TSIM (The Telehealth Framework)

TSIM (The Telehealth Framework)

by TSIM
Released September 2021
Publisher(s): TSO (The Stationery Office)
ISBN: 9780117093614

Read it now on the O’Reilly learning platform with a 10-day free trial.

O’Reilly members get unlimited access to books, live events, courses curated by job role, and more from O’Reilly and nearly 200 top publishers.

Start your free trial

Book description

The PDF version is ideal for those who require instant access and the flexibility to search for key topics and phrases.

The Telehealth Service Implementation Model (TSIM) is a structured framework for the development, implementation, and long-term sustainability of telehealth services.

TSIM has evolved from the extensive telehealth experience and expertise of the Medical University of South Carolina (MUSC), one of only two HRSA-designated National Telehealth Centres of Excellence in the US.

The comprehensive model developed by MUSC provides a six-phase approach, a common terminology, and standardised processes to address the challenges of digitising healthcare. It helps you to recognise your organisation's strengths and weaknesses, and set it up for success.

TSIM is intended for telehealth leaders and teams that are responsible for their organisation's digital transformation efforts. TSIM helps leaders simplify and deliver the complex process by providing a clear roadmap and structure.

Telehealth holds the potential to significantly improve the way healthcare is delivered and accessed, and TSIM provides the roadmap for a digital transformation that will deliver efficient, effective, and high-quality care.

Table of contents

  1. TSIM: The Telehealth Framework - A comprehensive guide to telehealthimplementation and optimization
    1. Contents
    2. Acknowledgements
    3. Foreword
    4. Preface
    5. 1 Overview
      1. 1.1 Introduction
        1. Figure 1.1 Overview of TSIM
      2. 1.2 Brief history of telehealth
      3. 1.3 The pandemic shift to virtual
      4. 1.4 Historical challenges to telehealth development and implementation
      5. 1.5 History of the MUSC Center for Telehealth and the creation of TSIM
      6. 1.6 Purpose of the TSIM guide
    6. 2 Technology
      1. 2.1 Telehealth modes of care delivery
        1. Figure 2.1 Telehealth modes of delivery
        2. 2.1.1 Synchronous “real-time” encounters
        3. 2.1.2 Asynchronous – store and forward
        4. 2.1.3 Remote patient monitoring
        5. 2.1.4 Mobile health
      2. 2.2 Telehealth technology solutions
        1. 2.2.1 Telehealth software
        2. 2.2.2 Video endpoints
        3. 2.2.3 Peripheral devices
      3. 2.3 Technology selection process
        1. Figure 2.2 Telehealth technology selection
        2. Table 2.1 Example scoring criteria for a telehealth solution RFI/RFP process
      4. 2.4 Connectivity
      5. 2.5 Information security
      6. 2.6 Interoperability
    7. 3 People
      1. 3.1 Building organizational structure and governance
      2. 3.2 Clinical champions
      3. 3.3 Telehealth administrative leader
      4. 3.4 Telehealth team formation
        1. Table 3.1 Telehealth team formation
      5. 3.5 Communication and collaboration
      6. 3.6 Responsibility chart
        1. Table 3.2 Example of a responsibility chart
    8. 4 Legal and regulatory
      1. 4.1 Medical licensure
      2. 4.2 Malpractice insurance coverage
      3. 4.3 Credentialing and privileging
      4. 4.4 Standard of care
      5. 4.5 Patient-provider relationship
      6. 4.6 Prescribing medications via telehealth
      7. 4.7 Informed consent
      8. 4.8 Documentation and medical records
      9. 4.9 Stark Law and Anti-Kickback Statute
      10. 4.10 Fair market value
      11. 4.11 Patient confidentiality and HIPAA
    9. 5 Sustainability
      1. 5.1 Financial management
      2. 5.2 Direct revenues
      3. 5.3 Indirect revenues
      4. 5.4 Alternative payment models
      5. 5.5 Value on investment
      6. 5.6 Funding from alternative sources
      7. 5.7 Billing compliance
    10. 6 Telehealth for efficient, effective care
      1. 6.1 Focusing on clinical goals of care
      2. 6.2 Identifying the primary value
        1. Table 6.1 Examples of primary value drivers
      3. 6.3 Care along the continuum
      4. 6.4 Provider care efficiencies
      5. 6.5 Hospital at home
      6. 6.6 Emerging care delivery models
    11. 7 Outcomes planning
      1. 7.1 Defining metrics of success
        1. Table 7.1 NQF’s telehealth measurement framework
      2. 7.2 Standardized telehealth metrics
        1. 7.2.1 Utilization metric
        2. 7.2.2 Patient and provider experience metrics
        3. Table 7.2 Net Promoter Score for assessing telehealth services50
        4. 7.2.3 Quality of care delivery metrics
        5. 7.2.4 Technical reliability metric
        6. 7.2.5 Sustainability metric
      3. 7.3 Performance metric maturity model
        1. Table 7.3 Performance metric maturity model
    12. 8 TSIM phases: Pipeline and Strategy
      1. 8.1 Pipeline (pre-Strategy phase)
        1. Figure 8.1 Pipeline – portal of entry for telehealth program ideas
      2. 8.2 Strategy phase
        1. Figure 8.2 High-level steps in the Strategy phase
      3. 8.3 Intake process
        1. Table 8.1 Sample intake form
      4. 8.4 Prioritization scoring
        1. Table 8.2 Example of prioritization scoring criteria
        2. 8.4.1 Prioritizing scoring – implementation support
        3. 8.4.2 Prioritizing scoring – potential impact
        4. 8.4.3 Prioritizing scoring – sustainability
      5. 8.5 Performance metrics identified
        1. Table 8.3 Examples of standardized telehealth performance metrics
      6. 8.6 Technology
      7. 8.7 Timeline projections
      8. 8.8 Service charter formation
    13. 9 TSIM phase: Development
      1. 9.1 Introduction
        1. Figure 9.1 Overview of Development phase
      2. 9.2 Development pre-check
        1. Table 9.1 Guide for pre-check meeting
      3. 9.3 Clinical pathway
        1. 9.3.1 Clinical workflows
        2. Figure 9.2 Example of an emergency medicine telehealth service workflow
        3. 9.3.2 Clinical and operational protocols
        4. 9.3.3 Emergency plans and procedures
        5. 9.3.4 Scheduling protocol
        6. 9.3.5 Training protocol
      4. 9.4 Technology pathway
        1. 9.4.1 Technology needs assessment
        2. 9.4.2 Technical support plan
        3. 9.4.3 Technology system changes and integrations
        4. 9.4.4 Technology testing
      5. 9.5 Legal and regulatory pathway
        1. Figure 9.3 Overview of legal and regulatory pathway tasks
        2. 9.5.1 Legal and regulatory – service review
        3. 9.5.2 Legal and regulatory – provider review
        4. 9.5.3 Legal and regulatory – site review
      6. 9.6 Outcomes pathway
      7. 9.7 Launch status brief
    14. 10 TSIM phase: Implementation
      1. 10.1 Introduction
        1. Figure 10.1 Overview of Implementation phase
      2. 10.2 Change management
      3. 10.3 Implementation roundtable
      4. 10.4 Training and mock calls
      5. 10.5 Pre-go-live brief
      6. 10.6 Go-live
      7. 10.7 Post-go-live debrief
    15. 11 TSIM phase: Operations
      1. 11.1 Introduction
        1. Figure 11.1 Overview of Operations phase
      2. 11.2 Service delivery management
        1. Figure 11.2 Overview of service delivery management
        2. 11.2.1 Service delivery – people
        3. 11.2.2 Service delivery – process
        4. 11.2.3 Service delivery – performance management
      3. 11.3 Operational technology management
        1. Figure 11.3 Overview of operational technology management
        2. 11.3.1 Operational technology – infrastructure reliability
        3. 11.3.2 Operational technology – incident response
        4. 11.3.3 Operational technology – technical resolution management
    16. 12 TSIM phase: Continuous Quality Improvement
      1. 12.1 Introduction
      2. 12.2 Challenges of the CQI phase
      3. 12.3 Building high reliability into telehealth services
        1. Table 12.1: Characteristics of high reliability
      4. 12.4 CQI throughout TSIM
        1. 12.4.1 Quality planning
        2. 12.4.2 Quality assurance
        3. 12.4.3 Quality improvement
        4. 12.4.4 Innovation
      5. 12.5 Service optimization
      6. 12.6 CQI tools
        1. Figure 12.1 Plan-Do-Study-Act cycle
        2. Figure 12.2 Fishbone diagram example
        3. Figure 12.3 Key driver diagram example
      7. 12.7 CQI – efficiency of care
      8. 12.8 Safety culture
      9. 12.9 CQI conclusion
    17. 13 TSIM summary
    18. Endnotes
    19. Appendix Ohio River Health System and TSIM
      1. A.1 Prior to TSIM initiation
        1. A.1.1 TSIM prerequisite checklist
      2. A.2 TSIM Pipeline and Strategy phases (1/2)
      3. A.2 TSIM Pipeline and Strategy phases (2/2)
        1. A.2.1 TSIM intake form and TSIM prioritization score for telestroke
        2. A.2.2 TSIM intake form and TSIM prioritization score for school-based telehealth
        3. Table A.1 TSIM intake form for telestroke
        4. Table A.2 TSIM prioritization score for telestroke
        5. Table A.3 TSIM intake form for school-based telehealth
        6. Table A.4 TSIM prioritization score for school-based telehealth
        7. Table A.5 Performance metrics for telestroke and school-based telehealth
      4. A.3 TSIM Development phase (1/2)
      5. A.3 TSIM Development phase (2/2)
        1. A.3.1 TSIM Development: clinical pathway
          1. A.3.1.1 Clinical pathway: telestroke
          2. Figure A.1 Clinical pathway: telestroke swim lane diagram
          3. A.3.1.2 Clinical pathway: school-based telehealth
          4. Figure A.2 Clinical pathway: school-based telehealth (on-demand) swim lane diagram
          5. Figure A.3 Clinical pathway: school-based telehealth (scheduled) swim lane diagram
        2. A.3.2 TSIM Development: technology pathway
          1. A.3.2.1 Technology pathway: telestroke
          2. A.3.2.2 Technology pathway: school-based telehealth
        3. A.3.3 TSIM Development: legal and regulatory pathway
        4. A.3.4 TSIM Development: outcomes pathway
          1. Table A.6 Telestroke outcomes assessment
          2. Table A.7 School-based telehealth outcomes assessment
      6. A.4 TSIM Implementation phase
        1. Table A.8 Telestroke post-go-live debrief checklist
        2. Table A.9 School-based telehealth post-go-live debrief checklist
      7. A.5 TSIM Operations phase (1/2)
      8. A.5 TSIM Operations phase (2/2)
        1. A.5.1 TSIM Operations: service delivery management
          1. A.5.1.1 Telestroke
          2. Figure A.4 Utilization dashboard – telestroke consultations by month
          3. A.5.1.2 School-based telehealth
          4. Figure A.5 Quality of care delivery dashboard – telestroke average DTN times by month
          5. Figure A.6 Utilization dashboard – school-based telehealth consultations by month
        2. A.5.2 TSIM Operations: operational technology management
          1. Figure A.7 Operational technology management: IT support process
        3. A.6 TSIM Continuous Quality Improvement
          1. Figure A.8 Baden Hilltop Hospital – telestroke DTN times by month
          2. Figure A.9 Baden Hilltop Hospital – fishbone diagram
          3. Figure A.10 Baden Hilltop Hospital – telestroke DTN times by month – post-CQI
          4. Figure A.11 Ohio River’s telestroke network – telestroke DTN times by month – post-CQI
        4. A.7 Ohio River case summary
    20. Index (1/2)
    21. Index (2/2)

Product information

  • Title: TSIM (The Telehealth Framework)
  • Author(s): TSIM
  • Release date: September 2021
  • Publisher(s): TSO (The Stationery Office)
  • ISBN: 9780117093614