# Presentation: 412719

## Prosthetic and Sensory Aids Service (PSAS)

- VISN 8 Home Telehealth Centralized Equipment Management System

**Notes:**
Prosthetic and Sensory Aids Service (PSAS)
Based on National Contract Guidelines
Adapted for V8 Home Telehealth Programs
By: Sarita Figueroa, MBA
VISN 8 CCCS Director Business Operations
VACO OCC Business Manager 

## Home Telehealth Devices

- Messaging

- Monitoring

**ViTel*****Care*****TM Turtle**

**Notes:**
Pictures of Home Telehealth Devices

## Home Telehealth Devices Peripherals

- Peripherals:  Accessories used with the HT devices, such as:
- Scales
- HB Pressure Monitors
- Pulse Oximeters
- Glucose Monitors
- Stethoscope

## Home Telehealth Messaging and Measuring Device (Health Buddy)

_**HCPCS**_: TH100   _Open this_
_**Vendor**_: Health Hero
_**Cost New**_: $589.47
_**Cost Refurbished**_**:**  $300
- 	DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 7/1/04 thru 6/30/05
- _Contract No_.: V797P-9131

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH100
Vendor: Health Hero
Cost New: $575  
Cost Refurbished:  $300
	DO NOT include shipping charges – freight is included in the price of product
Contract Period : 7/1/04 thru 6/30/05
Contract No.: V797P-9131
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home Telehealth  Messaging and Measuring Device

_**HCPCS**_: TH100   _Open this_
_**Vendor**_: Viterion
_**Cost New**_: $1,299
- DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 12/3/04 thru 12/2/09
- _Contract No_.: V797P-2067

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH100   Open this 
Vendor: Viterion
Cost New: $1,299
DO NOT include shipping charges – freight is included in the price of product
Contract Period : 8/27/04 thru 8/26/05
Contract No.: V797P-2067
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written

## Home Telehealth  Messaging and Measuring Device

_**HCPCS**_: TH100   _Open this_
_**Vendor**_: American TeleCare, Inc. (ATI)
_**Cost New**_: $1,400
- 	DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 12/17/04 thru 12/16/07
- _Contract No_.: V797P-2069

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH100   Vendor: American TeleCare, Inc. (ATI)
Cost New: $1,186.87 
	DO NOT include shipping charges – freight is included in the price of product
Contract Period : 12/17/04 thru 12/16/05
Contract No.: V797P-2069
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home Telehealth Monitoring and Measuring Device

_**HCPCS**_: TH102   _Open this_
_**Vendor**_: AMD Telemedicine
_**Cost New**_: $2,573.97
- 	DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 11/22/04 thru 11/21/05
- _Contract No_.: V797P-9135

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH102   Open this 
Vendor: AMD Telemedicine
Cost New: $2,499 
	DO NOT include shipping charges – freight is included in the price of product
Contract Period : 11/22/04 thru 11/21/05
Contract No.: V797P-9135
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home Telehealth  Monitoring and Measuring Device

_**HCPCS**_: TH102   _Open this_
_**Vendor**_: Viterion
_**Cost New**_: $3,900
- DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 9/27/04 thru 9/26/05
- _Contract No_.: V797P-9132

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH102
Vendor: Viterion
Cost New: $3,900
DO NOT include shipping charges – freight is included in the price of product
Contract Period : 9/27/04 thru 9/26/05
Contract No.: V797P-9132
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home Telehealth  Monitoring and Measuring Device

_**HCPCS**_: TH102   _Open this_
_**Vendor**_: Visual Telecommunications (ViTel Net)
_**Cost New**_: $2,892.21
- 	DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 12/6/04 thru 12/5/07
- _Contract No_.: V797P-9133

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH102   Open this 
Vendor: Visual Telecommunications (ViTel Net)
Cost New: $3,514 
	DO NOT include shipping charges – freight is included in the price of product
Contract Period : 12/6/04 thru 12/5/05
Contract No.: V797P-9133
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home Telehealth  Monitoring and Measuring Device

_**HCPCS**_: TH102   _Open this_
_**Vendor**_: Carematix, Inc.
_**Cost New**_: $2,150
- DO NOT include shipping charges – freight is included in the price of product
- _Contract Period _: 12/8/04 thru 12/7/07
- _Contract No_.: V797P-9134

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

**Notes:**
HCPCS: TH102   Open this 
Vendor: Carematix, Inc.
Cost New: $3,495
DO NOT include shipping charges – freight is included in the price of product
Contract Period : 12/8/04 thru 12/7/05
Contract No.: V797P-9134
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home Telehealth Video Phone

_**HCPCS**_: TH102
_**Vendor**_: KMEA
_**Cost **_: $824.50
-               .
- 	DO NOT include shipping charges – freight is included in the price of product.  _Low cost includes 2% discount._
**	*****Since there are several items under TH102 – you must enter the Item and PIP Descriptions as Video Phone in order to be compliant.  A new HCPCS code will be created for the Video Phone.***
**	****NOTE:**  The monitoring devices are computers that have videophone components.  They take the same biometric measurements as the messaging units but replicate face to face visits of a clinician via the video component.  All of  the information that is collected using them is transmitted to VA via servers that are located behind VA's firewall.
- _Contract Period_:   3/14/05 thru 3/13/08
- _Contract No_.: V797P-9146

- Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

- Must be entered EXACTLY as listed

**Notes:**
HCPCS: TH102
Vendor: KMEA
Cost : $810.46
              .
	DO NOT include shipping charges – freight is included in the price of product.  Low cost includes 2% discount.
	Since there are several items under TH102 – you must enter the Item and PIP Descriptions as Video Phone in order to be compliant.  A new HCPCS code will be created for the Video Phone.
	NOTE:  The monitoring devices are computers that have videophone components.  They take the same biometric measurements as the messaging units but replicate face to face visits of a clinician via the video component.  All of  the information that is collected using them is transmitted to VA via servers that are located behind VA's firewall.	

Contract Period:   3/14/05 thru 3/13/06
Contract No.: V797P-9129
Compliance: 95% of the total Telehealth items purchased. For those patients for which the contract item is not appropriate, they fall in the other 5% or a WAIVER can be written.

## Home TelehealthDevice Peripherals

**Peripherals:  **accessories used with the HT devices,
- such as:
- Scales
- HB Pressure monitors
- Pulse oximeters
- Glucose monitors
- Stethoscope
_**HCPCS**_**: Codes **
**TH101** MESSAGING PERIPHERAL DEVICES
- 	(blood P Cuff, scales for TH100 = (Health Buddy, Viterion 100, ATI)
**TH103** MONITORING PERIPHERAL DEVICES
- 	(glucometer, scales, stethoscope, blood P Cuff for TH102 = (Telemonitors, Viterion 500, etc) **     **

**Notes:**
Peripherals:  accessories used with the HT devices, 
such as:
Scales
HB Pressure monitors
Pulse oximeters
Glucose monitors
Stethoscope
HCPCS: Codes 
TH101 MESSAGING PERIPHERAL DEVICES   
	(blood P Cuff, scales for TH100 = (Health Buddy, Viterion 100, ATI)  

TH103 MONITORING PERIPHERAL DEVICES 
	(glucometer, scales, stethoscope, blood P Cuff for TH102 = (Telemonitors, Viterion 500, etc)      

## Why:  It would be more cost effective and efficient  with  centralized procurement, inventory and refurbishing management.
  The Home Telehealth Technology Specialist serves as one contact person to vendors, staff and patients;  standardization for JCAHO standards compliance regarding preventive maintenance; and bulk purchases cost benefit; inventory tracking and control.

-   The Home Telehealth Technology Specialist serves as one contact person to vendors, staff and patients;  standardization for JCAHO standards compliance regarding preventive maintenance; and bulk purchases cost benefit; inventory tracking and control.

**Home Telehealth****VISN 8 PSAS Centralized****Equipment Management****Program**

**Notes:**
Home TelehealthVISN 8 PSAS CentralizedEquipment ManagementProgram
Why:  It would be more cost effective and efficient  with  centralized procurement, inventory and refurbishing management.
  The Home Telehealth Technology Specialist serves as one contact person to vendors, staff and patients;  standardization for JCAHO standards compliance regarding preventive maintenance; and bulk purchases cost benefit; inventory tracking and control.

## Home TelehealthVISN 8 PSAS CentralizedEquipment ManagementProgram 

_**Ordering:**_
- Each program will retain a small inventory of Five (5) HBs units to issue as needed.
- PSA or designee will request “X”  # of device (s) using provided form on a monthly basis.  MVP will consolidate requests for each facility and forward request spreadsheet to HTT Specialist via e-mail .
- While in stock, refurbished devices will be issued over new ones.
- Purchasing:
- To be performed from centralized location using pertinent national contracts and accordingly with inventory needs.  HTT will purchase using prosthetics funding.

**Notes:**
Home TelehealthVISN 8 PSAS CentralizedEquipment ManagementProgram
Ordering:  
Each program will retain a small inventory of Five (5) HBs units to issue as needed.
PSA or designee will request “X”  # of device (s) using provided form on a monthly basis.  MVP will consolidate requests for each facility and forward request spreadsheet to HTT Specialist via e-mail .
While in stock, refurbished devices will be issued over new ones.
Purchasing:
To be performed from centralized location using pertinent national contracts and accordingly with inventory needs.  HTT will purchase using prosthetics funding.

## Home TelehealthVISN 8 PSAS CentralizedEquipment ManagementProgram 

_**Issuing: **_** From Care Coordination/Home Telehealth Program**
- 1.  	Care Coordinator will train the patient on the use and care of the device.
- Care Coordinator will   issues the device to the patient  (at the clinic, home or mail).
- Care Coordinator will  place a CPRS request to local PSAS with pertinent patient information and device serial number.
-  Care Coordinator generate a consult in CPRS with device serial #  issued to the patient. (patient’s 2319 is annotated by PSAS) .
- Care Coordinator will notify the vendor of patient enrollment, device serial #, etc. for activation.

**Notes:**
Issuing:  From Care Coordination/Home Telehealth Program
1.  	Care Coordinator will train the patient on the use and care of the device.
Care Coordinator will   issues the device to the patient  (at the clinic, home or mail).
Care Coordinator will  place a CPRS request to local PSAS with pertinent patient information and device serial number.
 Care Coordinator generate a consult in CPRS with device serial #  issued to the patient. (patient’s 2319 is annotated by PSAS) .
Care Coordinator will notify the vendor of patient enrollment, device serial #, etc. for activation.
From Local Prosthetic Dept:
PSAS staff will post to the patient’s 2319.
Within the PSAS package, the local prosthetic dept. will add the item(s) issued to the local inventory in order to be able to post to the 2319. 
Note:  	For HBs please note that there are two costs associated for new ($575) and refurbished devices.($300)

## Home TelehealthVISN 8 PSAS CentralizedEquipment Management

_**From Local Prosthetic Dept:**_
- PSAS staff will post to the patient’s 2319.
- Within the PSAS package, the local prosthetic dept. will add the item(s) issued to the local inventory in order to be able to post to the 2319.
_**Warehouse Inventory:**_
- The HTT Specialist will maintain appropriate inventory of devices;
- Will keep track of items from vendors, items to/from facilities & programs.

**Notes:**
Home TelehealthVISN 8 PSAS CentralizedEquipment ManagementFrom Local Prosthetic Dept:
PSAS staff will post to the patient’s 2319.
Within the PSAS package, the local prosthetic dept. will add the item(s) issued to the local inventory in order to be able to post to the 2319. 
Warehouse Inventory:
The HTT Specialist will maintain appropriate inventory of devices; 
Will keep track of items from vendors, items to/from facilities & programs.

## Home TelehealthVISN 8 PSAS CentralizedEquipment Management

_**Returning Devices:                       **_Back to centralized warehouse:
- Care Coordinator will instruct patient upon discharge,  to return device in pertinent pre-paid postage box.  (patient may drop at clinic or  coordinator may pick up at home).
- Care Coordinator will send a prosthetic request in CPRS, notifiying  that the patient was discharged and device was turned-in, with pertinent information and serial #.
- Prosthetic Dept. will annotate on the patient’s 2319 that the device was turned-in.
- Upon receipt of the device to centralized location, HTT Specialist will sanitize, refurbish, reprogram, box and stock for re-distribution.

**Notes:**
Home TelehealthVISN 8 PSAS CentralizedEquipment Management
Returning Devices:                       Back to centralized warehouse:

Care Coordinator will instruct patient upon discharge,  to return device in pertinent pre-paid postage box.  (patient may drop at clinic or  coordinator may pick up at home).

Care Coordinator will send a prosthetic request in CPRS, notifying  that the patient was discharged and device was turned-in, with pertinent information and serial #.

Prosthetic Dept. will annotate on the patient’s 2319 that the device was turned-in.

Upon receipt of the device to centralized location, HTT Specialist will sanitize, refurbish, reprogram, box and stock for re-distribution.

## Home TelehealthVISN 8 PSAS CentralizedEquipment Management

_**Funding:**_ To be managed as follows:
- 	Identified funding amount (or share) will be requested to each facility prosthetics and transfer to centralized facility FCP to fund purchases and
- HHT Specialist will keep track of costs for devices ordered and issued.
_**Account**_
- Station 673 – Tampa
-  ACC 0100A6000, CC 8250, BOC 313, FCP 792

**Notes:**
Funding: To be managed as follows:

CC/HT  Business Office will provide Tampa PSAS pertinent funding for the purchase of Home Telehealth technologies for programs under the funding stage.
Programs mainstreamed to the medical center, will request pertinent technology funds within their local budget plan/request. 
Programs will keep track of costs for devices ordered and issued, in order to reimburse Tampa VAMC for the cost of devices issued.
Account
Station 673 – Tampa 
 ACC 0100A6000, CC 8250, BOC 313, FCP 792

Contact:   Al Afanador, Home Telehealth Technology Specialist
 e-mail:     Adalberto.Afanador@va.gov
 Information:    Sarita.Figueroa2@va.gov
Coordination and Communication are key elements!!!

## Device Malfunctions
Will be returned to centralized location for replacement.
HTT specialist will claim warranty replacement to vendor and coordinate its exchange with vendor.
HHT specialist will track devices returned and reasons in order to further report to national office device and vendor’s performance.

Collaboration:  HHT specialist and CCHT MVP will work closely the coordination of action steps and flow of communication/information to ensure efficiency.

- Will be returned to centralized location for replacement.
- HTT specialist will claim warranty replacement to vendor and coordinate its exchange with vendor.
- HHT specialist will track devices returned and reasons in order to further report to national office device and vendor’s performance.
- Collaboration:  HHT specialist and CCHT MVP will work closely the coordination of action steps and flow of communication/information to ensure efficiency.

- Home TelehealthVISN 8 PSAS Centralized Equipment Management

**Notes:**
Home TelehealthVISN 8 PSAS Centralized Equipment Management
Device Malfunctions
Will be returned to centralized location for replacement.
HTT specialist will claim warranty replacement to vendor and coordinate its exchange with vendor.
HHT specialist will track devices returned and reasons in order to further report to national office device and vendor’s performance.

Collaboration:  HHT specialist and CCHT MVP will work closely the coordination of action steps and flow of communication/information to ensure efficiency.

## Home TelehealthVISN 8 PSAS Centralized Equipment Management

- Challenges:
- Flow of Communication among all (teamwork)
- Coordination of action steps
- Parties to follow roles & responsibilities
- Inventory Control in VISTA at VISN level
- Opportunities:
- Efficiency and Control
- Standardization & Compliance with National parameters
- VISN PSAS Home Telehealth Technology Specialist position
- Improve services with same resources
-             *Collaboration = transformation*

**Notes:**
Home TelehealthVISN 8 PSAS Centralized Equipment Management
Challenges:

Flow of Communication among all (teamwork)
Coordination of action steps
Parties to follow roles & responsibilities
Inventory Control in VISTA at VISN level

Opportunities:

Efficiency and Control
Standardization & Compliance with National parameters
VISN PSAS Home Telehealth Technology Specialist position
Improve services with same resources

            Collaboration = transformation