important role to play. The selection, testing, and embedding of tools, such as social networking platforms, within education programs can be very challenging. The goal was to create, in Phoenix, a "command-and-control" video…

Many developing countries have shown interest in embracing telemedicine and incorporating it into their healthcare systems. In 2000, the U.S. Army Yuma Proving Ground (YPG) initiated a program to assist the Republic of Panama in establishing a demonstration Panamanian rural telemedicine program. YPG engaged the Arizona Telemedicine Program (ATP) to participate in the development and implementation of the program. The ATP recommended adoption of a "top-down" strategy for creating the program. Early buy-in of the Panamanian Ministry of Health and academic leaders was regarded as critical to the achievement of long-term success. High-level meetings with the Minister of Health and the Rectors (i.e., Presidents) of the national universities gained early program support. A telemedicine demonstration project was established on a mountainous Indian reservation 230 miles west of Panama City. Today, three rural telemedicine clinics are linked to a regional Ministry of Health hospital for teleconsultations. Real-time bidirectional videoconferencing utilizes videophones connected over Internet protocol networks at a data rate of 768 kilobits per second to the San Felix Hospital. Telepediatrics, tele-obstetrics, telepulmonology, teledermatology, and tele-emergency medicine services became available. Telemedicine services were provided to the three sites for a total of 1,013 cases, with numbers of cases increasing each year. These three demonstration sites remained in operation after discontinuation of the U.S. involvement in September 2009 and serve as a model program for other telemedicine initiatives in Panama. Access to the assets of a partner-nation was invaluable in the establishment of the first model…

Improving outcomes through patient-centered care has emerged as an important focus of study in the clinical and research worlds over the past decade. While the principles of patient-centered care and community-centered care are found in philosophical writings in ancient times, only recently have physicians and the overall healthcare community begun to accept that the health and well-being of patients depends upon collaborative and integrated efforts between healthcare professionals, patients, and their communities. The aim of this chapter is to provide perspective and practical guidance on the Patient Centered Outcomes Research Institute, and extramural Dissemination and Implementation funding for telemedicine and telehealth-related research. Hopefully, this data analysis provides new ideas about how to be successful in competing for patient-centered clinical intervention effectiveness funding going forward.

The Arizona Telemedicine Program and its Health Resources and Services Administration (HRSA)-funded telehealth resource center established a Telemedicine/Telehealth Service Provider Directory (SPD) in 2015. This was established in tandem with a national Service Provider Showcase, a direct-to-hospital (DTH) telemedicine service vendor national meeting which helped launch the SPD. The Service Provider Directory (SPD) was designed to provide healthcare system telemedicine service users critical and convenient information about DTH vendors at a single, reliable, web site. The primary aim of this chapter is to analyze the SPD’s database to help characterize the telemedicine/telehealth DTH service industry. As of 2018, 129 DTH companies were listed in the directory (currently 168 companies). Eighty-four percent of companies listed in the SPD as of 2018 indicated they were medical specialty telemedicine service vendors to healthcare systems; 57% were medical specialty telehealth service ve...