ACCESS

Access

Principal Investigator
Howard Yonas, MD
Chair, UNM Department of Neurosurgery

Grant Managers

Department of Neurosurgery
UNM School of Medicine
MSC10 5615
Albuquerque, NM 87131-0001
Phone: (505) 272-3401
neuroaccess@salud.unm.edu

UNM Center for Telehealth
UNM Health Sciences Center
Office for Community Health
MSC11 6090
1 University of New Mexico
Albuquerque, NM 87131
Phone: (505) 272-8633
telehealth@salud.unm.edu

Technical provider
Net Medical Xpress

The project described is supported by Grant Number 1C1CMS331351-01-00 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this document are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies

Abstract

About 2.1 million New Mexicans, 33% of them in rural areas, depend on the University of New Mexico Hospital (UNMH) for critical neuro-emergent services. Out of 33 counties, 31 are medically underserved areas, resulting in patients transported long distances to UNMH to receive neuro-emergent care services.

Through ACCESS, UNMH and its partners will leverage community-based coalitions to reduce the cost of neuro-emergent services and improve outcome for patients with neuro-emergent disorders such as complicated mild traumatic brain injury (mTBI) and stroke. ACCESS will build and expand existing partnerships in a comprehensive neurology and neuro-emergent telehealth network to provide critical state-of-the-art telehealth services to all NM providers and their patients, especially CMS beneficiaries. The program will target 30 regional hospitals with imaging capabilities to provide optimum triage and care for these patients, irrespective of insurance status.

ACCESS will focus on improving the health of geographically, clinically, and socioeconomically populations by providing comprehensive care that extends beyond the clinical service delivery setting. ACCESS goals are:

  1. to provide better healthcare by overcoming disparities in access to care throughout New Mexico;
  2. to achieve better health for patients by providing timely access to neuro-emergent specialty care;
  3. to reduce cost by decreasing preventable transfers and triaging patients to local outpatient care settings.

To date ACCESS has partnered with 11 rural and urban NM hospitals to provide radiographic enhanced neuro-emergent consultations using technology implemented by the UNM Department of Neurosurgery in conjunction with Net Medical Xpress Solutions (NMXS). This model integrates an educational component via traveling educators and a telehealth educational program.

With ACCESS, all ERs in NM will have a telehealth platform that includes rapid radiograph image transfer and two-way audiovisual capacity as well as report generating capacity. This will enable consulting neurosurgeons and neuro intensive care specialists to review imaging and talk with/ examine the patient and generate a report. This platform will be used at bedside to examine and assess patients, increasing the confidence and decision-making capacity of local and tertiary care physicians and increasing family members’ confidence that decisions for their loved ones were optimal.

ACCESS will optimize care for over 8,400 patients with neuro-emergent conditions during the three-year contract and indefinitely for tens of thousands more due to its unique sustainability. Once this telehealth system (THS) is in place in ERs across the state, it will be readily adaptable to many other emergent consultative services.

ACCESS will be managed by the UNM Department of Neurosurgery and the UNM Center for Telehealth. UNM and NMXS will partner to provide the telehealth and teleradiology infrastructure and equipment. NMXS will be responsible for installing hardware and software components and helping to train the future IT telehealth workforce. The UNM Center for Health Care Informatics will collect quality metrics, health measures, cost-effectiveness data, and workforce-related metrics.

Total budget is estimated at $15,120,767. Projected cost of care savings is estimated at $20,738,322. We will ensure sustainability by March 2017. We expect to enroll 8,400 beneficiaries over the 3-year funding period. Funds will be used for THS implementation, provider education, and data collection and analysis. provider education, and data collection and analysis