Telemedicine: Is This the Future of Healthcare? CPHCC Conference Jeffrey Benabio, MD Dustin helvey, MBA, DPT

Virtual Care – Getting Closer to Patients Entire Industries have transformed: Large Companies simply disappeared: BP, D, F, KC, LA, PC

Robert Pearl, MD, TPMG CEO The Goal “I expect that by 2016, with the expanded use of video, the number of virtual visits—including secure e-mail, telephone and video encounters will surpass the number of in-person office visits for Kaiser in Northern California.” BP, D, F, KC, LA, PC Robert Pearl, MD, TPMG CEO

BP, D, F, KC, LA, PC SOURCE: http://www.cnn.com/2014/10/13/tech/web/google-doctors-video-chat/index.html?hpt=hp_t4

The Marketplace The Market: Revenue Growth 2013: $100 Million 2018: $13.7 Billion Average Video Visits by Household 2013: 2/Year 2018: 6/Year (↑ 200%) BP, D, F, KC, LA, PC http://www.forbes.com/sites/ciocentral/2014/04/03/virtual-health-care-visits-will-revolutionize-the-industry-if-we-let-it/

Voice of the Customer (VOC) Customers want… We need to provide… Immediate resolution of low-acuity needs Virtual Visits Same Day, 24x7 access E-visits & hotlines Convenient location Telephone Appointment Visits Hybrid Exam Rooms (RAD) Virtual footprint (Clinic, Work, Retail) From the Advisory Board’s 2014 Consumer Choice Survey. KP Now seeks to address the majority of these issues. Park Nicollet (St. Louis Park, MN) has an online system in which the consumer completes a 5-minute online interview and a nurse reviews the results, makes a diagnosis, develops a treatment plan, and arranges for a prescription or referral, if necessary, within an hour, for a $25 fee. Virtuwell.com offers people the ability to upload their questions about simple conditions and receive a treatment plan from a Nurse Practitioner within 30 minutes for $45. The patient may call the NP. Virtuwell has found an $88 reduction in average cost per case and 90% of cases resolved. Midland Memorial Hospital has a 24-hour hotline staffed by triage nurses. The nurse uses clinical judgment plus an evidence-based algorithmic system. S/he prescribes an ED visit, urgent care, or office visit. Two-thirds of calls are redirected from the ED, which saves patients about $122 per incident. No additional funds were needed to pay the nurses due to decreased ED demand. A substantial amount of research has been done on patient satisfaction in telemedicine and has found that it is higher than for in-person care. The leading reason for this is convenience. Teladoc, Doctoroncall, American Well, Doctorondemand, Doctorspring South Bay’s Millennial Project is an example of this. SD’s HealthSpot & KC’s Care Corners are example of work and retail clinics. Fontana & PC have texting pilots. http://www.fastcompany-digital.com/fastcompany/201410?pg=154#pg154

Patient Centered – Health Everywhere

Health Everywhere (Worksite) – 2014 Innovations in Care Delivery Virtual Care Wireless Monitoring Retail

Health Everywhere – Virtual Care Teledermatology – Best Practice Regional Spread KP Healthspot Station Over 470 patient visits 9.8/10 Satisfaction (MD & LVN) Virtual Consultations Pediatrics Cardiology Pilot – Specialty Care Virtual Lactation – Vidyo Virtual Endocrinology Virtual Acne Follow Up (Over 180 patients) Wireless Glucometer Pilots

Health Everywhere - Retail Kaiser Permanente Care Corner KP Primary Care telehealth in a retail setting Fast and convenient Improve productivity for store employees seeking care

Health Everywhere – Target Clinic Care Provided by KP

Innovation – Beyond 2014 Target Clinics – Powered by KP Mobile Health Vehicle – San Diego Central Hospital – 2017

Virtual Care – Getting Closer to Patients AmWell is the underpinning for BlueCross and UnitedHealth Virtual Care Delivery Platforms

Innovation = Adaptation "Your future success is not dependent on what you have done in the past or are doing now, but rather on how you adapt what you are doing to a constantly changing environment," "Innovation in healthcare will happen. For you and your organization, that innovation will be either disruptive or adaptive. It's your choice."