1. Telemedicine Delivery of Care Through Technology 2014 SSCET & UNO Engineering Forum Kim Landry, M.D., FACEP, FAAEM President/CEO Excalibur Telemedical Services Chief Medical Officer, Lifeguard Ambulance Service, LLC. Brett Jovanovich, MSHA President, Lifeguard Ambulance Service, LLC.

2. What is Telemedicine?

3. How does it work?

4. Examples 1. MD examines patient directly through extender 2. MD Specialist can assist the patient’s primary MD during a virtual visit at the bedside/office 3. MD and patient discuss issues virtually face to face with little to no exam taking place. i.e.Skype

5. Examples 4. Patient sends digital data to central receiving center. Data is processed and forwarded to patient’s MD 5. Medical assistant helps obtain data from patient and sends to central office for processing 6. Call center triages calls and offers medical advice

7. Mobile Healthcare Connections Leveraging existing technologies Cellular Data Encryption and Security

8. How can we deliver quality healthcare through telemedicine? Telemedicine equipment should: Allow for an exam that is equal to or better than a face to face exam

9. Images taken with AMD 2500 Exam Camera and Digital Otoscope

10. 12 lead EKG

11. Exactly what data and tests are available via telemedicine? General Exam Camera Skin lesions Eyes Throat Otoscope Ophthalmoscope Stethoscope (breath, heart, and bowel sounds)

12. Exactly what data and tests are available via telemedicine? 12 lead EKG Ultrasound X-ray POC Lab test (Chemistries, H/H, Dip Urine, Rapid Strep, RSV) Vital signs (BP, Pulse, Resp Rate, Temp, Pulse-oximetry, weight) Spirometer

13. Conclusion What is the goal of telemedicine?: Increases access to healthcare Improves health outcomes Reduces healthcare and other cost Assist in addressing shortages of healthcare providers Supports clinical education programs

14. Conclusion Technology today permits an equal or better exam than face to face Allows for more efficient delivery of quality healthcare A very positive experience for patients: No more hours in waiting rooms waiting to be seen Not having to fight traffic, parking, weather to get to a doctor when your sick Getting the care you need, when you need it – YOUR time is valuable, and so is your health