1. 1 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Video : responding to medical needs regardless of time and place Dr Petra Wilson Senior Director Internet Business Solutions Group (IBSG) Dr George Crooks OBE Medical Director and COO NHS 24 Scotland UK

2. 2 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Challenges Worldwide increased demand for services Aging populations Chronic disease management Access to services Personnel shortages Access and geographic distribution of specialty resources

3. 3 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Using Video to meet the challenges HealthPresence combines state-of-the-art video, audio, and medical information from devices to create an environment similar to what most people experience when they visit their doctor or specialist

4. 4 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Design and Development Form Factors Technology Regulation

5. 5 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Clinical safety and acceptability: NHS Scotland Pilot

6. 6 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group eHealth actions in the Digital Agenda Key Action 13 Undertake pilot actions to equip Europeans with secure online access to their medical health data by 2015 and to achieve widespread deployment of telemedicine services by 2020 The overall aim of the Digital Agenda is to deliver sustainable economic and social benefits from a digital single market based on fast and ultra fast internet and interoperable applications.

7. 7 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group The HealthPresence Experience High definition visual contact for rich patient doctor interaction Ease of use; Scalability - many pods to many doctors interoperability Empowerment Integration with medical devices and information systems Sustainability. accessibility

8. 8 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Evaluation of results First phase of study tested safety and acceptability 105 patients seen (51% male, age range 17-75) >90% had positive experience 100% thought Cisco HealthPresence useful in remote & rural areas Second phase: developing the concept for tele- stroke care Preventing a life of Dependency

9. 9 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Dr George Crooks OBE Medical Director and COO NHS 24 Scotland UK TELESTROKE NATIONAL DEPLOYMENT Preventing a life of Dependency

10. 10 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group

11. 11 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group

12. 12 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group internet TV telecare Face 2 Face SMS video mobile

13. 13 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group

14. 14 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Grampian Lanarkshire Lothian Highland Dumfries & Galloway Forth Valley Fife Tayside Ayrshire & Arran Shetland Western Isles Borders Greater Glasgow & Clyde Orkney What is in place now..

15. 15 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Stroke Thrombolysis Acute to Acute Home/Office to acute On the move 3G

16. 16 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group Stroke Thrombolysis 12 March 2011 (*Prior to telestroke this patient would not have been thrombolysed) I just wanted to pass on sincerest thanks on behalf of my Mum, my brother and myself for the treatment you were able to provide my Dad on Saturday. The progress Dad has made in the space of a few days is incredible and we know that has a lot to do with the clot busting drug you were able to prescribe…. Thank you so much

17. 17 Copyright © 2008 Cisco Systems, Inc. All rights reserved. Cisco Confidential Internet Business Solutions Group European Innovation Partnership Taking our learning forward, extending the partnership Focusing on innovation for care and cure. Exploring potential for awareness raising, prevention and early diagnosis. Making change happen!