1. Jeremy Bainbridge
Regional Director, MedNow

2. What is MedNow? Direct to Consumer Specialty Care 24/7 Easy Access
Save time & Money
Easy Access
Specialty Care
MedNow is Spectrum Healths tele-medicine program. Like all tele-medicine programs we are able to leverage different types of technology to deliver care to patient throughout the state of Michigan. This technology eliminates the need for the provider to be physically located where the patient it. MedNow is broken up into two very distinct programs-Our direct to consumer program where we can deliver low acuity primary care to anyone in the state of Michigan 24 hours a days-7 days a week and our specialty care which allows our patients to see a specialist from any of our regional locations
Opening up access
Keeping care local

3. Why? Transitioning from volume-based to value based care.
“It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change” Charles Darwin
As healthcare reimbursements continue to change we need to find a way that will allow us to transition from a volume based environment into a value based environment. By leveraging technology to provide care we are able to gain efficiencies with our providers and maximize our resource utilization and better meet our patients needs.

4. Why? Consumer Demand Technological Advancements Value Based Care
The healthcare consumer is also changing. Our patients are becoming more price sensitive as they are covering more and more of their healthcare costs. As more and more people have higher out of pocket costs or high deductible plans they are beginning to shop around for their care and are more willing than ever to change providers due to cost. Our customers are also demanding better access to care when it is convenient for them. Healthcare is one of the only industries that has historically ignored their customers needs when determining hours of operation.
Cost Savings

5. 76% of Michigan households have access to the Internet
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6. 68% of Americans own a smartphone

7. 80% of patients report being
comfortable communicating with physicians via text, or video
This number is continuing to rise as we all get more comfortable doing more things on our computers, cellphone and tablets. More and more people are leveraging technology to do things like online bill pay, shopping, streaming music and movies. In my house we do all of our grocery shopping on line and pick it up when it is convenient for us. Now Meijer is advertising a new program where they will deliver the groceries to your house eliminating the need to go to the grocery store!

8. 90% of the world’s population will have a smartphone by 2020
As smart phones become a part of all of our daily lives we are all beginning to use them to accomplish more and more. From grocery shopping-to buying movie tickets-to ordering food and more and more people are using them to receive health care.

9. Video Visits are ideal for non-life threatening conditions such as pink eye, allergies, cold and flu, sinus issues and more. MedNow video visits allow the provider to check you out using a webcam anywhere you have an internet connection.
Now that we have discussed why we are looking at tele-medicine as a path forward and the way that we are leveraging the internet and smart devices we can talk about our MedNow program. Our direct to consumer program allows patients with low acuity conditions to see a SH provider 24/7/365 using their smart device, laptop, tablet or home computer. They need to have a strong internet connection and a device with a camera.

10. Traditional Access Points Consumer- Oriented Access Points
New Care Model
Traditional Access Points
Low Acuity
High Acuity
Primary Care Office
Emergency Department
Consumer- Oriented Access Points
Typically in many of our regional communities there are very few choices for receiving health care-if they can’t get into their PCP office than they are left to either go without care or go to the ED. MedNow is allowing patient to receive care when and where the patient chooses. Patients can not receive care when they are at school, home, work or where it is convenient for them.
Source: Mehrota A et al, "Visits To Retail Clinics Grew Fourfold From 2007 To 2009, Although Their Share Of Overall Outpatient Visits Remains Low," Health Affairs, August 2012; Health Care Advisory Board interviews and analysis.

11. Driving Exceptional Value
Excessive test
5-hour Visit
20% need
Follow-up
40 min. wait
3 hour visit
We know that the average low acuity visit in the ED costs approximately $370 and takes about 5 hours from the time a patient leaves their home, receives care and then returns home.
If your community has an urgent care you are able to be seen that day at a cost of approximately $150 and about 3 hours time total time.
To be seen in your PCP office for the same low acuity condition it costs around $100 bucks and again total time spent is about 3 hours. The challenge in most PCP offices is that they do not have access. In most PCP offices it takes a few weeks to be seen if you are lucky.
When patients are seen for the same low acuity condition via video visit with MedNow the cost is $45 and the visit it done when and where the patient chooses. Patients can often be seen within 30 minutes and can choose a time that works best for them.
eVisits are another option that cost $25. We will talk more about eVisits in a couple minutes.
3 hour visit
Time to appt
3 weeks
Waiting
@ home
* Numbers are approximate

12. Symptoms treated with On Demand care
Allergies
Back Pain
Bites & stings
Cough, cold & flu
Diarrhea
Ear ache
Fever
Headache
Heart burn
Pink eye
Rash/hives
Sinus infection
Sore throat
Sprains & Strains
Smoking cessation
Urinary problems
Patients age of 3 years and older can be see for these conditions without leaving the comfort of their home. Patient must be located in the state of Michigan in order to use this service due to current provider licensure laws. We are able to see all patients regardless of insurance status and they do not need to have a Spectrum Health provider.
Treating patients 3 years and older

13. On Demand Demonstration
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14. eVisits allow you to describe your symptoms in a Myhealth questionnaire the provider will use to diagnose and treat the condition the same day.

15. eVisits

16. Differentiators Program Goals Open Up Access
Electronic Medical Record Integration
Part of Integrated Health System
Medical Assistant Support
24/7/365 Video Capability
Appointment Time Selection
Enhanced Patient Experience
Program Goals
Open Up Access
Keep Care Local and Convenient
Lower the Cost of Care

17. Specialty MedNow
allows patients with more serious conditions to have a consultation with a Grand Rapids-based Spectrum Health specialist via a secure video connection from remote Spectrum Health clinics and hospitals.

18. Specialty MedNow Equipment
Jeremy

19. Specialty MedNow Care Settings ED Inpatient Outpatient Home Oncology
Bariatrics
Behavioral Health
Cardiology
Diabetes
Infectious Disease
Pulmonary
Orthopedics
Pediatrics
Sleep
Wound Care
Vascular
Care Settings ED
Inpatient
Outpatient
Home

20. $195.03 Current State Patient Costs Total Time: 4.27 Hours
Patient Lives in Ludington, MI
Patient's Household Income is $40,957
Patient Owns Vehicle That Gets 16 MPG
Patient's Appointment is with Specialist in Grand Rapids, MI
Patient Must Take Time Off of Work to Attend Appointment
88 Minutes – Patient Travels to Grand Rapids (if traffic, construction, or weather allow)
Patient Locates Correct Parking Ramp of Specialist's Facility
10 Minutes – Patient Parks and Locates Building Elevator
10 Minutes – Patient Walks to Specialist's Office
20 Minutes – Patient Waits in Waiting Room
15 Minutes – Patient Waits in Exam Room
15 Minute – Patient Meets with Specialist
10 Minutes – Patient Leaves Office and Returns to Vehicle
88 Minutes – Patient Travels to Ludington (if traffic, construction, or weather allow)
Total Time: 4.27 Hours
Current State
Patient Costs
Food Expense: $9.00
Total Gas Expense: $100.47
Wages Lost: $85.65
Total Patient Costs Excluding Any Medical Expenses:
$195.03
Lung Mass Patient Story

21. $15.21 Future State Patient Costs Total Time: 0.7 Hours
Patient Lives in Ludington
Patient's Household Income is $40,957
Patient Owns Vehicle That Gets 16 MPG
Patient's Appointment with Specialist at Spectrum Health Ludington Hospital via Telehealth
Patient Must Take Time Off Work to Attend Appointment
5 Minutes – Patient Travels to Spectrum Health Ludington Hospital
5 Minutes – Patient Parks and Locates Specialist's Office
5 Minutes – Patient Waits in Waiting Room
2 Minutes – Patient Waits in Exam Room
15 Minutes – Specialist Meets with Patient via Telehealth
5 Minute – Patient Leaves Office and Returns to Vehicle
5 Minutes – Patient Travels Home
Total Time: 0.7 Hours
Future State
Patient Costs
Food Expense: N/A
Total Gas Expense: $1.43
Wages Lost: $13.78
Total Patient Costs Excluding Any Medical Expenses:
$15.21

22. Dashboard
When we started this program we assumed that we were going to be seeing a lot of year old men and we quickly found out we were wrong. The most common patient is a year old female. We also assumed that we would see very few patient over 65 which we were wrong about too! Many of our older patients are used to using technology and have had not problems using MedNow. The oldest patient that we have had was over 90 years old!

23. Prescription/ABX Metrics

24. Patient Satisfaction We look at many aspects of customer satisfaction-
patients feel that the provider spends enough time with them
More than half of patients prefer the video visit to a traditional office visit
Over 90% of patients say that the appointment times available fit their schedule
And over 90% of patient said they are more likley to use SH in the future because of this service

25. 338,000+
Patient Miles Saved
If the average patient drives 65 miles per hour we have saved our patients about 5200 hours of driving time
This is equal to 217 days or 7.2 months of driving time!

26. 3,500+
Avoided ED and UC visits

27. 69
Avoided Transfers

28. What’s coming
Competition
Disruptive Technology

29. Impact Changing the way care is delivered
Provider and Patient Satisfaction
Decreasing Cost of Care
Decreased ED/UC utilization
Avoidable transfers
Improved Access to care

30. Questions?
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