The Model

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

Hospital and Consultant Recruitment

For five years, the ACCESS leadership has worked closely together to introduce telehealth to referring medical centers, and that experience will help with our recruitment and enrollment process. To date, there are 11 hospitals in NM that practice telemedicine and have a contract in place with NMXS. They have shown support in becoming part of ACCESS. From the remaining 19 hospitals we have obtained their letters of support for this project and some of them have already started negotiations with NMXS.

Consultants in the spoke hospitals are at the heart of the ACCESS program’s success. Consultants will be comprised of local nursing staff that will represent the program at each hospital. They will receive special training and support for being part of this effort and are critical for ongoing education and quality control of data. They will participate in and lead quarterly webinars with local and UNMH health care professionals to discuss failures and successes and will be involved with our annual telehealth conference. We will also send our ACCESS research team to neurological and neurosurgical meetings to increase local professionals' knowledge of cerebral emergencies.

In 2011 and 2012 we had a successful telehealth conference in Albuquerque. As a result, we tripled the number of hospitals using teleradiology. We plan a similar telehealth conference annually to exchange experiences and develop a cohesive telehealth community among health care facilities in the state.

Our ability to enroll all NM hospitals is demonstrated by the fact that one-third of these hospitals have already employed teleradiology in one form or another and have a partnership with NMXS. Having already implemented and tested it extensively, this system is ready for rapid implementation throughout the state.

We will implement the telehealth system in two phase based on the hospitals’ volume and telehealth experience. As explained in the milestone section of our Operational Plan, we intend to have the first 15 phase 1 hospitals ready to enroll and go live with THS intervention within three months of launch (7/01/14). The phase-2 hospitals will go live six months after starting on 9/30/14. For detailed information about our readiness, please see Section C of our Operational Plan.

Following recruitment strategies will be employed: In hospitals with current telemedicine program (n=11) the telehealth personnel will be interviewed and recruited to become local consultants. We will also heavily recruit half of the ER health care providers to become telehealth care “super users” because we expect most of our patients /subjects to be enrolled when in the ER. (see also more in Study Design). Salary support being provided by this grant will free up time for the consultant to contribute to this program. Free education and CME/ CNE accredited online courses and conferences will encourage participation.

In hospital without telehealth care workforce will be recruited using peer-to-peer recruitment. Our experience has shown us that peer-to-peer learning and recruitment works best with rural hospitals that are sometimes suspicious of the "big university." Peer-to-peer outreach and exposure during recruitment activities will help to retain and recruit our telehealth workforce. ACCESS leadership will also visit each site for grand rounds to introduce the program.

ACCESS leadership will conduct quarterly webinars for all participating sites to help them manage the workforce they recruit for this program. We will also send electronic newsletters and use social media, including blogs and a website, to help create a sense of community among project participants and allow them to address issues in real time. These activities will also allow us to fluidly incorporate changes and suggestions from each site.