1. Telehealth Best Practices CP320.01 5/4/2015

2. Goal and Objectives Goal: Provide health care organizations with best practices for implementing a telehealth program. Objectives: Understand the importance of leadership’s role in running a successful telehealth program Clearly define the goals for the program Analyze the patient population to determine monitoring needs Track results for sustained success 2

3. Best Practices for Creating a Telehealth Program Top-Down Leadership Commitment Build an Innovative Culture Establish Financial Objectives Identify Program Goals Establish Model of Care and Resource Allocation Develop a Targeted Implementation Plan Integrate Standards and Plan for Scalability Develop a Targeted Marketing Strategy 3

4. Golden Rule: Leadership Commitment

5. Commitment from C-Level is critical to success 5 Strategy Tactics Create the vision through your model of care Drive cultural shift with defined staff roles/responsibilities Develop a business plan Establish realistic goals Hold staff accountable for implementing and managing the program Integrate telehealth into the care management of the patient

6. Build an Innovative Culture 6

7. 7 Innovative Culture The Power of Vision drives cultural change within your organization The vision identifies where you want to be, rather than where you are today Fosters commitment and energizes people Establishes standards Creates a bridge between the present and future

8. Remote Monitoring Value Increased Access Increased Volume Improved Communication Improved outcomes and care coordination Presence in Remote Community Competitive Edge Driver of Ancillary Services Private pay, mPERS

9. Financial Objectives 9

10. Revenue Generation Cost Avoidance Expense Reduction Increase Other Services Business Development Test New Markets What are Your Financial Objectives?

11. Why Measure Your Program Results? 11 Be a star referral source for hospitals CMS Penalties for Low Performers October 1, 2011 Hospital readmission rates aremeasured for Medicare patients with: CHF, AMI and Pneumonia October 1, 2012 The worst performing hospitals (bottom 25%) will lose 1% of total Medicare payments with the following disease added: COPD, CABG, PTCA and post-surgical vascular conditions Oct 1, 2013 Hospital readmission rates are reassessed for all 7 diseases and worst performing hospitals (bottom 25%) are penalized 1% of Medicare payments October1, 2017 Percentage of Medicare payments lost to the worst performers will rise to 2%

12. Cost Per Visit Traditional (HHA, MD office, ED) 48 minutes (cost/encounter) Genesis Touch: Video 20 minutes (cost/encounter) Tele-triage (phone call/assessment after VS acquisition) 5-10 minutes (cost/encounter) Savings: XX minutes $XX.XX Visit TypeTimeCost / Visit

13. Identify Program Goals 13

14. Clearly Identified Program Goals Develop Goals consistent with the Telehealth Vision: 14 Achieve stakeholder satisfaction Improving Outcomes Reduce re-hospitalizations Improve care management Reduce re-hospitalizations Improve care management Patient Clinical Provider Payer Patient Clinical Provider Payer Financial ROI Increase referrals Increase market share Partner with providers Increase referrals Increase market share Partner with providers

15. Example Program Goals 15 Example Goals Key Performance Indicators (KPI) Realize a x% improvement in the acute care hospitalization rate within 6 months from the start of the telehealth program when x% of the average daily census is using telehealth. Achieve a high satisfaction rate based upon survey results from physicians and patients each quarter. Reduce cost per visit, increase nursing efficiencies, reduce LUPA’s, reduce re-hospitalizations within 60 days. Realize a x% improvement in the acute care hospitalization rate within 6 months from the start of the telehealth program when x% of the average daily census is using telehealth. Achieve a high satisfaction rate based upon survey results from physicians and patients each quarter. Reduce cost per visit, increase nursing efficiencies, reduce LUPA’s, reduce re-hospitalizations within 60 days. Achieve stakeholder satisfaction Improving Outcomes Financial ROI

16. Measurement Criteria How to measure outcomes: Analyze a geographic subset of your patient population Establish baseline measurements for the subset –Number of monitors vs. average daily census –Current rehospitalization rates –Number of nursing visits per episode –Number of monitored days per episode Utilize the above measurements as a benchmark for comparison after telehealth is implemented 16 Checkpoint: Do you have enough monitors on enough patients to positively impact outcomes?

17. Data Analysis Measure results against goals Patient Management: –Management and triage of patient health data –Care management and the coordination of care –Clinical interventions Clinical Efficiency –Allocation of clinical resources to meet the needs of the patient –Clinical documentation practices which outline a consistent plan of care –Utilization of best practice product and process tools –Predetermined product capabilities and best practice supported workflow Program Effectiveness –Alignment of resources/roles/responsibilities to support processes and procedures 17 Data analysis is the most critical, yet most overlooked practice.

18. 18 Establish Model of Care and Resource Allocation

19. Telehealth Delivery Model Considerations: Share leadership vision and goals Evaluate your resources and determine program roles / responsibilities Outline expectations for nursing practice and expectations for success Create a workflow processes: Case Management Triage Equipment Management Data collection and analysis Awareness of increased consumerism within our healthcare system 19

20. Case Management – Care Coordination A process for managing patient data should be Implemented to provide oversight 7 days a week, holidays and weekends. The ideal candidate to oversee the program is your strongest clinician. 20

21. Stratify the Patient Population Monitor Placement: Which patients should be monitored? 21 Disease state: Review the patient’s current condition(s) Number of nursing visits per episode: Can the number of visits be reduced through the introduction of telemonitoring? Number of monitored days per episode: Recertify if patient hasn’t fully recovered High-risk populations: Polypharmacy

22. Develop a Targeted Implementation Plan 22

23. Rollout Program Implement your model of care with a small segment of your patient and nurse population before rolling out more widely Review results to: 23 Know when the patient needs a visit Teach patient about disease process Provide information to physician as needed Empower the patient to take an active role in their care

24. Program Evaluation Review all aspects of your initial targeted program: Revise your model of care to suit agency needs Identify your long-term telehealth champions Develop a contingency plan to maintain the program in the event of employee turnover 24 Every agency is different and will find a model that best suits them

25. Peer Review Utilize information gained from the program participants: How could we manage the patient more effectively? Could we have prevented the hospitalization? Did we miss the signs of deterioration? What are the key takeaways from installing and utilizing the monitor with patients? 25

26. Integrate Standards and Plan for Scalability 26

27. Integrate Standards 27 Document the processes and procedures you created for your telehealth program Communicate them to your team to ensure that every patient who is placed on a monitor receives consistent care

28. Plan for Scalability Develop a plan to expand the program within your current agency location If you have multiple branches, identify a strategy for incorporating telehealth within each location and a timetable for deployment 28

29. Develop a Targeted Marketing Strategy 29

30. Marketing and Wide-Scale Deployment Marketing is a great resource and provides much needed referrals in a competitive environment 30 Marketing Materials Create a Solution Overview that communicates your value Develop a case study based on your initial targeted implementation Seek co-branded marketing opportunities Create a Solution Overview that communicates your value Develop a case study based on your initial targeted implementation Seek co-branded marketing opportunities Grow Your Census Contact referral sources, including hospitals and physicians Contact current patients to educate them about your telehealth program Contact referral sources, including hospitals and physicians Contact current patients to educate them about your telehealth program Look for 3 rd party validation of your program results

31. Conclusion Telehealth can provide tremendous value to patients and care providers when a thorough strategy is developed. Telehealth is like a garden, it requires constant care and attention in order to flourish! 31

32. Learn More Get in Touch with Me at: Anne.Evans@Honeywell.com Reach out to your regional representative or call 1-888-353-5440 Learn More about Honeywell Life Care Solutions online: www.honeywelllifecare.com 32 Select Services Reduce costs and improve care coordination with Honeywell’s telehealth monitoring services. We help remove the complexity associated with offering telehealth by monitoring your patients from our nurse call center headquarters. https://www.honeywelllifecare.com/SelectServices