UCHealth Virtual Health Colorado Telehealth Alliance August 30, 2017 Debbie Voyles, MBA HOM Executive Director

Is this the Future of Healthcare?

Today’s Agenda Overview of UCHealth Virtual Health at UCHealth Stroke Virtual Urgent Care Remote Patient Monitoring vICU Safety View Centralized Telemetry Wearables Provider to Patients Home UCHealth Facility Non-UCHealth Facility What makes this successful Q&A

About UCHealth UCHealth is a private, nonprofit health system based in Colorado. We have 7 hospitals (3 new sites under construction), 22 freestanding EDs and over 100 clinics. UCHealth is not state or taxpayer supported We partner with University of Northern Colorado, University of Colorado, and Colorado State University. UCHealth includes the state’s only Academic Medical Center and is uniquely able to provide advanced care, clinical trials and nationally- renowned specialists Poudre Valley Hospital Fort Collins Medical Center of the Rockies Loveland Greeley Hospital Greeley (opening 2018) Longs Peak Hospital Longmont (opening August 31, 2017) Broomfield Hospital Denver Metro University of Colorado Hospital Denver Metro Highlands Ranch Hospital Denver Metro (opening 2018) Memorial Hospital North Colorado Springs Grandview Hospital Colorado Springs Memorial Hospital Colorado Springs

Virtual Health Mission We improve lives through virtual health. In big ways, through innovation and access to healthcare, unlimited by geography, enabled by common technologies. In small ways, by providing compassion and humanity within each personal encounter, anytime, anywhere.

Virtual Health and Epic UCHealth has imbedded Virtual Health into Epic Utilizes Vidyo as video platform for everything expect Safety View Same workflows as in person visit Providers document in the same note format as in person visit For Virtual Urgent Care and in home visits – launched within My Health Connection Ability to schedule Joint Appointment with other sites on Epic

UCHealth TeleStroke Program UCHealth Telestroke Network: Timeline and Growth July 2014: First Telestroke site implemented Total Telestroke patients in 2014 = 26 May 2015: Total telestroke sites: 3 --MHC/MHN --PPRH 2016- Total Telestroke Sites: 5 --Added VVH --MSTU Aurora, January --MSTU CO Springs, July June 2017 – Total Telestroke Sites: 7 --Added PMC and Associated FSED Total telestroke patients/month = 16 – 20; Project > 250 pts CY2017

Virtual Urgent Care (our Direct to Consumer Model) E-clinic = virtual urgent care Pilot launched September of last year, staffed by SOM ED physicians Moving to Emergency Providers at Broomfield Hospital starting September 11 2017 Approx 400 visits so far $49 “self-pay” currently Moving to billing insurance October 23, 2017 Patients access the service through their My Health Connection accounts Limited clinical scope: UTIs, sinusitis, cough, cold, pink eye, diarrhea, etc… Program is about improved access and customer service…

Basic operational metrics

Long’s Peak Hospital

Virtual Remote Monitoring

Virtual ICU - Detail Located at our Peoria facility Will use native Epic functionality already owned (Epic Monitor) One nurse can monitor 35-45 patients/beds simultaneously One provider can monitor up to 120 patients/beds simultaneously Initially, the hub will be staffed by: One nurse 24x7 One PSC/assistant 24x7 One Provider 7 PM to 7 AM, 24 hours on weekends and holidays

Safety View (Virtual Sitters)

Safety View - Detail One tech can monitor 12 patients simultaneously Central monitoring Co-Shared with vICU staff We assume 36 potential sitter patients per day when fully deployed Monitoring keeps patients safe through voice redirection AvaSure Two way audio communication into one room at a time One-way video

Virtual Telemetry

Virtual Telemetry - Detail One telemetry tech can monitor 45 patients simultaneously We assume 323 potential telemetry patients per day when fully deployed Helps with “alarm fatigue” for non-critically ill patients Continuous cardiac rhythm monitoring,

Patient Wearables

Patient Wearables - Our Vision Local and remote clinicians use Epic and alarm management to appropriately monitor and intervene Replaces Nursing documentation tasks Algorithms and risk scores embedded in Epic to enable prescriptive intelligence Device Integration Local and Remote Surveillance Sends data to cloud-based, data science partners Prescriptive Intelligence

Inpatient Outpatient Ambulatory Specialty Genetic Counseling OB/GYN Reproductive Senior’s Clinic Neurology-Telestroke Outpatient Center for Lungs and Breathing Remote Monitoring/eSitter/TeleICU Pharmacy Neurology-Mobile stroke Ambulatory MS Ortho Behavioral Health-Northern Region Rehabilitation Services Gastro-Digestive Health Depression Center Hematology Interpretation Services Surgery Burn Valley View-Didactic Specialty Pathology Dermatology Radiology Neurology-Spine Diabetes Education Palliative Care Radiology Cardiology eClinic Oncology

Key’s to Success

Keys to Success Part of UCHealth Strategic Plan Leadership Support Foundation is Built within Epic Readiness Assessments Epic Workflows Physician Champions Dedicated Staff Virtual Health Team Virtual Health Steer Operational Committees Epic Team Technology One size does not fit all

If we can dream it – we can do it!

Virtual Health Team Executive Director Debbie Voyles, MBA HOM Medical Director Christopher Davis, MD, DTMH Program Manager David Coffman, MBA PMP Telehealth Architect David Severenuk Telehealth Coordinator MacKenzie Lintz-Lessard Telehealth Analyst John Thompson UCHealth.org