Telemedicine What is it? What’s the potential? Where to start? What’s in the solution?

Telemedicine What is it? Remote Monitoring mHealth Medical devices Examples: Pacemaker EKG data via telephone line Hypertension management campaigns via smartphones Insulin pump data uploads USB blood pressure cuffs with data uploads Interactive 2-way communication + information technology 2-way exam and/or consultation over video conference 2-way conversation over telephone Examples: Telepsychiatry Telestroke Telecardiology ATA Definition: Telehealth = Telemedicine Remote healthcare technology to deliver clinical services

Telemedicine What’s the potential? % growth $$$ 2x in 5 years Value PropositionExample Increases access to care and reaching new marketSame # of doctors, increasing # of patients Rural access to specialties and services Greater community access (i.e. LTC) Reduces emergency room visits and hospitalizationsPreventative remote monitoring and consultation Enables collaboration and optimizing resourcesMore efficient and frequent check-ups to monitor care and progress Increases patient complianceEase of data collection and submission Quality of care to prevent readmissionsOngoing remote monitoring and appointments $3.3B Healthcare IT

THE PERFECT STORM Rising healthcare costs Technology advancements Affordable Care Act 30M newly insured Medical staffing stays constant Lack of primary care capacity

Telemedicine Status, Trends & Drivers Providers moving from fee-for-service to value based care ACA penalties for readmissions and hospital-acquired conditions Improve quality of care Expand providers’ geographic footprint Reach new patients More efficiently use doctors’ time Supporting remote locations Community hospitals or a newly- acquired nursing home

Telemedicine Where to start? How to start? Follow the trail Neurologists Cardiologists OB/GYN Neonatologists ICU What is the nature of the consultation? Follow-up Routine preventative Reactionary Where do patients present? Hospital ED Urgent care facility Community hospital Rural location LTC facility Where are the specialists? Emergency Department! Patients typically present in the ED i.e. stroke, cardiac event, trauma

BANK ATM AM ATM $$ ATM

Metro Area Hospital Rural Hospital A East Metro Urgent Care South Metro Urgent Care North Metro Urgent Care West Metro Urgent Care Rural Hospital B Rural Hospital C Rural Hospital D Northeast Metro Dermatology Northwest Metro Eye Clinic Southwest Metro OB/GYN Southeast Metro Counseling LTC Rehab Northeast Hospice Care Nursing Home Assisted Living

Ingredients for Telemedicine

Ergotron StyleView Telemedicine Carts

Telemedicine Software

What a session looks like PATIENT SIDE Ergotron Telemedicine Cart with peripherals Patient has nurse clinician in room Patient sees doctor EMR and charts live and shared Medical devices used in room DOCTOR SIDE Doctor has smartphone, tablet or laptop Doctor sees patient Doctor sees EMR and charts Doctor sees outputs of medical devices