tim hulen, remote presence like really being there
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1/7/2013
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Remote Presence like Really Being ThereIowa HIMSS Business Meeting
I. Introductions‐ Telemedicine History
II. Framing the Remote Presence Opportunity A. Regional Market Dynamics and Opportunities
B. University of Iowa Stroke program
III. InTouch® Telemedicine System: A Proven Offering to Build, Support and Grow an Acute Care Telemedicine Network
IV. Beam out to SB‐ Birds eye view
V. Questions
Agenda
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Acute Telemedicine Traditional Hindrances• Repurposed video‐conferencing
– Single location limitation
– Designed for single application
• Must hire staff to manage system and drive implementation
– IT Resources on both ends
– Poor reliability (especially in emergent care)
– Internet variability = frequent disconnects
– No 24x7 help for issues
• Orchestration of every use required
– Heavy reliance on nursing staff
– Not a part of Doctors normal life
– Lack of Diagnostic compatibility
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Market Landscape
Competition for Services-Distance no barrier
State and Federal Regulations standards
Census Fluctuation
Specialist needed in Rural areas to handle growing elderly population
Specialist –Needed to meet new laws (Stroke/Stemi, etc)
ACO programs
Reimbursement Changes
FDA Changes for Active Patient Monitoring
What patients expect!
• World Class expertise accessible anywhere / anytime.
• Frictionless scalability to expand services
• Want it to work every time!
• Continuous training –Education (support)
• Fit Life style of patient and doctor
• Benefits to achievement– Quality
– Safety
– Cost effective Access to Healthcare
– Community
– Family Support
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Where to Start
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Can I see my Doctor? How far will I travel? What about quality? Family and Work
constrains?
Staffing? Whom is responsible to make work ? What if I have a problem? How do I secure services for
my facility?
Doctors need? Support? IT infrastructure? Help Desk ? Funding? Up keep? Capitalization?
Growth?
Government changes? Reimbursement? Doctor Shortage? Competition?
Increasing Acuity
Home
Clinic
Primary Care
EMS Ground
EMS Air Acute Care
Transfer
Rehab
Long Term Care
Home
Care Continuum
Chronic Disease Integrated Mgmt‐Improve bundle mgmt‐Reduce acute care episodes
Routine Care Access‐ED throughput‐Avoid bounce backs
Acute Care Specialist Access‐Hospital revenue growth‐Hospital throughput
Remote Presence
Multi‐Service line usage Focused Neurological /ED service lines
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InTouch® Telemedicine System
A complete and integrated system for your acute care telemedicine program needs
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The industry’s only end‐to‐end products and services solution specifically designed to improve patient care and enhance hospital profitability in acute care settings.
The ITH Cloud-Based Connectivity and SupportBenefits to the Customer
SureConnect
SureConnect Cloud
SureConnect Server
SureConnect SIP ServerSureConnect
MCUCustomer’s MCU
Existing EndpointInTouch Endpoints
InTouch ControlStation
Expanded Service and SupportThrough SIP
(Can use customer’s MCU for connections to H323 endpoints)
InTouch Interoperability
• One ControlStation for all endpoints• Far end camera control• Real‐time status for non‐ITH endpoints
(when registered to ITH SIP server)• CS and ITH endpoints can participate in
broadcast events • iOS devices
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ControlStations• Laptop• Desktop• Kits
SureConnect• SureNet• ActiveTrak• BestConnect
FDA Cleared, Purpose Built Endpoints
Standards BasedVideo Conferencing
SureApps• SureNotes• StrokeRESPOND• SurePACS• MultiPresence
SureSupport• 24/7/365 Service• Account Support• Product Support
ITH Overview
What separates InTouch?
• Detailed Implementation Tool kit
• Strategy Development
• Physician Engagement & Planning
• Clinical Program development
• Technical Implementation
• Outreach Development
• Marketing Outreach
• Scalability
• Single Platform
• Mobility
• Specific Assigned team to Project
• Lease to reduce obsolesces
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Applications
Live RP ApplicationsAnkle/Foot Clinic
Cardiology
CHF Clinic/Education
Critical Care
Dermatology
Education
Emergency Medicine/ Burn
Grand Rounds
Ambassador Program
Neurology/Stroke
Neonatology
Nephrology
Nutrition
OR Nursing Education
Pacemaker Adjustments
Perinatology
Psychiatry
Surgery (Telementoring)
Trauma
Fetal UltrasoundNeurological UltrasoundEchocardiograph UltrasoundUltrasonic TransducerEchoencephalographObstetric-gynecologic ultrasonic imagerFetal ultrasonic monitorFetal stethoscope (Class I)Obstetric ultrasonic transducer OtoscopeStethoscope
FDA Cleared ancillary devices paired with RP technology
Beam InUniversity of IowaErin RindelsNeuro‐Science and Stroke
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ControlStation™
Laptop Desktop Kit
Connection Wizard User Interface w / MultiPresence Alternative Views
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RP‐7i™
• Autonomous navigation– Promotes physician independence
• Socially ergonomic interaction• Self docking to preserve battery life• Privacy phone• On‐board printer• Built‐in stethoscope• Sense Array• Safety bumper• Plug‐ins for medical device peripherals• Wireless
RP‐Lite™
• Cart‐based technology• Manually mobile• Adjustable height• Built‐in stethoscope• Privacy phone• Plug‐ins for medical device peripherals• Wireless
RP‐Xpress™
Be at the point of care anywhere
• Lightweight and rugged• Portable• State‐of‐the‐art camera• Rear view camera• Viewfinder• Plug‐ins for medical device peripherals• Wireless• Cellular
RP‐Vantage™
• Adjustable height and reach• Secondary monitor for O.R. staff• Head microphone and boom microphone• Wireless and hard‐wired options • Preset views for quick transitions• Remotely controlled boom camera• Plug –ins
o 2 USB ports o Ethernet o S‐Video o Composite video
SureSupport
• Dedicated regional support personnel
• 24‐hour telephonic and on‐line chat support
• On‐site maintenance, troubleshooting and repair
End‐to‐end troubleshooting responsibility across all network locations
SureConnect
SureNet: Cloud‐based server infrastructure managed by ITH• Secure and reliable connections anytime anywhere• Evergreen technology that scales on demand• Rapid deployment of telemedicine networks
ActiveTrak: Pro‐active continuous endpoint monitoring• Continuous network and endpoint monitoring• Automated alert system• Individual session‐quality metrics and analysis tools
BestConnect: Optimal telemedicine experience• Connection Wizard• Connection Optimizer• Dynamic Bandwidth Manager
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SureApps
MultiPresence™
SureNotes™ and StrokeRESPOND™
SurePACS™
Why is FDA Clearance important?
MDDS (Medical Device Data Systems) Final Rule
“…If a third‐party company or hospital develops its own software protocols or interfaces that have an intended use consistent with an MDDS, or develops, modifies, or creates a system from multiple components of devices and uses it clinically for functions covered by the MDDS classification, then the entity would also be considered a device manufacturer…”
Medical Devices; Medical Device Data Systems ‐ FDA Final Rule ‐ [FR Doc. 2011‐3321 Filed 02/14/2011 at 8:45 am; Publication Date: 02/15/2011]
The Only Total Solution for TeleStroke
Remote PresenceTotal Solution
FDA Cleared System‐ Remote Presence Endpoint‐ StrokeRESPOND®‐ SureVIEW™‐ SurePACS™‐ CS Interface: PC, iPAD
Services‐ Program Planning‐ Implementation‐ Dedicated Account Management
Cloud + Support‐ SureConnect®‐ SureSupport™‐ SIP Interoperability
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