TeleMasterTelemedicine Platform

Talor SaxVP Business Developmentwww.ewavemd.com

talor@ewavemd.com +972-54-222-3575 (Israel)+1(419) 825-6771 (USA)

Jan 2010

Agenda

• Profile• TeleMaster Product Description• Case Studies

– Remote Diagnostics• Procardia Call Centre• Disease Management – CHF patients

– Orissa Project• 51000 Medical Kiosks with Patient/Physician Virtual Encounter

EWAVE MD PROFILE

eWave MD – Profile

• International software company • Healthcare oriented since 2000• Secure Web-based solutions and products specialists• ISO 9001:2000 compliant• Over 250 professionals• Active in US, Europe, Brazil, India• ~ 10, 000 physicians worldwide• ~ 3,000,000 patients• Outpatient EMR – National HMO• Patient Portal and PHR

eWave MD – Profile

• This video was produced by Maccabi Health Services• The clip shows the reality of a Maccabi patient • Most of the applications were developed by eWave MD

* To view this video online please visit:http://www.youtube.com/watch?v=tbOlQ7e7LX8

Partners

Technology

•

Devices

Applications

Certifying Entities

Member

Organizations

Products“TeleMaster”

Turn Key Telemedicine Solution Platform

TeleMaster

• TeleMaster is a proven, robust and flexible telemedicine turn- key solution, designed to respond to the broadest range of needs within the scope of modern eHealth.

• TeleMaster is a secure medical tele-diagnostic platform providing physicians with diagnostics and treatment for patients who are physically remote.

• Provides both immediate real-time (Emergency/Urgency) and queued diagnostics.

• Supports both centralized diagnostic centers for on-site physicians, as well as virtual distributed diagnostics in which physicians provide diagnostic services remotely from their clinics.

• A Centralized Medical Call Centre

TeleMaster - Turn Key Telemedicine Solution Platform

• Enables a wide range of Telemedicine implementations such as (or combination of):

• Remote Diagnostic Services• Home Care Monitoring

• Virtual Encounters• Telemedicine Kiosks

From anywhere by any one to anywhere and anyone

Patient home

VPN

Diagnostic Center

Clinic

HospitalRemote Diagnostic physician

Remote Diagnostic physician

Remote Diagnostic physician

Remote Diagnostic physician

On-premise diagnostic physicians

VPN

Telemedicine Process

• Diagnosis Workflow

• Physical or Virtual Diagnosis Center

• Store and publish result

• initiate medical interference

• Transfer files to diagnostic call center (virtual or physical)

• Collect Data from Medical devices

• Open API –connect any device

Collect

Transfer

Diagnose

Publish

TeleMaster: a triple win situation

Patients

• Improve Life Quality

• Awareness

Payer

• Reduce Costs

Care

Giver

• Increase efficiency

Use ANY medical device (Public use or Home use)

Benefits

• Increases efficiency • Complete Workflow Management• 100% Secured & Reliable • Queue Management• Expendable

Benefits – Increase Efficiency

• TeleMaster Management application has Proven increase in diagnosis capacity -

E.g. Procardia ECG call centre is manned only with Cardiologists due to the workflow designed by eWave MD making it unnecessary to use nurses or technicians;

HR available: During morning hours: 3 to 4 doctorsLunch time closed and doctors work on received holter readings from technicians;Afternoon1 to 2 cardiologistsOverall working hours: 0800-1900

Actual Average time required for each diagnosis: 1 minute 39 seconds

Benefits – Complete

• Complete Process– TeleMaster automatically manages the entire process -

Collect, transfer, diagnose, publish;– no need for the referring provider to contact the diagnostic

center directly

Benefits – Reliable and Secured

• Secured Reliable Complete and 100% monitored file transfer– TeleMaster is a critical application influencing life and

death – TeleMaster secures the file transfer on any type of

communication infrastructure ensuring 100% that any sample take will be delivered to the expert in complete

– TeleMaster will alert on any loss of data or delay in providing answers

Benefits - Queue Management

• On large scale telemedicine operations, queue management and process management are critical to ensure the required SLA to any patient and referring physician

• TeleMaster manage queues, will route any incoming exam to the right expert based on availability and other business rules

Benefits - Expendable

• TeleMaster is an open system, enabling expanding it to cover additional needs such as local regulations, local billing, local workflow etc.

• TeleMaster can work with any medical device

Supporting Services

• Based on our Flexible Software Platform and unique Suite Of Services we offer:– Rapid deployment of clinical information systems– Secured, Standard based, interoperability and highly

Customizable clinical solutions – Taking complete responsibility on all of the operational

aspects; Servers, Maintenance, Support, Training etc.

call centre workflow

• An important factor for the success of the TeleMaster is based on the “call centre workflow”

• Designed to reduce costs in Human Resources, as well as increase in efficiency.– Huge costs lay in the Human resources required to answer in a speedy way

“peeks” of calls when most of the day these same Human Resources are idle.

• Automated Queue Management System,– Enabling the prioritization of incoming readings via several parameters like:– Emergency/Urgency;– Time of arrival for evaluation;– Type of commercial agreement;– Etc.

TeleMaster Compatibility with

• 12 lead ECG• Single Lead ECG• Holter• Blood Pressure• Precision weight scale• Glucometry• Spirometry• Height• Spo2• Temperature• Etc.

Implementations

• Health Insurance– Improvement of service– Reduction of costs, efficiency etc– Retention of users

• Oil Companies;– Remote locations of difficult access

• Private and public hospitals– Hospitalization home– "High Early“– Senior Citizens

• National Organizations to provide healthcare;– Release of the emergency units of "false cases”– Dramatic reduction in costs (release of beds, fewer people in the emergency room etc.).– Retention of citizens in remote areas

CASE STUDIES

Case Studies“TeleMaster” - Remote Diagnostics

National Level Center

Procardia (Israel); Raytel (USA)

Procardia Cardiology remote diagnostic center

• 18,000 Holter readings performed during 2009.• 1,200 Holter readings during December 2009;

• • Medical Device used: Dell Mar Reynolds – Life Card CF (USA);• Compact Flash card reader : SanDisk or any one available• Software required: Local Dell Mar Reynolds software installed in local PC to

enable downloading of the Holter reading locally, and transmitting it to the diagnostic center (TeleMaster).

• Human resources required (2009):» 5 technicians per day;» 5 days a week» 22 days a month» 12 months/year.

• These technicians are trained in the initial evaluation of the Holter, “arranging” all the required information after first analysis for the Cardiologist approval.

• Total Technician time paid per year: 7,920 hours• 2 cardiologists performing evaluations and referrals during idle time in the ECG call centre. • Average time per technician/per Holter reading (including idle time): 26.4 minutes

•

Procardia Cardiology remote diagnostic center (cont)

• 140,000, 12 Lead ECG readings during 2009.• 11,775, 12 Lead ECG readings during December 2009;

• • Medical Device used: Norav Medical (Israel);• Human resources required (2009):• Procardia ECG call centre is manned only with Cardiologists due to the

workflow designed by eWave MD making it unnecessary to use nurses or technicians;

• During morning hours: 3 to 4 doctors• Lunch time closed and doctors work on received holter readings from

technicians;• Afternoon1 to 2 cardiologists• Overall working hours: 0800-1900• Actual Average time required for each diagnosis: 1 minute 39 seconds• • Software required: Local Norav Medical software installed in local PC to enable

downloading of the ECG, and transmitting it to the diagnostic center (TeleMaster).• (as per clients request)

Case Study – Remote Healthcare

• Tele-diagnostic service for cardiac exams • Used by Leumit & Maccabi (Israel) & Philips

Healthcare (USA)• Cost reduction – profitable for both provider and

patient• Improves waiting period for tests and results• Supports a virtual and physical interpretation center

Solutions and Products – Telemedicine Applications

Tele EKG

Tele Holter

Holter Diagnosis Technician

Case StudiesDisease Management

National Level HMO

Maccabi HMO

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Congestive Heart Failure (CHF)

Home Care Chronic Disease Management Model

Maccabi Health care – CHF patients monitoring

• Home Care• 2,000 patients – largest CHF study in the World• Monitored 24 hours from home by medical call

centre• With and without Video• Blood Pressure and Precision Weight scale

Solutions and Products – Disease Management

• Improve the quality of health care services provided• Improve and maintain quality of life• Reduce unnecessary hospital admissions (e.g. due

to patient anxiety)• Reduce administrative Primary Care Physician (PCP)

visits• Decrease mortality• Reduce costs• Establish central database for patients as a

supporting tool for DM (Disease Management)

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Solutions and Products – Disease Management Tele-monitoring

Information SystemsRF

Patient houseMaccabi

Call center

PCP

Regional center

Devices:• BP

• pulse • Weight

HUB

Phone Lines

Background• There are ~ 6000 CHF patients, 0.3% of total

Maccabi members• Half of them are hospitalized once a year v.s. the

other half that are hospitalized more than once a year

• Mortality within six months after hospitalization is 18%

• On average, each patient has 22 family doctor visits a year

Program Objectives

• Improve the quality of health care services provided• Improve and maintain quality of life• Reduce unnecessary hospital admissions (e.g. due to patient

anxiety(• Reduce administrative Primary Care Physician (PCP) visits• Decrease mortality• Reduce costs• Establish central database for CHF patients as a supporting tool for

DM (Disease Management)

For the patient:•Expands access to professionals outside the immediate geographical area of residence.•Patients receive results immediately, regardless of their location.

For the health system, diagnostic center and physician:•Expands clinical service delivery to broader geographical audiences.•Supports billing, management, workflow, and storage. •Improves efficiency by focusing on medical services rather than administrative tasks.•Supports centers of excellence and enhances reputation.•Increased efficiency, thus reducing costs with increase quality of service.

Product Features•Flexible, customizable process definition and workflow management. •Supports integration and interoperability with PACS, billing, electronic medical record solutions and other information systems•HIPAA-compliant •Exam priority management according to: type, source and other relevant characteristics•Event-driven expert system with decision support capabilities•Entry of exam results in pre-defined and customized forms •Comprehensive reporting•Main storage of all medical data and diagnostics •Strong archiving, search and retrieval capabilities•Administrative tracking including billing and process reporting

Centralized and Distributed Diagnostic Center•The flexible workflow of the TeleMaster enables the use of;

Local call centers, located in One or various physical location;Virtual call centersRemote users, interconnected via the Net.

•All data is stored and secure in one database, regardless of where the information is viewed.

Major Benefits

Orissa Telemedicine Project - Solution Overview

Virtual Encounter Workflow

Thanks

Talor SaxVP Business Developmentwww.ewavemd.com

talor@ewavemd.com +972-54-222-3575 (Israel)+1(419) 825-677\1 (USA)