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National Telehealth Research Symposium 2019: Collaboration at its Best

Some members of SEARCH, SPROUT and local NTRS organizing committee at the poster session and networking event.

Successful meetings don’t just happen. There’s a lot of hard work that goes into the planning, organization and execution of these events. The National Telehealth Research Symposium 2019 that was recently held in Chicago is a perfect example of how organizations with common goals can collaborate to create a top-tier meeting (without any vendor support or involvement!) to promote research in connected health and telemedicine. The NTRS 2019 meeting was put together by SEARCH (the Society for Education and the Advancement of Research in Connected Health) and SPROUT (Supporting Pediatric Research on Outcomes and Utilization of Telehealth; a group within the American Academy of Pediatrics). SEARCH’s mission is to promote a platform for researchers, free from commercial bias, to prove the benefits of Connected Health via their annual symposium, with the goal of sharing research findings and to foster collaborations among researchers and organizations who wish to define, develop, and contribute to the field of connected health research. SPROUT’s mission is to promote, develop, and disseminate multicenter value-driven research on pediatric telehealth with the goals of identifying best practices for implementation of pediatric telehealth, determining the impact of telehealth on healthcare quality, and establishing a network of institutions to conduct collaborative research on pediatric telehealth.

Clearly there was synergy from the first thought of holding a joint meeting with so much overlap in the societies’ goals and missions. Both groups had previously held independent meetings, but through mutual attendance of key leaders at prior some of these meetings, the idea of joining forces blossomed and very quickly NTRS 2019 was a reality. Appropriately enough, some of the SPROUT members were associated with the Ann & Robert H. Lurie Children’s Hospital in Chicago and a local host site was readily identified. Interestingly, the building the meeting was held in was the American Dental Association’s Headquarters – sorry no free toothbrushes or floss being handed out in the lobby.

The 2.5-day meeting was a great mix of joint sessions followed by breaking out into general and pediatric focused sessions, and all were very well attended up until the very end of the third day. Each day started off with a keynote presentation, each one focusing on a different topic. The keynote on Day 1 was “The Road to Competencies: Leveraging Telehealth Skills for Clinician Education” presented by Scott Shipman and Sarah Hampton from the Association of American Medical Colleges (AAMC). A number of us on the organizing committee are actually members of the task force examining telehealth competencies for medical students so it was great to see the topic brought to a broader audience. Admittedly this articular topic was not research based, but it is of such critical importance for training our future healthcare workforce that we all agreed it would make a great keynote – and it was. The talk provided a nice overview of the Task Force’s efforts to date and hopefully the final product will be released in the near future.

Day 2’s keynote highlighted our pediatric partners with a presentation n “Advocacy and the Pediatrician: Leveraging Technology and Improving Access to Care” presented by Mark Del Monte, CEO, American Academy of Pediatrics. This talk was a great complement to many of the research talks presented throughout the meeting, especially during the dedicated pediatric focused breakouts. To outsiders the idea of dealing with adult and child/adolescent healthcare separately might seem odd, but they really are such different populations that the distinction is critically important – especially in the context of telehealth. To get an idea of the types of topics that are being researched in pediatric populations check out the AAP website at https://services.aap.org/en/search/?k=telemedicine&page=1&sort=newest.

The final keynote was of great interest to all attendees no matter what their specialty, clinical focus area or research field – “Telehealth: A National Payer’s Experience” presented by Donna Laliberte O’Shea, MD, MBA, CPE VP and National CMO, Population Health Management, UnitedHealthcare. Although just one payer’s perspective it was very encouraging to see all of the ways this large organization has been promoting and integrating telehealth into its provider portfolio and making it successful in terms of payment and impacting patient outcomes.

It was impossible to attend both tracks of the meeting so I focused on the more general side than the pediatric, I did attend a couple of those sessions as well, although I would have loved to have a clone of myself to attend both. The abstracts and agenda are available on the SEARCH website (or just contact me) if you want to see the wide array of research topics being investigated these days as well as the variety of methods being used to assess impact and outcomes. I’ll just highlight a few of my favorite presentations by my favorite group of researchers – students preparing for future careers as providers and healthcare researchers.

Darlina Liu, MS3 at NYU School of Medicine, presented on her lit review “Feeling the Burn:

The Application of Telemedicine for Acute Burn Care Management in Low and Middle Income Countries” She examined different types of telemedicine programs for acute burn care management in low‐ and middle‐income countries, finding that programs in South Africa, Iran, and Turkey relied on experts from within their respective countries, while programs in Ukraine, Nepal, Poland, the Occupied Palestinian Territories, and Sao Tome Principe relied on the expertise of individuals from the US, UK, and Taiwan. Tele‐consultation was the most popular function, followed by patient follow‐up, burn assessment, and tele‐education, with 55% of programs being mobile‐based, 30% computer‐based, and the rest included both.

Another medical student, Jennifer Milsten from Oklahoma University College of Medicine, carried out a retrospective chart review to examine the “Utility of Tele‐echocardiography for screening CHD in a Level II NICU”. Over a 3-year period, telemedicine was used to screen 29 infants for congenital heart disease, and 38% had significant tele-echocardiogram findings requiring follow‐up with conventional echocardiography either as inpatient at a regional Level IV NICU or outpatient following discharge and 62% had normal findings. 28% were scheduled for follow‐up in outpatient settings and only 10% required transfer to a Level IV NICU. Strong agreement was noted between echocardiogram findings done via telemedicine and conventional echocardiography and no case of critical CHD was missed.

Highlighting the true diversity of presentation topics, Rohan Patil from the Department of Physics, George Washington University talked about “Quantifying Telemedicine Consult Features to Provide Feedback with Machine Learning”. They used image processing and Natural Language Pprocessing to assess mock tele‐neurology consults for stroke patients, specifically at lighting, neurologist's eye contact, neurologist's posture, and stroke protocol medication (IV‐tPA) adherence. They quantified good eye contact and posture and created a dictionary to identify keywords useful for identifying when a physician adhered to a specific stroke protocol. Their eventual goal is that by defining what good lighting/eye contact/posture look like, their program can recommend that provider adjust his/her behavior to improve consult quality.

NTRS also continued two of innovations we introduced at the 2018 SEARCH meeting. The first was 3 rounds of Research Flashes in which poster authors had (precisely) 2 minutes to summarize their poster content in order to draw attendees to view their poster in more detail during the dedicated poster sessions. It worked! Traffic was heavy and there was plenty of opportunity for these authors to answer questions and discuss their research in more detail – even at the networking event attendees spent a good deal of time at the posters along with socializing and snacking!

Secondly, we encored our Education Blasts. These are not only quite informative but also fun to do. In a short (~15 minutes) overview, different research techniques are highlighted by an expert in the field. This year we had 2 Blasts: “How to Do Systematic Lit Reviews” by Dr. Kathy Wibberly, PhD from the University of Virginia and Mid-Atlantic Telehealth Resource Center and “Study Design Methodology” by Jen Rosenthal and Hadley Sauers-Ford from the University of California Davis. Both provided a wealth of useful “how-to” points and nicely demonstrated the wealth of study and analysis tools and methods for telehealth research beyond simple lit reviews and randomized controlled trials. A quick show of hands from the audience revealed that a few were already using some of these techniques but a whole lot more are going to look into them - hopefully for research presented at next year’s meeting!

We’re still assessing this year’s meeting and stoking our energy for planning next year’s, so I can’t tell you where and when it will be – but I can guarantee it will be held. The level of enthusiasm and excitement over the incredibly high level of quality investigations now being done in the telehealth arena was palpable. If the most critical naysayers about telehealth had attended the NTRS 2019 they would have gotten the data they keep saying doesn’t exist. I encourage all of you to check out the abstracts, attend the 2020 symposium and get out there and do some high-powered research!

 

About the Author

Elizabeth Krupinski, Ph.D. is a Professor at Emory University in the Department of Radiology & Imaging Sciences and is Vice-chair of Research. She is Associate Director of Evaluation for the Arizona Telemedicine Program and Director of the SWTRC. She has published extensively in these areas, and has presented at conferences nationally and internationally. She is Past Chair of the SPIE Medical Imaging Conference, Past President of the American Telemedicine Association, President of the Medical Image Perception Society, and Past Chair of the Society for Imaging Informatics in Medicine. She serves on a number of editorial boards for both radiology and telemedicine journals and is the Co-Editor of the Journal of Telemedicine & Telecare.

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