Ting Shih, CEO & Founder
[email protected]://clickmedix.com
Solution for Healthcare Providers: Do more, with less.
Mobile Health and Education Delivery System
Solution for Healthcare Providers: Do more, with less.
Mobile Health and Education Delivery System
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 2
• 32 Million more Americans would become insurance beneficiaries including1:
o Children with pre-existing conditionso By 2014, anyone with preexisting health problems can obtain insuranceo Medicaid expands to 133% of poverty levelo Annual out-of-pocket medical costs will be capped at $5,950 for individuals
and $11,900 for families
• Budgets for health providers2
o $10.5B cut from projected Medicare hospital payments over 10 years of inpatient or overnight care through a downward adjustment in annual base payment increases
o $4.2B cut from Medicaid disproportionate share payments to hospitals over the next decade
Challenge: Do more, with less $Challenge: Do more, with less $Challenge: Do more, with less $Challenge: Do more, with less $
Sources1 New York Times, Washington Post, CBS News, Reuters (http://awesome.good.is/transparency/web/usersubmissions/healthcare/giannini/transparency.jpg) 2 http://capsules.kaiserhealthnews.org/index.php/2013/01/doc-fix-in-senate-fiscal-cliff-plan-cuts-medicare-hospital-payments/
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 3
• Budgets for health providers forming ACOs based on patient outcomeso Rewards for cost-savings achievedo Penalties for costs exceeding budget
New Healthcare Delivery Model: ACOsNew Healthcare Delivery Model: ACOsNew Healthcare Delivery Model: ACOsNew Healthcare Delivery Model: ACOs
1Source: Nyew York Times, Washington Post, CBS News, Reuters (http://awesome.good.is/transparency/web/usersubmissions/healthcare/giannini/transparency.jpg) http://www.infographicsarchive.com/health-and-safety/the-aco-prescription-cure-or-disease/#prettyPhoto/1/
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 4
• Eliminating 19-35% of operational expenses• Focusing on public-private partnerships in local communities
who can help address higher volumes and more complex case• Improving GME programs to incorporate patient-centered
quality programs to enrich experience for students and refreshing the program to reflect a 21st century health care market. This includes enhanced relationships with community partners and increased focus on outpatient care.
• Right-sizing inpatient operations and administrative functions that will help cover critical services and strengthen medical education programs
Dealing with Budget Cuts: Dealing with Budget Cuts: Louisiana State ExampleLouisiana State Example
Dealing with Budget Cuts: Dealing with Budget Cuts: Louisiana State ExampleLouisiana State Example
1Source: Nyew York Times, Washington Post, -172737281.html
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 5
Solution: Solution: Mobile Health and Education SystemMobile Health and Education System
Solution: Solution: Mobile Health and Education SystemMobile Health and Education System
As mobile technologies advances, traditional healthcare delivery models can be vastly improved through innovative mobile network powered healthcare services.
This proposal illustrates how to deliver highest quality healthcare with less resources to typically hard-to-reach and non-compliant population with chronic diseases of hypertension, diabetes, cancer, heart diseases, and dementia using mobile technologies.
The proposed mobile health solution elements have been deployed and successfully demonstrated as viable products by ClickMedix founder in more than 12 countries including the US, China, Taiwan, India, Peru, and Philippines.
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 6
Current patient health behavior exacerbates health conditionsCurrent patient health behavior exacerbates health conditionsCurrent patient health behavior exacerbates health conditionsCurrent patient health behavior exacerbates health conditions
Diseases such as heart disease, diabetes and hypertension can be prevented, reversed, and controlled with diet, exercise, early
screening and continuous monitoring.
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Primary objectivesPrimary objectivesPrimary objectivesPrimary objectives
1. Serve more patients, at a fraction of the cost through mobile health (mHealth) and education services
2. Enhance medical capacity in rural areas through two-way tele-consultations and continuous training
3. Improve patient health outcomes through continuous patient management
4. Collaborate on building cost-effective health services via mobile health and education platform foro Chronic diseases (Cardiovascular, diabetes)o Maternal/child health careo Cancer screening services
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• Facilitate remote medical consultation by doctors and specialists in less than 3 days for patients any where
• Increase by 4 times the number of patients a doctor can serve• Enable a single doctor to reach up to 10,000 rural patients
when combined with community health workerso Each doctor manages 10 nurseso Each nurse manages 10 health workerso Each health worker serves 100 patients through monthly home-
visit care
• Provide HIPAA-compliant communication infrastructure for improve healthcare services
• Through integration with existing EHRs, help health organizations achieve meaningful use
Our solution can:Our solution can:Our solution can:Our solution can:
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Addressing healthcare challenges and aligning Addressing healthcare challenges and aligning with healthcare focus areaswith healthcare focus areas
• Telemedicine to extend reach of existing resource
• Remote training to increase workforce of skilled workers
• Public-private partnership with community-based health workers and health organizations
• Develop integrated health information system to streamline and monitor service delivery among partners
• Home care visit and follow-up care to reduce readmission rates
• Use electronic health records or integrate with existing health systems to achieve full digitization of health information
Budget Cuts:Lack of
Resources and Doctors
Increased insured patients
and senior population: More, sicker
patients
Penalties for readmission and delay to
digitization of health
information
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Expected benefits from proposed mHealth Expected benefits from proposed mHealth solutionsolution
• Enable early detection of potentially dire diseases• Minimize time (< 3 days) to access medical experts for targeted
disease care• Save on consultation and transportation fees by minimizing clinic
visits (up to 25% savings for seniors3)
Benefits
• Increased revenue from patient retention and telemedicine consultations
• Attract more patients by offering specialty care• Reduced paper work and administrative costs (up to 25% reduction3)
• Increased revenue from patient retention and telemedicine consultations
• Attract more patients by offering specialty care• Reduced paper work and administrative costs (up to 25% reduction3)
• Increased medical capacity to treat patients and capture revenue previously on backlog
• Improved collaboration among medical experts and referring primary physicians and rural nurses
• Real-time data for expedited healthcare interventions• Enhanced health education materials from global base of health
demographics• Reduced costs from data collection and analysis
• Real-time data for expedited healthcare interventions• Enhanced health education materials from global base of health
demographics• Reduced costs from data collection and analysis
3Source: http://www.alliedhealthworld.com/visuals/smartphone-healthcare.html
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Patient sees local health
provider with health issue
Health provider (health workers, nurses,
primary doctors)
uses ClickMedix to capture
appropriate patient info
Treatment Plan
Treatment and
follow-up care
Treatment Advice
Patient case
Doctors review and collaborate on case
From:Hospital Referral Centers
$
1.Links appropriate doctors and specialists2.Package data securely with time series, multi-media analysis
How It Works: mHealth telemedicineHow It Works: mHealth telemedicineconnect patients to doctors anywhereconnect patients to doctors anywhereHow It Works: mHealth telemedicineHow It Works: mHealth telemedicineconnect patients to doctors anywhereconnect patients to doctors anywhere
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How to serve 10,000 more patients at lower costs?How to serve 10,000 more patients at lower costs?
Community Partners/Satellite Clinics
Hospitals
Telemedicine and remote training
Mobile phone reach to patients
Urban hospitals and medical universities
By extending the reach of scarce medical experts to provide remote diagnosis/treatment and education to community partners, who become increasingly skilled at caring and engaging end-patients.
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Do more with lower-cost health workers equipped Do more with lower-cost health workers equipped with smartphones and diagnostics deviceswith smartphones and diagnostics devices
Do more with lower-cost health workers equipped Do more with lower-cost health workers equipped with smartphones and diagnostics deviceswith smartphones and diagnostics devices
Digital stethoscope: records audio sounds and send to remote doctor for diagnosis
Note: can integrate with other diagnostics devices as identified (blood pressure cuff, blood glucose meter, etc.)
Otoscope for tele-ENT
Fundus scope for tele-diabetes retinopathy screening
Dermatoscope for tele-skin cancer screening
Tele-radiology application enabling multiple doctors to review images
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Home or on-the-go mHealthcare KitHome or on-the-go mHealthcare KitHome or on-the-go mHealthcare KitHome or on-the-go mHealthcare Kit
14
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Health workers or nurses can use smartphones with ClickMedix to capture Health workers or nurses can use smartphones with ClickMedix to capture diagnostics and symptoms information to expedite treatmentdiagnostics and symptoms information to expedite treatment
Health workers or nurses can use smartphones with ClickMedix to capture Health workers or nurses can use smartphones with ClickMedix to capture diagnostics and symptoms information to expedite treatmentdiagnostics and symptoms information to expedite treatment
1) Measurable improvement in health outcomes
2) Reduction in time to delivery effective treatment
3) Reduction of workforce operational costs
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 16
ClickMedix system connects every step and ClickMedix system connects every step and maximizes benefits for patients and providersmaximizes benefits for patients and providers
ClickMedix system connects every step and ClickMedix system connects every step and maximizes benefits for patients and providersmaximizes benefits for patients and providers
Assess / Triage
Patient record generation via SMS and call-centers
Auto-assessment to generate leads
Diagnose / Treat
Point-of-care diagnostics
Remote diagnosis via telehealth
Treatment administered through home-visit nurses or doctors
Follow-Up / Prevent
Auto-reminders
Home-visits
Shared record with family members and doctors
Improve/Train
Aggregated data to expedite funding for intervention development
Continuous training to build medical capacity
Infectious Diseases
Mothers &
Children
Chronic Diseases
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 17
Products
Click-Education
Description
• Medical schools• Training institutions
Customers
Click-Research
•Tele-Geriatrics Certification•Tele-Home Care Certification•Mobile Telehealth Certification
Click-Health
• Primary care clinics, rural clinics• Secondary and tertiary hospitals• Telehealth centers• Home-visit health workers• Nursing homes• Patients
•Tele-Primary Care•Tele-Geriatric Care•Tele-Maternal & Pediatric Care•Home-Visit Care•Electronic health record (EHR) and device integration
•Epidemiology research•Clinical trial research
• Research organizations• Pharmaceutical companies
ClickMedix can be configured for select ClickMedix can be configured for select healthcare services or packaged solutionshealthcare services or packaged solutions
Click-Specialist
• Primary care clinics, rural clinics• Secondary and tertiary hospitals• Telehealth centers• Patients
•Tele-Dermatology•Tele-Wound Care•Tele-Radiology
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 18
• Featured Programso Harvard Massachusetts General Hospital Department of Dermatology:
Hansen’s Disease Teledermatology Screening, Trinidad & Tobagoo Grameen Health Innovations, NYC: Primary care for low-income women and
children, USAo Albert Einstein College of Medicine: Rural Health Teledermatology, Uganda
and Guatemalao Global Development Collaborative: Tele-primary care, Peruo University of Illinois at Chicago Medical Center: Teledermatology and Tele-
Wound Care, USAo China Hospital: Home-visit maternal care and geriatric care, China
ClickMedix ProgramsClickMedix ProgramsClickMedix ProgramsClickMedix Programs
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 19
• Contact:Ting Shih, CEO & Founder of ClickMedix
Email: [email protected]
Website: http://clickmedix.com
Joins in to create the future of healthcare!Joins in to create the future of healthcare!Joins in to create the future of healthcare!Joins in to create the future of healthcare!
http://clickmedix.com
Company Overview
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 21
• Founded and developed by MIT / Harvard / Carnegie Mellon University graduates and faculty in 2011 after 3 years of pilots in more than 10 countries
• Our Mission is to bring faster, lower-cost, and higher-quality health services to all patients regardless of income-level and household environment by connecting patients and frontline health providers to medical experts using mobile technologies.
• We are world-class technologists, public health practitioners, development activists, entrepreneurs, and business strategists to bring new sustainable and cost-effective telehealth solutions powered by mobile phones.
• Our innovative connected mobile health (mHealth) and education platform connects health service providers, reduces cost of service delivery, and optimally utilizes tiers of existing health system for patient care. A community health-worker or a clinic nurse with a Click-enabled mobile phone is able to act as the primary agent for quality healthcare delivery.
ClickMedixClickMedixClickMedixClickMedix
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International DeploymentsInternational DeploymentsInternational DeploymentsInternational Deployments
Geriatric and
Chronic Diseases
Maternal and Child
Health
Infectious Diseases
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Clients/Partners
Services PopulationReach
Click-Health: geriatric care, maternal/pediatric care
Click-Specialist: dermatology
420,000
Click-Specialist: dermatology, pre/post surgery, cervical cancer Screening
100,000
Click-Health: diabetes/nutrition study, TB surveillance, HIV+ staging
Click-Education: maternal and pediatric care, tele-geriatrics certification
90,000
Clinics / hospitals
Governments
Research Institutions and medical schools
43
3
3
Our Customers (International)Our Customers (International)Our Customers (International)Our Customers (International)
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Outcomes of using ClickMedix Outcomes of using ClickMedix implementationsimplementations
Outcomes of using ClickMedix Outcomes of using ClickMedix implementationsimplementations
• Government health departments- Government of Botswana saves 500K USD annually on transportation alone- Less crowding in hospitals and increased capacity to see more patients through remote
consulting doctors• Non-government health organizations
- Saves 2-5 personnel resources from digitizing paper-forms while getting real-time data and auto-generated reports
• Health providers- Additional revenue by enabling tele-consultation with remote specialists while providing
better treatment to patients• Community health workers
- Increased efficiency (e.g. more patients visited) due to time-savings from filing paper reports
• Patients- Faster treatment (days instead of months)- Eliminated unnecessary travels (saved on transportation and loss of wage)
• Medical schools & research institutions- Enhanced education through access to real-patient cases and consult responses- Enhanced international reach of patients and network of other medical experts- Real-time research data collection and analysis
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• Witnessed rapid improvements in patient health when a remote expert/specialist is involved to provide diagnosis and treatment advice for symptoms unfamiliar to local health practitioners
• Medical Expert = health practitioner who specializes in treatment of particular diseases and can quickly recognize associated symptoms
• Some patients who otherwise would need to wait for months or even years to see an expert/specialist received effective treatment within 72 hours via remote consultation
• 100% patients accepted mobile-phone usage of capturing symptoms information including images when used by health practitioners
• Training health practitioners to use mobile phones took an hour or less• In-country health practitioners including health workers liked the “novelty” of
using mobile phones for data collection• In-country health practitioners felt empowered to treat their own patients
through advice of remote experts/specialists • Cost savings realized through reduction of transportation costs and increased
ability to serve more patients without increasing staff
Lessons LearnedLessons LearnedLessons LearnedLessons Learned
Confidential | © ClickMedix, LLC 2013 http://clickmedix.com 26
Deployments: USDeployments: USDeployments: USDeployments: US
Client/ Partner Problem Statement Reach (2011) Improvements
American Academy of DermatologyTele-dermatology for university-affiliated and federally-fundedClinics (2010)
• Lack of dermatologists (3:100,000 patients)
• On average, county clinic shave 600-1,000 backlog of patients needing dermatology diagnosis
• Cost of care is prohibitive for patients to seek dermatological care
• Cost of hiring dermatologist for government clinics/hospitals are prohibitive to having enough dermatologists for the patient population
Current:• 162K population coverage• 140 clinic GPs (general
physicians) and nurses trained
• 30dermatologists trained• 27 clinics• 10 cities in the USScale up plan: Increase # of clinics using
service by at least 100%
• Reduced triage and treatment time from months to <72 hrs
• Reduced referral scheduling time from average 6 months to < 3 weeks
• Reduced time for medical resident to seek attending approval from days to < 24 hrs
California state medical centerTele-dermatology for US city medical hospitals and 7 clinics (2010)
Current:• 22K population coverage• 120 clinic GPs (general
physicians) and nurses trained
• 3dermatologists trained• 1 hospital, 7 clinics
• Reduced backlog from 500 to almost 0 in 3 months
• Reduced triage and treatment time from months to <72 hrs
• Reduced referral scheduling time from average 6 months to < 3 weeks
University of Illinois Telehealth Center for 5000+ state clinics teledermatology Consultation (2011)
Current:• 5M population coverage• 5,000 clinic GPs (general
physicians) and nurses being trained
• Deployment in progress
United StatesUnited StatesUnited StatesUnited States
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Deployments: Africa and CaribbeanDeployments: Africa and CaribbeanDeployments: Africa and CaribbeanDeployments: Africa and Caribbean
Client/ Partner Problem Statement KPIs: Reach (2011)
Improvements
Botswana Ministry of Health
•Mobile tele-dermatology•Mobile tele-pre/post oral surgery•Mobile tele-radiology•Mobile cervical cancer screening(2009-11)
• Lack of medical doctors (1 surgeon, 1 dermatologist, 5-10 radiologists for the country’s public health system)
• High costs of travel and logistics to treat patients and manage health staff
• Inefficient reporting and monitoring mechanism
• 120K population by 20 rural GPs
• 6 current GP
• Reduced triage time from months to < 72 hrs• Reduced treatment time from months to days• Reduced transportation cost to ~500K/year (USD)• Reduced time to seek foreign second opinion from 6-12
months to < 24 hrs• Reduced data reporting time from months to minutes• Reduced personnel hours spent on reporting and
analysis
Uganda Kisoro Hospital
Mobile tele-dermatology(2011-12)
• Lack of medical doctors (1 primary physician)
• No Internet availability• No electronic record
system
• 10K population • Reduced triage time from months to < 72 hrs• Reduced treatment time from months to days• Eliminated transportation costs
Egypt Ministry of Health
Mobile tele-dermatology(2008-2011)
• Inconvenient travel by patients to seek specialist care
• Long wait time to see specialist
• Lack of specialists in remote areas
• 10K population by 20 rural clinicians (GPs, nurses)
• 5 current GPs
• Demonstrated in-person and remote diagnosis concordance of > 70%
• Reduced triage time from months to < 72 hrs• Reduced treatment time from months to days• Reduced time to seek foreign second opinion from 6-12
months to < 24 hrs• Reduced data reporting time from months to minutes• Reduced personnel hours spent on reporting
AfricaAfricaAfricaAfrica
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Deployments: Africa and CaribbeanDeployments: Africa and CaribbeanDeployments: Africa and CaribbeanDeployments: Africa and Caribbean
Client/ Partner Problem Statement KPIs: Reach (2011)
Improvements
Guatemala District
Hospital
Mobile tele-dermatology(2010-11)
• Lack of medical specialists
• High costs of travel and logistics to treat patients and manage health staff
• 50K population by 5 rural clinicians (GPs, nurses)
• 1 current GP
• Reduced treatment time from months to < 72 hrs
• Reduced time to seek foreign second opinion from 6-12 months to < 24 hrs
• Reduced data reporting time from months to minutes
Guatemala Mayan Medical Aid Clinic
Mobile tele-dermatology(2011-12)
• No trained dermatologist
• 20K population by general physicians and nurses
• Reduced treatment time from months to < 72 hrs
• Reduced time to seek foreign second opinion from 6-12 months to < 24 hrs
Trinidad DistrictHospital
Mobile tele-dermatology(2011-12)
• No trained dermatologists to assist in early screening of highly prevalent Hansen’s Disease
• 10K population by general physicians and nurses
• Increased detection of Hansen’s Disease• Enabled early treatment of identified patients
CaribbeanCaribbeanCaribbeanCaribbean
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Client/ Partner Problem Statement KPIs: Reach (2011) Improvements
St. Luke’s Medical Center
Mobile tele-dermatology(2011-12)
• Lack of dermatologists• Rural clinics have significant
backlog of patients needing dermatology diagnosis
• Travel logistics often prevents patients from seeking dermatological care
• Costs of hiring dermatologist are prohibitive to having enough dermatologists for the patient population
• 125K population coverage
• 2 dermatologists trained
• Reduced triage and treatment time from months to <72 hrs
• Reduced referral scheduling time from average 6 months to < 3 weeks
Caloocan City
Mobile tele-maternal health(2011-12)
• Low utilization rates of pre-natal services in urban poor communities
• 1,000 pregnant women by 200 CHWs
• 5 current CHWs
• Improved mothers’ knowledge in maternal care
• Improved utilization of pre-natal services in urban-poor communities
• Improved maternal and child outcomes among pregnant women
Society for Nutrition, Education & Health Action (SNEHA)
Mobile tele-maternal and child health (2012)
• Lack of general population knowledge about maternal and child care
• 200 population coverage
• Real-time population data collection for mothers and newborns
• Early detection of treatment needs for mothers and newborns
AsiaAsiaAsiaAsia