Oral Presentation

(V2-03) VTC-Virtual Teleconsultation Services: A Roadmap from Pilot Project to Established State-Wide Service

Sunday, April 23
12:10 PM - 12:30 PM
Location: W230 BC

Introduction: A state-wide virtual teleconsultation service (VTC) serves to provide outpatient tertiary care medical and surgical consult services in the patient's home community through a network of community practice providers.
Background: The VTC started as an overlap of an identified community need for specialty consultations with an emerging technology with the potential to provide a low-cost, patient friendly solution. Beginning as a Duke Endowment project with five partner practices and a small patient volume, the project gradually developed into a network of nearly 70 community practices linked to an urban health center.
Methods: Because all 46 South Carolina counties have federally-designated medically-underserved areas, a state-wide telemedicine needs assessment for rural South Carolina was performed in 2009. A pilot program was initiated with the following stakeholders; the Medical University of South Carolina (MUSC), a tertiary care health system; the MUSC Office of Information Technology; and SC Area Health Education Consortium, a state health agency. Funding for the pilot program was gained from the Duke Endowment for a 2 year trial period. A hub and spoke model was developed. After the pilot period, the state of SC appropriated $19 million for fiscal year 2014-2015 and an additional $12.4 million.
Results: The VTC program began with pilot programs in Psychiatry, Surgery, and Nutrition. This has grown to outpatient services in more than 20 medical and surgical subspecialties, including General Surgery, Dermatology, Endocrinology, Gastroenterology, among others. Beginning in 2012 with 9 outpatient consults, we have experienced significant growth, completing 588 consults in 2015, with 124% growth over the past year. Strong drivers of clinical growth were seen in pediatric and adult nutrition and psychiatry. Patients have seen significant benefits, including travel miles saved and travel hours saved. Over the life of the program, patients have avoided 231,008 travel miles with an average of 148 miles per patient. Patients have saved 4,620 hours in travel, with an average of 3.0 hours per patient. Patients have saved $158,496 in direct travel costs.
Conclusion: Formation of a state-wide virtual teleconsultation service requires buy-in from multiple stakeholders, including referring providers, patients, information technology personnel, and clinicians willing to conduct telehealth consults. When implemented, a VTC service can bring a relatively scarce resource of specialty tertiary care to patients in rural, underserved areas in a cost-effective way.

Learning Objectives:

Aaron Lesher

Assistant Professor of Surgery and Pediatrics
Medical University of south Carolina

Dr. Lesher received his MD degree in 2006 from Duke University School of Medicine. He then completed his internship and general surgery residency at the Medical University of South Carolina. Dr. Lesher then went on to fellowship training in pediatric general and thoracic surgery at University of Tennessee Health Sciences Center/LeBonheur Children’s hospital. Dr. Lesher has developed an interest in pediatric telemedicine in order to address healthcare disparities in the children of South Carolina.


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Brittany Pinckney

Telemedicine Program Assistant
Medical University of South Carolina

Brittany M. Pinckney joined the MUSC Center for Telehealth in October of 2015 as an Outpatient Telehealth Program Assistant. Collaborating with the VTC Outpatient Program Coordinator, Ms. Pinckney works to ensure the successful scheduling and coordination of telehealth care throughout the state of South Carolina. Brittany provides Telehealth patients, and South Carolina VTC participating practices, with personalized, and streamlined customer service experiences. As a result of her efforts, Telehealth encounters continue to be consistently and reliably organized for completion in an effective and dependable manner. Ms. Pinckney also collaborates with marketing efforts to promote MUSC specialties within the VTC program.

Brittany earned her Bachelor in History at Converse College and is currently pursuing her Master's Degree in Health Administration with Ashford University. She began her career with MUSC in 2014, serving as a Patient Access Specialist for MUSC Hollings Cancer Center. In 2015, Ms Pinckney was personally selected to act as a Patient Access Specialist for the MUSC Wellin Head and Neck Tumor Clinic. Upon joining the MUSC Center for Telehealth in late 2015, she completed two National School of Applied Telehealth courses to obtain certification as both a Telehealth Coordinator and a Telemedicine Clinical Presenter.


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Samir Fakhry

Charles F. Crews Professor, Department of Surgery
Medical University of SC

Dr. Samir Fakhry was Principal Investigator, together with Dee Ford MD, from September 2009 until March 2012 on an NIH research project entitled “Critical Care Excellence in Sepsis and Trauma”. In June 2011, he was awarded a Duke Endowment grant to create a Virtual TeleConsult Clinic using telemedicine technologies to provide specialty consultation to underserved areas in SC. That project evolved to become part of the state funded Center for Telehealth and he is its medical director. He has authored over 100 peer-reviewed publications, abstracts and book chapters and currently serves as President of the American Trauma Society.


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Laura Langston

Teleconsulation Service Coordinator
Medical University of South Carolina

Laura is a Telehealth Program Coordinator, and she operates the Virtual Teleconsultation Services. She began a career in telehealth in 2009 as the program coordinator for Critical Care Excellence in Sepsis and Trauma, the Southeastern Virtual Institute for Health Equity & Wellness tele-critical care, and The Virtual TeleConsult Clinic. She has received publication credit for a manuscript titled “A Mixed Methods Descriptive Investigation of Readiness to Change in Rural Hospitals Participating in a Tele-Critical Care Intervention,” published in BMC Health Services Research 2013.


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(V2-03) VTC-Virtual Teleconsultation Services: A Roadmap from Pilot Project to Established State-Wide Service

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