1

Appendix A

Current State Workflow

Treatment of the Child with ADHD in the Rural Primary Care Setting
Current State Workflow

Patient Yes
improvement
reflected in
Primary Care Provider (PCP)

feedback?

No

Follow-up (soonest
available
PCP requests appointment usually
Specialist in No 1 month +)
Diagnose Initiate treatment feedback from PCP evaluates Follow-up in
Start patient s Stop
ADHD plan caregivers and results six months
community?
school

Yes
Titrate medication
Patient and Caregivers

Caregivers fax Patient begins

Refer patient to Patient begins
VADRS-Caregiver taking titrated
specialist taking medication
results to PCP medication

Caregivers evaluate
patient using the
VADRS-Caregiver

Teachers evaluate Teachers fax VADRS-

patient using the Teacher results to
VADRS-Teacher PCP
Teacher
USING TELEPSYCHIATRY TO TREAT CHILDREN WITH ADHD 2

Appendix B

Future State Workflow

Using Genoa Telepsychiatry to Treat children with ADHD in the Rural Primary Care Setting
Future State Workflow
Primary Care Provider

No
Follow-up with
Specialist in Begin collaboration
Diagnose patient and
Start patient s with telepsychiatrist Stop
ADHD caregiver in six
community? within one week
months

Yes
Telepsychiatrist

Yes

Begin Telepsychiatrist Videoconference

Patient No
pharmacotherapy evaluates VADRS- with patient and
improvement
via Caregiver and caregiver within one Titrate medication
reflected in
videoconferencing Teacher results from week of starting
feedback?
with patient EHR medication
Patient and Caregiver

Patient begins
taking medication

Refer patient to
specialist

Caregivers evaluate
patient using the Patient starts taking
VADRS-Caregiver titrated medication
and upload to EHR

Teachers evaluate
patient using the
Teachers

VADRS-Teacher and
upload into EHR
USING TELEPSYCHIATRY TO TREAT CHILDREN WITH ADHD 3

Appendix C

Genoa Telepsychiatry Budget

Genoa Telepsychiatry
Hardware quantity cost per total cost Year 1
Desktop computer with webcam 1 $1,229.99 $1,229.99 $1,229.99

Total Hardware Cost $1,229.99

Training quantity hours cost per hour total cost Year 1

Train primary care providers how to use Genoa platform 4 4 $96.15 $1,538.40 $1,538.40
Train medical assistants how to set up for patient appointments 4 4 $15.00 $240.00 $240.00

Total Training Cost $1,778.40

Cost of Telepsychiatry Service per patient hours cost per hour total cost
Flat hourly fee per patient 0.75 $175.00 $131.25
Medical assistant 1 $15.00 $15.00

Total Cost of Telepsychiatry per patient $146.25

Cost of Telepsychiatry Service per year quantity cost per total cost Year 1
Total Cost based on 7 patients per week 364 146.25 53,235.00 53,235.00

Total Investment Cost Year 1

Total Investment per year $56,243.39

Income from Telepsychiatry Services quantity Billable amount Year 1

Income from new patient visit per year based on one new patient per week 1 $200.00 $10,400.00
Income from return visits per year based on 6 patients per week 6 $175.00 $54,600.00

Total Income $65,000.00

Return on Investment Year 1

Total Income - Total cost $8,756.61

There are certain liberties taken in creating this exel spreadsheet. Every effort was made to make a best guess judgement
on the prices and incomes utilized. A brief synopsis of where the figures were obtained is listed for review.

Desktop Computer $1,229.99 Best Buy - HP Pavilion 27" Touch-Screen All-In-One

Hourly wage for Primary Care MD based on $200,000 &2080 hrs/yr $96.15 Payscale
Hourly wage for medical assistant $15.00 Payscale
Income from new patient $200.00 Psychiatric diagnostic eval w/ medical services + New patient, outpatient +
30 minute psychotherapy + Telehealth originating site facility fee
Income from return visit $175.00 Established patient, outpatient + 30 minute psychotherapy + Telehealth orginiating site facility fee
Software/ Platform $0.00 Genoa does not charge an additional cost for the platform or software implementation
Training cost $0.00 Genoa does not charge an additional training cost