In 2010, the Lugar Center created the Wabash Valley Rural Telehealth Network (WVRTN) an Integrated Rural Health Network (IRHN) to promote quality, innovative, and cost-effective care strategies through collaborative partnerships with multiple independent health organizations in west-central and southern Indiana, east-central Illinois, and northern Kentucky. Beginning with tele-behavioral health in 2007, the WVRTN’s annual telemedicine consult volume has grown from 92 to nearly 6,000 over 30 sites. Nine live video interactive telemedicine specialties have been implemented to include behavioral health, cardiology, pulmonology, nephrology, child psychiatry, neurology, diabetes education, occupational health, and pediatrics. A patented store-and-forward platform facilitates rural ambulance electrocardiogram transmissions.
UH, and WVRTN, is a current Health Resources and Services Administration, Federal Office of Rural Health Policy grantee, under the Evidence-Based Telehealth Network Grant Program (EB-TNGP) aimed at supporting the implementation and evaluation of broad telehealth networks to deliver 24-hour Emergency Department (ED) consultation services via telehealth to rural providers without emergency care specialists. EB-TNGP’s main focus is through systematic data collection and analysis to establish an evidence-base assessing the effectiveness of Tele-Emergency care for patients, providers, and payers. WVRTN is the only network funded under this initiative currently offering and evaluation tele-behavioral service in rural Critical Access Hospital (CAH) EDs (see project map).
Beginning in 2010 in an effort to expand access to, coordinate, and improve health care quality, the Lugar Center developed inter-organizational network affiliation agreements for WVRTN partners to address issues such as governance, fiduciary responsibility, and oversight across this rural IRHN. Multiple, equal partners are represented from a variety of health care organizations. A hub-and-spoke model utilizes a shared video conferencing platform to facilitate coordination between established referral patterns and identified patient needs of the respective organizations and communities. This strategy also enhances each partner’s economies of scale in lieu of making an individual investment of the necessary video conference infrastructure.
Network Partners rely on standardized equipment across the WVRTN, which promotes cost-effective and compatible end-point solutions proven to fully and successfully integrate into a multitude of care environments. All solutions interact through the WVRTN’s shared licensing agreement through an agnostic, web-based platform that affords maximum integration and mobility. This infrastructure meets federal and industry standards to assure privacy of patients and clinicians using the system, as well as confidentiality of information transmitted via the system to maintain HIPAA compliance through the WVRTN’s existing business affiliation agreement. All video end-points and the infrastructure are upgradable and scalable. A combination of iPADs, Desktop Computers, Integrated Telehealth Rooms, and Panasonic Toughbooks provide high-quality live video and audio. To date, all the network devices have demonstrated high performance for bandwidth scalability ranging from 364 Kb/s to 720 Kb/s through the network’s combination of dedicated DS-3 lines, point-to-point fiber optic connections, Ethernet service, and dedicated wireless links to Network Partner sites via the central hub at Union Hospital. The video endpoint solutions, as well as the web-based platform was developed at the direction of the Partners based on feedback obtained utilizing provider and patient surveys, as well as anecdotal reports, regarding end-user satisfaction, and ease-of-use.