The biggest challenge isn t technology, it s managing change 

Doctor Donald Kosiak is the medical executive director of Avera eCARE. The initiative, which is part of Avera Health, is introducing one of the most important telemedicine programs in the United States. In fact, it currently provides healthcare services across an area of almost 900 thousand square kilometers.

A few days before his speech at the Annual HIMSS Conference and Exhibition, Kosiak summarizes his work with the organization in rural areas and provides a preview of his speech at the Latin American version of the event.

What are Avera Health’s most recent technological innovations in healthcare provision?

During the first twenty years of Avera eCARE, the focus was on clinical and hospital practices based on telemedicine. In recent years, however, we have started to connect with homes and non-traditional locations. One example of this work is healthcare training in using mobile applications to manage obesity and diabetes and the use ofapplications in emergency cases from any online or mobile device.

We are also starting to develop a transition team to concentrate on the most vulnerable members of our population: the elderly. We have created a team of geriatric experts, pharmacists, clinicians and nurses to facilitate the transition from hospital to home. This allows us to better administer to their immediate needs with a care team that is specialized in keeping elderly adults healthy and out of hospital. This program is calledeLTC and it connects patients to service providers at the virtual hospital run by Avera eCARE using audiovisual and bi-directional telemedicine technology. With the help of staff at the unit, the eLTC can precisely evaluate the conditions of patients fromhundreds of kilometers away.

What challenges did you face?

The biggest challenge, surprisingly, isn’t technology: today we can connect with anyone all over the world extremely easily. The biggest challenge is managing change: i.e. helping patients and healthcare professionals to learn to do things in new and innovative ways. The second most important challenge is licensing and certification of doctors when the process starts to cross borders: the more extensive the regulatory processes for medical practice the more the adaptation and use of the telemedicine is limited.

Bearing in mind the number of rural areas in Latin America, what IT strategies could help the region to provide better healthcare coverage?

Avera got into telemedicine with the objective of providing care for rural patients. We firmly believe that geography shouldn’t dictate the efficiency of healthcare or access to professionals but it is true that the large distances between hospitals and specialistshave started to affect the quality of the care provided. That is why we support medical professionals with healthcare plans and logistical planning through fixed and mobile units located in healthcare establishments. We even help a lot of rural clinics by arranging appointments with specialist doctors to avoid patients having to move from their place of residence. And for less urgent consults we also have direct offers for consumers that allow any patient to have access to a ‘low demand’ doctor via a computer or smartphone.

Currently, Avera provides telemedicine services to an area of almost 900 thousand square kilometers. In fact, we have plans to double this figure over the next two years and this presents us with the challenge of reaching rural and border areas.

What subjects will you address at your presentation at the HIMSS Latin America Annual Exhibition and Conference?

I’m going to talk about the best practices in telemedicine we have developed around the world and to share some of the successes and failures that often happen during the initial development of a telemedicine program. I am also going to talk about the clinical and financial impact of these projects and, finally, the future uses of telemedicine.

INFO: The talk by Dr. Donald Kosiak will take place on Wednesday, November 4 at 4:15PM and last until 5PM at the HIMSS Latin America Conference. You can register for the event here.

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