Final Proposal Telemedicine

PRE-PROPOSAL 1. Media Artifact

Link to your media artifact(s) giving background on the issue:

https://drive.google.com/file/d/0B071EQRTO0_MaThqSXVaNnJRVG9HVXRyY3g3bkxlbEY3XzVR/view


2. Persona and POV statement Persona:

Persona name: Tomas Korn

Age: 18

School/Occupation: Freshman at the University of Michigan 

Location: Ann Arbor

 

Quote: “School is so hard that I get very stressed leading me to be sick often, especially with the cold weather!” 

 

About:

  • The only person in his family to attend college, first-generation 

  • Loves to play sports and card games in his free time 

  • Valedictorian of his high-school 

 

Goals:

  • To have a stellar GPA above 3.8

  • To be very healthy and not lose sleep 

  • Get  a job out of college in order to help his family 

POV Statement:
  • Tomas Korn, a first-generation University of Michigan student who is under a full scholarship, needs to maintain his health while in college because he needs to achieve high grades and not be distracted by going to the doctor to pay bills. 


 

3. Potential Solutions

Describe three reasonable, feasible potential solutions or approaches that would help address this problem.

  1. Telemedicine in student dorms

 

  • Telehealth currently includes technologies such as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices, which are used to collect and transmit patient data for monitoring and medicinal interpretation. 

  • Develop a new software that will track the health of students, note how often people get sick, and diagnose the severity of community health problems with every instance of telemedicine communication. 
  •  Distribute these technologies to student dorms so students can receive medical assistance without dealing with financial or geographic burdens. 
  • The removed costs associated with housing patients and maintaining hospitals, along with the higher gross margins of hosting software online, actually allows district governments and in this case the Univeristy of Michigan, to drive down the costs of healthcare; Researchers at the University of California Davis compared rural hospital’s costs for installing telemedicine equipment versus the expenses of on-call specialists and transport costs and empirically found that “each instance saved an average of $4,660.”


 

  1. Once a month Doctor checkup funded by Government:
 
  • A specialized nurse or doctor visits student dorms once per week to check up on individuals who feel sick or need any form of assistance.
  • Funded by the government through tax programs and donations from the public and hospitals 
  • Some forms of checkups include common vaccines and general health inspections, none are forced to complete inspections or vaccines (optional)
  • Doctors could either be volunteers or other college medical students who would like to practice their skills on students 
   
  1. Expanding buildings for health programs targeted at students: 
 
  •  Similiar to buildings and facilities like that of UHS, there will be an expansion of these facilities with more special attention.
  • New construction will have to take place and this will hopefully reduce the wait time students currently have to endure. 
  • Included in this expansion of services is more doctors and nurses. 
  • Students can now not worry about wait times given the expansion and will begin to attend medical facilities more frequently reducing the illness rates.   
BACKGROUND AND RESEARCH PROCESS Context

Reference to a current Michigan bill or law that relates in some way to your proposal:

http://www.legislature.mi.gov/documents/2019-2020/billintroduced/Senate/htm/2019-SIB-0001.htm

Why this proposal will make a difference in the lives of students of all ages across Michigan, or a significant subgroup (by age, background, economic status, and/or region, etc.) of students in Michigan: 

When looking at the proposal as a whole, we will see various positive benefits to students in college here at the U of M or other colleges in Michigan. The age groups of 18-20 will be of those receiving the most benefits from this proposal. In terms of economic status, we will see those of low-income backgrounds having great impacts in their lives. With telemedicine, students will now have a free and convenient source of healthcare in their dorms. This will save them money, time, and also guarantee that students are receiving the adequate care they need as students. This is the first time students are away from home and cannot always receive the care from their parents. By implementing Telemedicine, we will see increased confidence in remaining healthy while at college. 

How and where did you learn about the issues underlying your proposal?

Dylan’s brother consulted for a nonprofit that implemented this form of technology (telemedicine) and we thought it was incredibly intriguing. We also learned that Michigan’s broader population had a problem with students lacking access to health-care through quick and free services. We then posed the idea of using telemedicine to help students here at umich, to make the process more efficient. 

How has your service activity influenced your thinking about this proposal?

Our service activity is teaching younger students the art of public speaking and debate. The most important skill gained from debate is your ability to voice your opinion, creatively think, and advocate for new policies. Our hope is that we can get young students to construct unique ideas and push for them in their respective communities (such as telemedicine at U-M). Debate forces you to think outside the box and respond to other’s policies, a core idea that is emphasized in this class. Spending time teaching kids how to think critically and get creative about the issues affecting their lives has prompted us to do the same. 

Link to your media artifact(s) giving background on the issue : 

https://drive.google.com/file/d/0B071EQRTO0_MaThqSXVaNnJRVG9HVXRyY3g3bkxlbEY3XzVR/view

Consultations

 

CONSULTATION 1: Dr. Escolar discussed telemedicine and how it works in the medical industry, some of its benefits/harms, and methods of potential implementation for students. 

CONSULTATION 2: Dr. Rub discussed the problems of health for students at umich, students lack access to serious health care because UHS is either super crowded or they lack the necessary tools to be efficient. 

CONSULTATION 3: UHS representative who preferred to not be named discussed how we could implement telemedicine to umich’s specific environment, perhaps student dorms to maximize efficiency. 

 

Reaction or advice from a Topic Coordinator:

Professor Fahy informed us that Telemedicine for a whole homeless population would be almost impossible given that it would be tax-funded and that it doesn't solve a larger issue. When discussing the implications of this proposal, he emphasized how relying on tax funding will not make it appealing in the eyes of legislators. He recommended that we also take a different approach and look at how this could help students at Michigan. This led to the development of a new POV statement which correlated with our new proposal that was no longer tax-funded and made for students. Professor Fahy was of great help and truly allowed to get our best step forward for the final proposal. 

Research process:

Describe your research process — indicate who you talked to (including but not limited to consultants), what you read, what your thinking was, how it changed over time, and how your consultants changed your thinking. This description of your research process definitely could include “dead ends,” or ideas you had that didn’t ultimately bear fruit.  In short, we want to know what you did and how it led to your legislation, and we also want you to give us a window into your thought process.  

Telemedicine was initially introduced to us when Dylan’s older brother consulted for a nonprofit organization that utilized this type of technology. We did additional research to truly learn the dynamics of telehealth technologies and really get to understand how it operated in any given setting. We learned that the best part about telemedicine is that it is intended to focus on efficiency. It solves issues dealing with geographical and financial barriers to health care, as people can access medical assistance from remote locations. Our thought process in learning this was how could we apply telemedicine to a situation we wanted to fix that dealt with issues of barriers or efficiency. 

Speaking with Dr. Escolar, we learned about how helpful telemedicine can really be in saving time and simply allowing people to get the help they need with minimal burdens. Dr. Escolar told us that simple devices like facsimile machines and telephones turn out to go a long way in a medical diagnosis, which shocked both of us. Moving forward, we first had a great idea to use telemedicine technologies in homeless shelters and allow lower-income individuals to access medical help via these devices. However, we discussed with our professors and wanted to focus on students at the University of Michigan instead. Something we both deal with, along with thousands of other students here, is getting sick and being unable to go to medical facilities. These facilities include UHS, Urgent Care, Minute Clinic, or any other place that offers medical help. Whether it is costly, or it is hard to get too, we simply had problems doing it. 

Dr. Rub explained to us how many students have been complaining to him that they cannot reach these medical institutions when they are ill, especially considering how cold it gets in the state of Michigan. Therefore, we had the idea to place telehealth technologies in dorm buildings to allow students to get in touch with medical assistance without having to travel or pay. We researched how the University of Michigan could subsidize this policy and learned that they have budgets for both student dorm life and a budget for medical assistance related to student affairs as well. We felt it should come out of both since it is distributed between both of these causes. While we figured it would be expensive, we actually came across a study by the University of California-Davis that found that telemedicine actually reduced costs in one instance because of the decreased patient transfers, which actually makes sense. 

A UHS representative personally explained how this would lower costs as well, using the same justifications and warrants. As a result, we felt it would be a good idea for U-M to fund this in the long term because it would not only drive down the cost of medical help but also provide an efficient way for students to be treated. 

 

Author contributions:

Please delineate--in detail--who made what contributions to the process and to the finished proposal? Who took on which responsibilities in researching ideas, drafting language, etc.?

  • Dylan led the research background of Telemedicine. He had the original plan of implementing this technology for the homeless which eventually evolved into using it for U-M students. Dylan composed the step by step plan as to how this would work and the funding necessities. He was also highly aware of the process of how Telemedicine works and whether it would be feasible to implement. In terms of the written assignment, Dylan contributed to all parts of the proposal evenly.  researched background of telemedicine, its intricacies, and the necessities for it here at U-M. 

 

  • Francisco was responsible for organizing the calls for our consultations and he coordinated the process for interviewing them. He also assisted in finding the necessities of Telemedicine here at the U-M. He reached out to multiple students and asked about their opinions on current healthcare at Michigan and what they could see to be improved. Francisco made sure that our proposal also did not involve any tax obligations from the government and discovered the solution as to find out alternative sources of funding. In terms of the written assignment, Francisco contributed to all parts of the proposal evenly. 

  FORMAL PROPOSAL The sections below should comprise your final proposal language, submitted for consideration by your peers and potential inclusion in the MSC Platform. Preambulatory clauses WHEREAS....1.7 million students in the U.S are left without health-care coverage  WHEREAS.... Prices on healthcare services have grown faster than other prices in the economy

WHEREAS....Telemedicine saves an average of $4,660 of on-call specialists (UHS cost) 

Operative clauses

THEREFORE BE IT RESOLVED....

1.  Implement telemedicine at the University of Michigan by providing various technologies such as telephones, facsimile machines, electronic mail systems, and remote patient-monitoring devices, which are used to collect and transmit patient data for monitoring and medicinal interpretation. 

2. Develop new software that will track the health of students, note how often people get sick, and diagnose the severity of student health problems with every instance of telemedicine communication.

3.  Install devices in a college dormitory to ensure access to all individuals who wish to receive medical assistance. 

Counter-arguments:
  1. It will be more costly and more difficult to deal with a completely new telemedicine program, rather than just improving current medical facilities. 

  2. In the long term, it will make all students use the ‘time-efficient’ telemedicine equipment which will just make current medical buildings go to waste and essentially be a sunk cost. 

  3. Telemedicine is complicated to use and understand, it will require expensive training programs to get both students and staff familiar with completely new equipment they have not used before. 

Costs and funding:

Michigan has a lot of money to spend. Endowment distributions — the money university units and affiliated organizations get to spend — totaled $346 million in fiscal year 2018, up from $325 million a year earlier. Telemedicine can come from this budget and can be recorded under student dorm renovations, or even from the medical budget. The University of Michigan does not display exact numerical figures regarding their specific budgets to the public, but we do know they exist. 

People who work in medical buildings, along with those who are interested in seeing the expansion of current medical buildings and facilities, will be opposed to the idea of installing telemedicine equipment in off-site locations because funding will be allocated less towards them. 

It is estimated to cost about $20,000-$30,000 per large unit system installed. With approximately one on each dorm floor, this would amount to about $100,000 per campus dorm. If this were to be say implemented at the U of M, about 44 units would be installed totaling to $1,100,000 in costs. 

References:

These can include websites or other information you have found about the issue.

Obamacare has led to fewer uninsured students, study finds. (2016, March 17). Retrieved from https://www.insidehighered.com/news/2018/03/30/obamacare-has-led-fewer-uninsured-students-study-finds.

University of Michigan - Ann Arbor Room And Board. (2019, September 13). Retrieved from https://www.collegefactual.com/colleges/university-of-michigan-ann-arbor/paying-for-college/room-and-board/.




 

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Total votes: 29