Telehealth Program Overview Dr. Narendra Kini Miami Children’s Health Systems Chief Executive Officer © Miami Children’s Health System 2017

School Health Primary Care Services Settings: 3 Schools Technology: Mobile Solution (suitcase) Commonly seen services: Minor illnesses Cold, flu, fever, sore throat, earache Sinus or upper respiratory infection Rash or skin conditions Eye conditions Allergies Laryngitis Head Lice Insect Bites Mouth and Cold sores Healthcare Team: Family ARNPs and physicians On site Telehealth Presenter Statistics: 221 students seen 93% of parents and students surveyed were “Very Satisfied”; 6% surveyed were “Satisfied”

Pediatric Subspecialist Services Domestic and International consults Provider to provider or direct to consumer consults Second opinion consults Domestic emergency medicine care, subspecialist services and inpatient unit – partnership with adult hospitals 33 subspecialty areas 95% of Nicklaus Children’s Hospital privileged physicians are credentialed in telemedicine

NICU Babycare Provide support and education to parents and families post discharge at home for continuity of care Additional services include Lactation education Objectives: reinforce discharge instructions and promote carryover in the home environment provide advice on common newborn concerns to support the child’s care in the home environment prevent disease complications by emphasizing the importance of medication adherence and education optimize parent’s awareness of the newborns health status and facilitate early intervention and follow-up with the pediatrician

Telehealth Center We are re-imagining the healthcare experience and innovating how we support families and children at the point of illness and throughout the continuum of health and wellness Expanding telehealth into the retail market, partnering with insurance providers and offering wellness services for adults and children. Support sophisticated video-conferencing, diagnostics and testing, allowing clinicians, parents and patients to consult with a team of specialists Our Telehealth Center allows us to care and monitor children wherever they are, whenever they need us – bringing expert care and peace of mind to families and children. In 2016, our Telehealth Command Center saw 625 cases; 383 adult patients and 242 pediatric patients. Current 2017 programs are on pace to exceed 2016 volumes by over 25%.

Rehabilitation Services Tele-Dentistry Tele-Intervention: Partnership with the State Early Steps Program Lack of access to Rehabilitation Services in rural Monroe County Consultation between Infant Toddler Developmental Specialist (ITDS) and Pediatric Rehabilitative Healing Arts Specialists Specialized Services: Brachial Plexus Injuries Intensive Therapy Programs: Constraint Induced Movement Therapy (CIMT) 107 cases seen to date 40- feet unit equipped with two dental operatory suites State-of-the-art Telehealth equipment Two-way communication between the mobile unit team and dental colleagues at Nicklaus Children’s Hospital The program provides dental screenings, assessments and exams to underserved/underinsured children in South Florida (12 years and younger).

TytoCare™ Partnership MCHS and TytoCare™ partnership will serve as a population health management tool and expand telehealth services for consumers. Bringing remote telehealth services to patients’ homes, schools, global locations, expanding current offerings and improving patient care. TytoCare is a handheld remote examination device and telehealth platform that enables anyone to capture ear, throat, lung, skin, heart, and temperature exam data TytoCare platform with integrate with MCH Anywhere®, the MCHS telehealth application.

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