1 Impact of VRI use in Healthcare The Leader in On-demand Video Remote Interpreting 1 Connect to a live interpreter in less than 30 seconds. Stratus Video Dan Gatti Tony Bradshaw

2 Objectives 2 Technology will always improve skills of interpreters This presentation will make you aware of new technology and impact on healthcare How can on demand video can help meet the register of the patient Not all video is the same How does the cloud help interpreters? What is available in social networking to improve skills? Are they secure? How do we take the mystery out of technology? Establish standards, train and educate interpreters. How will iPads, Smart Phones, Tablets and wireless PCs impact interpreting? What are the issues/ best practices for interpreters adapting new technology? How do supervisors work with hospital administrators and IT departments? Privacy, security and network integrity become very important. As they strive to be HIPPI compliant.

Language Service Provider Market 26,000 companies - $13B revenue 65% have between 2 and 5 employees 25% have between 5 and 20 employees Source: Nataly Kelly-Common Sense Advisory

4 Interpreting Dynamics 4 Largest cost is scheduled interpretation (in person) Typically 2 hours plus travel Over the Phone (OPI) largest volume. Specialized phone with two handsets Difficult to meet the register of the patient Video Remote Interpreting (VRI) requires skill and training Medical terminology much more difficult Training, More Training, Practice, Practice, Practice How do we take the mystery out of technology? Establish standards, train and educate interpreters. How will iPads, Smart Phones, Tablets and wireless PCs impact interpreting? What are the issues/ best practices for interpreters adapting new technology? How do supervisors work with hospital administrators and IT departments? Privacy, security and network integrity become very important. As they strive to be HIPPI compliant.

5 Technology Today New Terminology (Something as a Service) 5 What is a Cloud? Google Mail All kinds of Devices connect to the cloud Doximity social network for healthcare professionals WebMD Timely health and medical information

6 IT Challenges 6 Wireless everywhere Public and Private Virtual Private Networks (VPN) Security Encryption HIPAA iPads Video Legacy devices SIP H.323 Firewalls Network Engineer opening Firewall “Hey You, Get off of my Cloud”

7 Changing Technology Shapes the Industry 7 There are all types of technology providers including: Language Service Providers Processor manufactures like Intel Computer companies like IBM, HP, Dell Audio Visual providers (AV)like Williams Sound Telecommunications companies like AT&T or Verizon Networking companies like Cisco and Juniper Video Phone companies Polycom and Tandberg Video Remote Interpreting companies like Stratus Video System Integrators like Cerna Modality companies like GE, Siemens

8 ODI- On Demand Interpreting 8 Connect to a live interpreter in less than 30 seconds.

Stratus Video a ZVRS Company Process 40,000 Video Calls Every Day 50,000 active users on the network 400+ Certified Interpreters (ASL, Spanish & Portuguese) 24X7X365 On-Demand Connects to Live Interpreter via Video in less than 30 seconds Supports any platform iPad, Tablet, PC, Mac, iPhone, Android All Legacy Video Phones, Polycom, Tandberg, Lifeline Leveraged ZVRS’ video technology Industrial strength redundant Video Telephone Network Just like Verizon and AT&T 54 Million Video Calls Per Year 99

Software Works Across All Common Platforms PC or MAC iPhone and iPad Smartphone and Tablet Polycom and other Video 10 Android Rolling Cart Connect over Wi-Fi, 3G, 4G or LAN

11 Bedside Technology 11 iPad or Tablet ODI interpretation Intelligent Monitors Audio Visual providers (AV)like Williams Sound Telecommunications companies like AT&T or Verizon Networking companies like Cisco and Juniper Video Phone companies Polycom and TandbergIntelligent Monitors Intelligent Monitors at bedside Access your patient record See medication Order from pharmacy Select food Internet access Interpretation available

12 Every device should connect the same way! 12 Stratus ASL Interpreters Stratus Spanish Interpreters OPI Interpreters PatientDoctor/Nurse 1 1.Patient/Nurse/Dr. selects language option on touch-screen 2. Client (ODI) calls Interpreter – Answers in less than 30 seconds (24x7x365) 2 OPI Partner ASL Interpreters Spanish Interpreters Other Languages Call Flow for VRI and OPI Other VRI Interpreters

13 Hospital Call Center 13 Stratus ASL Interpreters Stratus Spanish Interpreters OPI Interpreters PatientDoctor/Nurse OPI Partner 1.Patient/Nurse/Dr. selects language option on touch-screen 2. Call routed to Video Call Center 3. Call overflowed to VRI if required - extends resources - any time of day - any day of week ASL Interpreters Spanish Interpreters Other Languages Video Call Center Other VRI Interpreters Overflow from Call Center

What to expect from VRI Interpreter 14 Features 1.Name and identifier # -Kat Window in Window -Can be moved 3. Privacy Window -Close view from Interpreter 4.Audio Control -Mute 5. Digital Whiteboard Video Interpreting requires training to meet register of patient

Over 400 Highly Qualified On-Demand Interpreters US Citizen At least 3 years interpreting experience Stratus Employee in Call Centers. Completed medically accredited training. Hold national or state equivalent certification Achieved 4.0 CEU RID certification. Provided over 100 hours of interpreting services in a medical environment. Have processed in excess of 1000 medically related video calls Adhere to Professional Code of Conduct HIPAA Certifiedf Ethics 15 National Certifications NIC, NIC Advanced, or NIC Master, RID CI, CT, IC/TC, CSC, SCC:L or MCSC NAD Level IV or V ACCI Level IV or V, Texas BEI-3 or higher

Interpreter Call Center Work Area Purpose built for Interpreters Customized software video phone client specifically designed for the interpreter Same configuration everywhere HP Elite 8200 (dual monitors 19” and 22”) Larger monitor for administration Ergonomic Design Table moves up and down Quiet 16 Agent Information Web Cam Screen Stratus can build same configuration for you

26 Stratus Call Centers 17

Redundant Nationwide Video Telephone Network 18 over 3 years interoperability with Cisco Private HIPAA Compliant Secure Network

19 What’s an Interpreter to do? 19 It’s not what you know that makes the difference. It’s what you DO with what you know that makes the difference. ” Dr. Julie White Learn technology Make a friend with IT “Interpreters will never be replaced by technology, they will be replaced by interpreters who use technology.”

20 ODI- On Demand Interpreting 20 Connect to a live interpreter in less than 30 seconds.