1. CAMILLE INFANTE, COO JENNIFER CAVALLARO, M.D, CMIO LYNETTE SEID, VP FACILITIES TONY NGO, VP ANCILLARY SERVICES PROJECT PLAN FOR FEBRUARY 14, 2014 Lakeland Regional Health System Project Proposal: Telemedicine

2. WHO WE ARE Est. in 1914, Lakeland Regional Health System (LRHS) is a community-based health care network with multi-hospitals including specialty departments in Centers of Excellence for Cardiology, Oncology, Women’s Health, Behavioral Health, Neuro-Sciences and Orthopedics. Includes senior communities for independent and assisted living and long-term care, Employee Assistance Plan, home care, hospice, teaching/research environment, and holistic medicine. 2

3. OUR CHALLENGE LRHS leadership is challenged to provide Centers of Excellence services to remote clinics: Long distance between remote clinics and the Centers of Excellence Long patient access wait time for specialty appointments Physician resource inefficiencies due to extensive travel time Less physician and patient interaction for regular follow-up appointments/consultations Low patient satisfaction scores Lakeland Regional Health System’s lack of integration between the metropolitan hospitals and the remote clinics must be properly addressed to retain its goal of providing high quality patient care. 3

4. THE SOLUTION Implementation of telemedicine technology at Lakeland Regional Health System remote clinics What this provide for LRHS and the community: Increase physician accessibility/ productivity by allowing patients to interact with their physician via video conferencing Reduce patient access wait times by allowing more convenient times for patient follow-ups and consultation Improving patient satisfaction Better serve the rural communities by extending specialty care services to those who are in need of primary and secondary care Improve the overall efficiency and integration of the health care continuum between metropolitan and rural areas 4

5. OUR VISION Lakeland Regional Health System Goals : Partnerships with patients and communities Convenient appointments at local clinics with centers of excellence physicians Physicians and nurses working as a team Physician-to-Physician consultations 5

6. FEATURES 6

7. SCOPE AND LIMITATIONS In-Scope Telemedicine Hardware Cisco HealthPresence© 2.5 Software Centers of Excellence Specialties Physician & Nurse Training Out-of-Scope Infrastructure Upgrade Emergency Services Invasive Procedures Specialties other than those listed Assisted Living and Long-Term Facilities Home Health/Hospice 7

8. ORGANIZATIONAL SCOPE 12 Remote clinics Cardiology, Oncology, Neuro & Ortho Phase I Behavioral Health, Dermatology Women’s Health Phase II Assisted & Long-Term Care Home Health & Hospice Phase III 8

9. PROJECT SUCCESS FACTORS Immediate increased patient access to specialist care. Improved health outcomes. 25% increase in physician productivity. 75% decrease in appointment cancellations and no-shows. Increased patient satisfaction scores. 9

10. PROJECT BUDGET 10

11. PROJECT TIMELINE 11

12. BUSINESS RISKS AND MITIGATIONS 12 RiskRisk Mitigation Strategy Lack of acceptance of patients to use telemedicine The project team will work with the project Physician Leader and identify ways to prepare patients for the new technology. Recommendations include Telemedicine preview day at each clinic to demonstrate the technology Quality of network infrastructure and WiFi capabilities The project team will closely monitor the progress of the complementary IT Infrastructure Project to ensure delivery of a strong network and WiFi capabilities Privacy and Security concernsThe project team has identified IT Security resources to join the project team Continuity of care in EHRThe project team will work with the clinics and specialty physicians to define the training necessary to provide continuity of care in the EHR Credentialing of physiciansThe project team has identified ARL resources to ensure appropriate credentialing

13. PROJECT ORGANIZATION STEERING COMMITTEE Camille Infante, COO * Tony Ngo, VP Ancillary Services Clark Gable, CFO Susan Leonard, CTO Jennifer Cavallaro, MD, CMIO ** Lynette Seid, VP Facilities Vivian Leigh, CIO PROJECT TEAM Lynette Seid, Lead Project Manager Raj Sidana, IT Analyst Rick Ricketts, Project Manager I Christine Stern, Training and Dev IT Infrastructure (as needed) IT Communications (as needed) IT Security (as needed) IT Network (as needed) Compliance Billing InternalAudit Nursing Accreditation, Regulatory and Licensing Regulatory Affairs Training and Development Appointment Call Center HumanResources * Business Sponsor ** Business Owner 13

14. TRAINING SCOPE 14

15. TRAINING TOPICS Project Managers Strategic Planning Telemedicine Technologies Managing organizational change Legal and regulatory considerations Data collection and management reporting Office Admin Informing patients about telemedicine, confidentiality and privacy Working with remote clinicians Patient exams Operating telemedicine equipment and scopes Collecting program data Clinical Providers Clinical protocolsPrivacy and Security Performing telemedicine consultations Using the telemedicine equipment Regulatory Issues Technical Staff How to apply telemedicine technologies Telecommunications fundamentals Knowing equipment types Equipment maintenance Troubleshooting 15

16. TRAINING APPROACH Ongoing training for new staff and refresher courses will be given to ensure skills are adequate. The remaining stakeholders will be trained by the cross functional team. Cross Functional Team/Super Users Project managers, representatives from each department of clinical providers, operations staff, administrations, and technical staff. Vendors 16

17. FOR YOUR CONSIDERATION 17 Request approval for telemedicine project The Telemedicine Project meets all LRHS goals: Partners with patients and communities Convenient appointments at local clinics Physicians and nurses working as a team Physician-to-Physician consultations Increases physician productivity Project budget: $485,394 Project timeline: start 6/1/14 - go live 10/1/14 Project sponsor: Camille Infante, COO

18. 18 Questions? TELEMEDICINE PROJECT