© American Telemedicine Association Telemedicine Today Jonathan D. Linkous, CEO American Telemedicine Association

© American Telemedicine Association NAME GAMES  Telemedicine  Telehealth  E-Health  Telecare  Remote Medicine  m-Health

© American Telemedicine Association A COUPLE OF HELPFUL DISTINCTIONS HIT and Informatics Telemedicine

© American Telemedicine Association Focused on support systems Electronic Records E-Prescribing Management Information Systems Electronic Payments HIT AND INFORMATICS

© American Telemedicine Association Focused on patient care Telehealth Mobile Health (mHealth) Remote Monitoring Outsourced Specialty Services TELEMEDICINE

© American Telemedicine Association WORLDWIDE DRIVERS FOR TELEMEDICINE Accelerating demands and costs Shortages of health professionals Global public health concerns

© American Telemedicine Association Kathleen Casey-Kirschling January 1, 1946, 12:00:01 am

© American Telemedicine Association 694,000 1,078, ,000 32,000,000

© American Telemedicine Association TSUNAMI OF CHRONIC ILLNESS “Frequent Flyers” 5-10 percent of admissions, 1 percent of users 22 percent of costs Primary chronic conditions: cardiac/COPD/mental health/diabetes

© American Telemedicine Association COST OF CHRONIC CONDITIONS 10

© American Telemedicine Association Country World10.0%21.4% China6.9%22.7% Germany23.2%34.5% United States16.1%25.5% POPULATION > 60 YEARS

© American Telemedicine Association

HISTORY OF TELEMEDICINE

© American Telemedicine Association HISTORY OF TELEMEDICINE Boston Logan Airport to Massachusetts General Hospital 1967

© American Telemedicine Association HISTORY OF TELEMEDICINE STARPAHC – On the Papago Indian Reservation 1975

© American Telemedicine Association TELEMEDICINE CIRCA 2005

© American Telemedicine Association HOSPITAL HUB-AND SPOKE NETWORKS 200 networks 3,000+ sites

© American Telemedicine Association ARIZONA TELEMEDICINE PROGRAM © American Telemedicine Association

TELEMEDICINE SERVICES Outsourced services – teleradiology, neurology, mental health Service contracts - prisons, oil rigs, ships, international

© American Telemedicine Association TEXAS PRISON HEALTH MEDICAL NETWORK © American Telemedicine Association

VETERANS ADMINISTRATION © American Telemedicine Association

EMERGENCY SERVICES AND DISASTER RESPONSE

© American Telemedicine Association CONTINUING MEDICAL EDUCATION

© American Telemedicine Association TELEMEDICINE CIRCA 2013

© American Telemedicine Association BIG MED

© American Telemedicine Association Abdominal Radiology Angiography and Interventional Radiology Body Imaging Breast Imaging Cardiovascular Radiology Chest Radiology Diagnostic Radiology Emergency Radiology Gastrointestinal Radiology Genitourinary Radiology Head and Neck Radiology Interventional Mammography MRI Radiology Musculoskeletal Neuroradiology Nuclear Medicine Nuclear Radiology Pediatrics Radiation Oncology Teleradiology Thoracic Ultrasound Vascular and Interventional Radiology

© American Telemedicine Association OUTSOURCED AND SHARED SPECIALTY SERVICES

© American Telemedicine Association ONLINE SERVICES AND CONSUMER HEALTH APPS

© American Telemedicine Association ADVANCED TECHNOLOGIES Robotics Remote Surgery Live Monitoring via Cell Phones

© American Telemedicine Association PATIENTS SERVED BY TELEMEDICINE 2012 North America data

© American Telemedicine Association PATIENTS SERVED (2012) Civilian Network Consults Federal Network Consults Remote Monitoring Implanted Devices Cardiac Monitoring Internet-Pharmacy Services Internet Clinical Consults Teleradiology Outsourced Specialists

© American Telemedicine Association 1. Historic resistance to change 2. Lack of consistent adoption and integration pathways 3. Changing service delivery models and payment coverage ADOPTION ISSUES

© American Telemedicine Association RESISTANCE TO CHANGE Discovery to implementation in medicine = 15 years TIME Rate of Change Society Business Technology Healthcare

© American Telemedicine Association WHAT ATA DOES

© American Telemedicine Association ROAD MAPS FOR ADOPTION AND INTEGRATION

© American Telemedicine Association ATA PRACTICE GUIDELINES Goal Quality Assurance for Payers, Public, Policy Leaders

© American Telemedicine Association Technical Clinical Business ATA PRACTICE GUIDELINES

© American Telemedicine Association COLLABORATIONS

© American Telemedicine Association OTHER ATA ACTIVITIES Member Networks Meetings and Education

© American Telemedicine Association Identifying and Translating Market Changes Consulting with Policy Leaders OTHER ATA ACTIVITIES

© American Telemedicine Association 600 Scientific Presentations 200,000 Square Feet of Exhibits 6,000 Attendees The World's Largest Telemedicine, Telehealth & mHealth Trade Show ATA th Annual International Meeting & Trade Show May 5-7, 2013 in Austin, TX

© American Telemedicine Association Connecticut Avenue, Suite 540 Washington, DC 20036