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EP-115 - Specialty Care via Telemedicine for Chronic Disease Management in an Urban Federally Qualified Health Center

Monday, April 30
9:35 AM - 9:50 AM
Location: Education Zone, Booth 2416, Screen 2

Co-locating clinical services and integrated care models, often considered best practices in healthcare, have been well described in various traditional in-person settings, yet remain relatively underdeveloped with respect to telemedicine. We describe the development of a new program, which co-locates specialty care from an Academic Health Center via telemedicine with traditional primary care at a Federally Qualified Health Center (FQHC) to expand access to specialty care for the management of chronic disease for an urban, underserved patient population.
In order to address the greatest burden of disease in a traditionally underserved urban neighborhood, we developed the capacity to provide secure, live audio-visual encounters for patients with difficult to manage hypertension, diabetes and chronic kidney disease. Patients are referred to the program by their primary care provider, with the ability to obtain both initial consultation and ongoing care from a specialist at their usual site of care, the FQHC. Participating specialties include cardiology, endocrinology, and nephrology. The program has been able to successfully obtain reimbursement from the local Medicaid program as well as private insurers. Formal evaluation of provider and patient satisfaction, clinical outcomes and other detailed program metrics is ongoing and interval results from Year 1 of this 3 year grant supported study will be presented.
Experience to date has demonstrated keen interest, with demand outstripping available provider hours for certain conditions and demonstrates promise regarding improved access to care for urban underserved patients who often face a disproportionate burden of chronic disease and numerous barriers to accessing specialty services, including transportation and time lost from work. Early success in billing and reimbursement bodes well for future financial sustainability. Challenges remain regarding provider to provider communication for full care integration.
According to a recent national survey, the majority of community health centers do not offer telemedicine services, and the number of urban centers using telemedicine was far lower than rural centers. Our experience developing a new program for specialty care via telemedicine at an urban FQHC may inform future efforts to enhance the use of telemedicine at community health centers, improve access to care for underserved patient populations, and advance best practices of clinical care integration.

Learning Objectives:

Guenevere V. Burke

Assistant Professor
GW Department of Emergency Medicine

Dr. Guenevere Burke is an assistant professor of emergency medicine at the George Washington University (GW). In this role, she leads medical education and interdisciplinary graduate programs in health policy, health equity and healthcare technology. These unique programs capitalize on the extraordinary health policy resources available in the Washington DC region and have been featured in the popular media for their singular contributions to medical education. In collaboration with Kaiser Permanente, Dr. Burke also pioneered new residency programs in health policy for the Northern and Southern California regions. Dr. Burke holds a secondary appointment as assistant professor in the department of health policy and management and co-directs the Leaders for Health Equity program, an international health sector fellowship funded by the Atlantic Philanthropies and based at the George Washington University.

Dr. Burke is a board certified emergency physician who provides clinical care in traditional and telemedicine encounters through the GW Department of Emergency Medicine. Passionate about the promise of technology to transform current care models and improve access, Dr. Burke is involved in Improving Specialty Care via Telemedicine, an innovative chronic disease management program for patients at a local Federally Qualified Health Center, supported by CareFirst. She serves as President of the District of Columbia American College of Emergency Physicians.

Dr. Burke completed fellowship training in health policy at GW, medical education at UCLA and residency training at the University of Southern California, where she served as chief resident. She holds an MBA from the Massachusetts Institute of Technology and previously worked in international healthcare consulting and hospital finance prior to her career in medicine.


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Neal Sikka

Section Chief, Innovative Practice
GW Medical Faculty Associates

Neal Sikka, MD is board certified in Emergency Medicine and is an Associate Professor of Emergency Medicine at the George Washington University School of Medicine and Health Sciences, the Chief of the Innovative Practice & Telemedicine Section at the GW Medical Faculty Associates, and the Medical Director of the OnSite Medical Access Program.

Dr. Sikka is an emergency medicine physician with a particular interest and expertise in telemedicine and technological applications to healthcare. He has over 12 years of telemedicine experience and is recognized as a national leader in telemedicine expertise. He holds a seat on the Advisory Board of the MidAtlantic Telehealth Resource Center, is an active member of the GW mHealth Collaborative, and was a founder and the first chair of the American College of Emergency Physician’s Telemedicine Section. He has developed undergraduate and graduate education related to emergency medicine and telemedicine and regularly speaks at regional and national telehealth meetings.

His research has focused on improving patient care through technology and he has received funding for telehealth related research from the McKesson Foundation, the Centers Medicare and Medicaid Innovation Challenge Grant Award to use remote medical monitoring to improve care for peritoneal dialysis patients. Most recently, he is PI on a CareFirst Foundation Grant to provide specialty care via telemedicine in DC area Federally Qualified Health Centers.


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Nicholas Reed

Innovative Practice Program Coordinator
GW Medical Faculty Associates

Nicholas Reed is a Program Coordinator with the GW Medical Faculty Associates’ Department of Emergency Medicine where he works on various unique telemedicine programs within the Innovative Practice & Telehealth Section.

Nicholas holds a Bachelor of Science in Public Health from Rutgers University. Prior to joining the Innovative Practice & Telehealth Section at GW, he worked in a variety of clinical, education and administrative settings, including pre-hospital care, online continuing education, and occupational health. His experience in healthcare and telemedicine includes work in the United States and internationally, in the Middle East.


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EP-115 - Specialty Care via Telemedicine for Chronic Disease Management in an Urban Federally Qualified Health Center

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