HealthNet connect Telehealth

1. HealthNet connectTelehealth Rodney Brown Executive Director HealthNet connect, HNc Services & BroadNet connect

2. Who are we? Wholly owned subsidiaries of UnityPoint Health • HealthNet connect(HNc) is a company established for healthcare entities to securely share healthcare information using our private technology infrastructure. • BroadNet connect (BNc) and HNc Services Inc. are communication and technology services companies developed to provide value added services to healthcare, business and government.

3. Why Telehealth • It’s ALL about ACCESS! • The population that uses the health care system the most nationwide can be categorized in two groups; adolescents (under the age of 18) and seniors (aged 65 or older). According to census data these two groups make up roughly 45% of Iowa’s total rural population.

4. What is HNc Telehealth?

5. Telehealth Definition • Telehealthrefers to a broader range of services that includes telemedicine and other remotely provided services such as clinical education programs, patient support and education, health information exchange, clinical decision support, electronic health records and laboratory systems, and disaster response support.

6. HNc Telehealth Initiative Mission • To define, develop and coordinate a Telehealth strategic plan in order to establish a comprehensive Telehealth program throughout the HealthNet connect base. The initiative will consist of processes, programs, tools and services to help the HNc participantsimplement, support and sustain a Telehealth business. Areas of Focus: • Administrative • Processes to administer and manage Telehealth • Financial • Financial implications and sustainability models • Clinical • Tools, education and resources to make adoption and use simple for clinicians and patients • IT • Tools, systems and partners to support the program

7. Must Haves for Telehealth • Funding • Network Infrastructure • Fiber Network, Private Routing, VPN • Ease of Technology • Reimbursements and/or Shared Savings • Acceptance/Confidence • Leadership, Physicians and Patients • Resources/Time • People and Processes

8. Key Adoption Issues • Resource capacity to support Telehealth– including both clinical staff delivering services and Telehealthsupport staff (i.e., technology support) • Difficulties using the Telehealthtechnology – demands on clinical time for organizing and using Telehealthtechnology, (i.e., getting equipment connected between sites, and integration of clinical information systems and peripheral devices to support Telehealthinteractions). • Lack of reimbursement models for Telehealthservices ‐ rural community network hospitals, and the physicians which provide Telehealth/telemedicine consultations for them, bill and receive reimbursement for providing these services.  Physicians are reimbursed just as if they were seeing the patient physically in their office. However expanded Medicaid and Medicare reimbursements are needed • Lack of funding to start or keep program going – grant funding is limited and access to technology/equipment and staff can be costly. • Lack of Standard Program Guidelines, Change Management and Training – availability of guidelines and training programs. Standard procedures for using Telehealthtechnology and services.

9. Program Scope This initiative will initially focus on four pilots to develop proof of concept. However the ultimate goal is to establish a comprehensive Telehealthprogram expanding on these pilots and in other areas within healthcare and in other industries (schools, correctional, business).

10. Expected Benefits • The following benefits will expand well beyond the initial pilots and should also be used as a source of measuring success: • Improved patient and care-giver access to health services • Reduced unnecessary travel time and cost for patients/care-giver and clinical staff • Improved patient and care-giver involvement in care planning • Improved ability for rural practitioners to access specialist health services • Improved ability to conduct screenings and health promotion within our communities • Increased viability of providing services locally in rural and remote communities

11. Technology/Support • The objective is to integrate and utilize Telehealthwithin the HNc community and beyond. Through the use of technology and strategic vendors/partnerships, improve our population’s health by improving access to care, coordination of care and delivering healthcare at a distance. Use of the technology will improve the health outcomes of our population. It will employ industry standards in allowing organizations to provide remote patient monitoring, medical services and interactive patient encounters.

12. Technology Guiding Principles • Our guiding principles for any technology we use internally or via vendor products are: • Ease of use – intuitive use by physicians, clinicians, staff and patients • Compatibility – interfaces between multiple end users and facilities, both technically and operationally • Drives Access – increases use of Telehealthand utilization of services • Industry Standard – complies with industry protocols • Promotes Sustainability – cost effective; contributes to increased revenues or costs avoidance

13. HealthNet connect - a Powerful, Secure Infrastructure When clinical consultations occur at a distance, a special range of issues in relation to security, privacy and authentication emerge. Data in the form of video and audio, as well as clinical data are transmitted between locations, all of which are exposed to the risk of interception. The communications network and applications need to have encryption to ensure compliance.

14. HNc Network Infrastructure • HNc has identified four network factors that have been critical to its success: • Healthcare information traveling over the HNc network is prioritized over other network traffic to enable faster speeds, ensuring high-quality and smooth two-way video. • HNc provides VPN-level security as well as encryptions of data transferred over the network to meet healthcare security requirements. • A “flat network” that enables equal access to information for all network participants (vs. information controlled by regional hubs) with additional access to Internet2 and the National Lambda Rail for expanded research and education. • A scalable network that allows for expansion – geographically, number of sites, bandwidth and new services.

15. HNc Application Infrastructure • HNc will use a comprehensive Telehealthcollaboration software platform that stands out in two ways: • It facilitates the aggregation and transfer of information by allowing remote sharing of output from interoperable third-party medical devices. • It uses a flexible design that lets healthcare organizations take full advantage of compatible third-party applications and services, including electronic medical record (EMR) systems, directory services, and applications for practice management.

16. HealthNet connect & BroadNet connect “Providing the Next Generation of Communication and IT Services…NOW!” www.healthnetconnect.org