Canada’s 10 Most Prominent Telehealth Solution Providers In 2020

1. 2020 CANADA'S VOLUME-07 ISSUE-01 MOST PROMINENT TELEHEALTH SOLUTION PROVIDERS IN 2020 Wello Wello Wello Wello

4. Telehealth Services and the War against Pandemic A n old adage says, ‘Necessity is the mother of invention’. However, at times, inventions need a necessity to help prove their effectiveness. The concept of Telemedicine and Telehealth has been around since the 1920s when radios were used to deliver medical advice to clinics on ships. With evolving times and growing penetration of technology, especially in the last decade, telemedicine has blossomed. It has seen a surge, most awaited, amid the ongoing global pandemic. using telehealth services with the lockdown giving a positive push, others took upon themselves and reliable service providers to create a transformation program that could assist them and their patients. These transformation programs aimed at implementing telehealth solutions for patients with chronic illnesses as well as fighting the pandemic. Right from teleconsultation, delivering medicines at the doorstep, routine check-ups, to providing information about COVID-19 and its preliminary symptoms screening, telehealth has found more takers than ever. Moreover, it is helping infected healthcare practitioners stay in touch with their patients even when they are quarantined. It took a pandemic and months of lockdown across the world to realize how Telehealth can be the solution to many problems that we currently face. The pandemic aside, there are patients who need regular monitoring, interaction with their medical practitioners, tests, and other medical assistance to help them stay fit and keep themselves going. But when a lockdown came into effect, they did not know what to do, where to go and whom to ask. Through this edition by Insights Care, we bring to you Canada’s 10 Most Prominent Telehealth Solution Providers in 2020, that have been fighting the pandemic with technology. On the cover we have Wello, a virtual healthcare service, providing Canadian employees access to While some healthcare practitioners were already

5. Editor’s Note holistic medical care, 24/7. Staffed with the most caring nursing practitioners and medical coordinators, Wello members receive immediate assistance via phone, video chat and/or instant messaging. Through a series of interviews, get to know more about Aetonix, a telehealth service provider that aims to simplify care for patients with complex needs, covering both chronic and acute care; Cloud DX, a prominent name among many telehealth solution providers in Canada; and Maple, a platform that connects patients with doctors in minutes through their computer or mobile device. SNEHA SINHA Other prominent companies we would like to mention are, Hamilton health sciences, Island Health, OTN, eHealth Centre of Excellence, ATA, and Akira Health. As you flip through this edition, take a peek at insightful articles curated by experts and our in- house editorial team. Stay Safe! Stay Healthy!

6. Cover Story Wello Ensuring Delivery of Quality Healthcare to All Canadians 08 Articles 28 40 New Warriors Telemedicine: The Front-line Weapon against Covid-19 Unlocking Benefits Telehealth: Taking Modern Healthcare to the Next Level C o n t e n t s

7. INTERVIEW WITH INSIGHTS CARE 24 18 36 Aetonix Cloud DX Delivering Quality Care at Home Maple Offering Comprehensive and Seamless Telehealth Services Leveraging Innovation and Technology for Providing Convenient Healthcare CXO Standpoint Why Adopting HIPAA- Compliant Telehealth is Critical Amid the Pandemic Stepping Up COVID-19: Leveraging Virtual Care for the Pandemic 32 20 CXO

8. Pooja M. Bansal Editor-in-Chief Anish Miller Senior Editor Sneha Sinha Abhishaj, Shruti Managing Editor Quality Assurance Team Visualiser David King Art & Design Head Art & Design Assistant Amol Kamble Asha Bange Co-designer Paul Belin Deepanjali Jena Art & Picture Editor Mark Williams Marry D’Souza Business Development Manager Marketing Manager Sarah Wilson, John Smith Kelli, Bill, Amy Business Development Executive Sales Executives Jacob Smile Pratiksha Patil Technical Head Assistant Technical Head David, Robert Technical Consultants Alina Sege Amol Wadekar Digital Marketing Manager Assistant Digital Marketing Manager SME-SMO Executives Atul, Gemson Eric Smith Research Analyst Tanaji Circulation Manager sales@insightscare.com July, 2020 Corporate Offices: Insights Success Media Tech LLC 555 Metro Place North, Suite 100, Dublin, OH 43017, United States Phone - 302-319-9947 Email: info@insightscare.com For Subscription: www.insightscare.com Insights Success Media and Technology Pvt. Ltd. Office No. 22 & 510, Rainbow Plaza, Shivar Chowk, Pimple Saudagar, Pune, Maharashtra 411017 Phone - India: 7410033802, 74100058552 Email: info@insightscare.com For Subscription: www.insightscare.com https://twitter.com/Insightscare Follow us on : www.facebook.com/InsightsCare/ Copyright © 2020 Insights Success Media and Technology Pvt. Ltd., All rights reserved. The content and images used in this magazine should not be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from Insights success. Reprint rights remain solely with Insights Success Media and Technology Pvt. Ltd. Insights Care is powered by Insights Success Media and Technology Pvt. Ltd.

10. Cover Story Vince Danielsen Founder

11. Wello Ensuring Delivery of Quality Healthcare to All Canadians Wello Wello Wello

12. T have been impacted significantly and are now pivoting to adapt to any such crises in the future. imes have changed. The COVID-19 pandemic has compelled us to change the way we do our everyday activities. Industries across the world Wello is a virtual healthcare service, providing Canadian employees access to holistic medical care, 24/7. Staffed with the most caring nurse practitioners and medical coordinators, Wello members receive immediate assistance via phone, video chat and/or instant messaging. However, the healthcare industry and everyone associated to it has been at the forefront of this fight against the Coronavirus. Taking into consideration the effects of the pandemic, skepticism about how the common public will be able to acquire their basic rights to quality healthcare is on the rise. Wello makes healthcare easier and keeps communities healthy by offering a wide range of primary care needs, mental health support, medical advice and navigation through employee benefits plans. The company was launched in 2017 by INLIV, a 40-year medical facility specialized in the delivery of primary healthcare, preventative health services, ongoing care programs and medical condition management. Wello’s comprehensive expertise in virtual healthcare is fueled by a very deep understanding and culture of healthcare delivery to employees, as well as untarnished records for medical compliance and privacy that runs decades. Undoubtedly, according to experts, the most promising solution to this pressing issue is telehealth. The usage of telehealth services was prevalent even before the COVID-19 pandemic. Only now, its acceptance and adoption is set to surge, considering the aforesaid changes that the common public and healthcare providers will have to adhere to. With the combination of medical care and technology, Wello’s services are currently supporting the health journeys of over 400+ Canadian businesses and hundreds of thousands of employees across Canada. Foreseeing this emergence of better and impactful telehealth services and solutions, we at Insights Care bring to you this edition titled Canada’s 10 Most Prominent Telehealth Solution Providers. In this endeavor, we crossed paths with a company that most certainly exhibits the potential to be one of the top telehealth solution providers. That company, featuring on our cover, is Wello. Exhibiting Healthcare Excellence When Wello was developed, the philosophy wasn’t to

13. As a key component of its service offering, Wello supports employees’ mental health with diagnosis and navigation within their employee assistance program build a virtual walk-in clinic model, but instead to ensure that patients would receive a unified and persistent continuity of care, which are crucial elements to bring better healthcare outcomes and successful delivery. Wello’s ability to develop continuity of care happens through the employment of all clinicians to ensure that screening, training and medical protocols are focused on follow up for all sorts of medical conditions, focused chronic conditions management, specialist referrals, and diagnostics. Wello virtual healthcare is not only able to focus on episodic care, but also to focus on the treatment of chronic conditions and behavioral health strategies. As a key component of its service offering, Wello supports employees’ mental health with diagnosis and navigation within their employee assistance program. employers face today in helping employees access care, positioning virtual care as a solver of both cost and benefit navigation issues, while being able to customize to the need of employers. Wello’s corporate values of care, passion, team and growth, flows through to the positive and caring service provided by clinicians to employees, which translates into strong customer relationship and retention. By working on disability and mental health issues, Wello is preventing people from entering long and short term disability, and supporting employers on their employees’ disability support. To support a seamless continuity of care experience, Wello integrates with other organizations’ benefits to help employees navigate through their benefits programs, and thus enhance their healthcare journey. Exemplary Leadership Surpassing Challenges Wello’s source of inspiration comes from its founder, Vince Danielsen and his passion for ensuring that all Canadians have better and more holistic access to medical care. As a cancer survivor at the age of 15, Vince has a firsthand understanding of how good care can make a difference for someone. Being an innovator in a new medical delivery system and introducing a new employee benefit in Canada comes with many challenges. Wello has deep experience of employers’ health care needs and how to deliver services to employees that deliver valuable health care experiences. This understanding of corporate wellness has been essential to Wello’s early success. During his journey as a patient battling cancer, Vince was supported by doctors and nurses and this has fueled his career path to work in healthcare and look at ways how he can improve healthcare access in Canada.His experience has given him a deep sense of empathy for what people go through when facing health challenges and it is with this lens that he created the Wello experience in virtual healthcare that delivers a caring experience with excellent health outcomes. Secondly, due to Wello’s experience, the company understands how to deliver medical services with expertise in safe, private and compliant care. Over the years, Wello has become a trusted advisor through the quality of services, and its scalable intuitive platform that is easy to implement within employee benefit programs. These elements are essential in the delivery and acceptance of virtual healthcare in Canadian workplaces. As a Calgary Stampeders receiver, winning Grey Cup Championships in 1998 and 2001, football showed him the value of growing strong teams, and this translated into building a culture as a company that is collaborative, open and trusting. Wello operates as a culture driven organization. Each Wello staff member understands the challenges that

15. Vince threw the same focus and determination into becoming the leader of Wello, with a great understanding of healthcare models that are delivered to business and consumer markets. According to Vince, healthcare systems run better when the service is not siloed, fragmented and where there is a team approach. This approach has made Wello successful in delivering virtual healthcare services with the same philosophy of working together. Today, Vince is proud to be running companies that are changing the way Canadians think and feel about healthcare – all so that they can live healthier, richer lives. When asked about his opinion on the current scenario of the telehealth solutions sphere, Vince expressed, “when telehealth initially came out, there was an early adopters segment focused on virtual walk-in clinics. This was very many point of care, episodic solutions with a start and stop for cold flu, skin rash, prescription refills. With the world in a state of change, the telemedicine segment has shifted from becoming a new, innovative health benefit and opportunity to access healthcare differently, to a necessity to support physical distancing and ease the pressure off the face- to-face medical system.” When Canadians think of amazing virtual health care experience and medical outcomes wewant them to think of Wello “Since day 1, Wello has been providing patients with access to chronic condition management and behavioral health management with a virtual healthcare service that delivers high-value service into the occupational health segment.” “Virtual health and mental health has been quickly adopted by major providers in the industry. In the future, there will be segments that will focus more on specific chronic conditions, such as, diabetes and heart disease which are conditions that a high percentage of employees’ experience and drive a high cost to employers. Another segment that will emerge will be focused on the use of virtual healthcare to manage and support employers in managing short and long term disability.” “On an employer perspective, the current benefit-plan offerings are fragmented, with little integration between providers. The integration of multiple benefits providers on a virtual platform will provide a more single solution, including services such as mental health, medical second opinion, and employee

16. assistance programs, supporting the opportunity to deliver better health outcomes for employees and reduce costs for employers.” Patients enjoy the holistic approach to care provided by the Wello clinicians, who manage to develop strong patient-medical provider relationships that enhance the customer experience. The convenience of our app makes it easier and quicker for patients to stay healthy and engaged in their health care. “As the virtual healthcare industry continues to evolve, I also see continued integration with retail and pharmacy businesses that want to enhance their service offerings." From an employer standpoint, we are bringing healthcare and keeping employees well by working closely with HR leaders and employee benefits managers to support their employees’ health. Ultimately, the Wello service successfully bridges the gap between accessible, personalized care and better health outcomes. The direct consequences on the employees’ engagement cannot go unnoticed: reduced absenteeism reduced STD and LTD claims, increased positive and healthy work environment, and impacted work-life balance. Why Wello? From an employee healthcare delivery point of view, Wello has been successfully shown to overcome barriers to health services caused by the distance between patient and provider, division of care due to gaps in time between appointments, and lack of available providers in certain areas of Canada. As support of, traditional care delivery, Wello drastically increased the efficiency of care delivery by connecting patients to clinicians in less than 20 minutes, allowing multiple conditions handling in the same appointment, or providing guidance within the healthcare system. Strength Lies Within Wello always keeps in mind that healthcare is delivered by people. “What we have always known through our history, is that when medical providers

17. are healthy and engaged, they will always deliver better healthcare experience. At Wello, we focus a lot on our company culture: Care, Passion, Team and Growth. We believe that the care we deliver to each other as a collaborative team improve drastically the patient’s experience. Wello’s leadership is very much connected to the mission of our staff: help employees live amazing lives and all our motivation comes out of this statement,” says Vince. client surveys show very positive experience feedback. Our Net Promoter Score (NPS) is an industry-leading 80, and maintains over 4.8/5 satisfaction rating from the high praise from our clients and likelihood to recommend us,” asserts Vince. Beholding A Successful Future With continuous technology and service development, Wello envisions to continue to be on ways to provide easier access to healthcare for Canadians, while helping businesses support happy, healthy and productive employees. Through a team of passionate and caring clinicians, Wello virtual healthcare has successfully improved patient access to medical care while reducing healthcare costs for employers. Being a virtual healthcare company much of Wello’s staff work remotely. This brings many challenges to ensure a full team environment. Every leader in the company is committed to keeping communication lines open, and continuing to provide opportunities to connect and engage with other employees. Wello always supports its own staff on their personal and professional growth by understanding how progress makes people more motivated. The company is also committed in staying on the cutting edge of innovation, as innovation is the future delivery and its staff brings a mindset of how can they deliver new models of care that impact clients lives and the future of health care in Canada. “When Canadians think of amazing virtual health care experience and medical outcomes we want them to think of Wello,” Vince expresses. On the employer perspective, Wello wants them to believe in a company that will be more than a benefit supplier, but a true trusted advisor and collaborator to reshape the health care delivery to their employees. “Wello is very proud of how our post appointment and Wello will continue to expand its medical and allied health practitioners workforce from coast to coast as it develops a true team-based healthcare experience for employers. The company will continue to invest and be at the cutting edge of technology innovation with one sole focus of providing the most ease of accessing medical care and driving behavioral health changes for those in need. Since day 1, Wello has have been providing patients with access to chronic condition management and behavioral health management with a virtual healthcare service that delivers high-value service into the occupational health segment Over the coming years, one of Wello’s ambition is to leverage its influence in Canada to grow in a more global North American market. “We believe that the growing need for virtual healthcare as a root component of employee benefit programs goes far beyond our Canadian borders,” concludes Vince. To learn more about Wello and its range of services, click here : https://www.wello.ca/

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20. Aetonix Offering Comprehensive and Seamless Telehealth Services H been either inventing or discovering new things. Starting from bashing a rock to make a tool, to artificial intelligence, everything we invent or innovate is for our advancement and that stands out as revolutionary findings. umans are an ingenious species and since the day we came into existence, we have or treatment. It was to address this issue that Michel started Aetonix. offers premium-quality and patient- centric care to all those in need. Kindly brief our readers about the company. Before we dig deeper into the science behind this invention, let us delve into the story of Aetonix’s initiation. This story will shed some light on the ‘why’ of Aetonix. Michel: Aetonix began its journey in 2014 with the aim of simplifying care for patients with complex needs, covering both chronic and acute care. Usually, such patients suffer from a healthcare system that is very fragmented. They cycle through the system without anyone ever establishing a complete 360-degree picture of their care plan. Aetonix, via its platform aTouchAway, forms a Circle of Care around patients, so they can be coached and guided according to customized care pathways set for them by healthcare organizations. We are a full-service remote patient monitoring company. When Michel’s 83-year-old aunt was suffering from Alzheimer’s disease, she found it difficult to let family and healthcare professionals know what she needed, leading to problems with her care, and feelings of isolation. However, the key point to be noted here is that the intention within our persistent nature to innovate or invent something, is to experience and offer superior comfort and seamless solutions. Starting from companies, industrialists, scientists, and small vendors who continuously strive to innovate or invent something new, all serve the same purpose. Michel was concerned and realized his aunt wasn’t the only person with these common problems that arise with aging; Alzheimer’s and dementia, and other types of healthcare issues. So he founded Aetonix, to simplify care for those who needed it most – patients with complex needs. Adhering to the same thought, our paths—in the quest to find Canada’s 10 Most Prominent Telehealth Solution Providers in 2020—crossed with Michel Paquet, the Founder and CEO of Aetonix. After keenly observing the healthcare industry, Michel realized that there was a gap between the patients and healthcare professionals. As a result, patients were not able to receive the right prognosis What are the distinct products and services provided by Aetonix , setting it apart from its competitors? Today, Aetonix has developed state-of- the-art use cases for other complex care like COPD, Diabetes, heart failure, hip/knee surgeries, cancer, and COVID-19 in recent times. Michel: One should know that almost all reputable remote patient monitoring companies offer telehealth, which is virtual two-way calling, and remote The below conversation with Michel helped us understand how Aetonix www.insightscare.com 18 | July 2020 |

21. INTERVIEW WITH INSIGHTS CARE Michel Paquet, Founder and CEO patient monitoring that involves remotely transmitting a patient’s vital signs to their care teams. Aetonix goes beyond that and uses clinical forms, educational resources, reminders and a host of other features to build customized workflows for patients. We enable organizations to guide and coach their patients by forming of the circle of care around them that consists of physicians, nurses, specialists and even family members. Michel: There is a lot of consolidation happening. More traditional telehealth firms are acquiring each other, remote patient monitoring firms are being acquired by insurance companies, and remote care vendors are partnering with each other where one is more specialized in hardware and logistics, and the other in software. It is hard to say what the future folds, but in general, the market is getting warmer for remote care adoption amongst healthcare facilities. scenarios that may be the need of the hour. What would be your advice for the budding startups and entrepreneurs in the industry? Michel: First and foremost, they should just do it. That is, start an organization. The best way to learn is by doing and learning from all the experiences on a daily basis. Healthcare is a very competitive field, so they shouldn’t be afraid to get their hands dirty in the process. They should also surround themselves with partners with healthcare expertise that will help them understand the healthcare environment. What are the key attributes that helped Aetonix to overcome challenges? What are the benefits gained by your clients and what strategies do you embrace to keep them engaged? Michel: We have tremendous partners who help and counsel us to do better. We are housed in Invest Ottawa, whose mentorship program has been very valuable. Our advisory board is totally committed to our vision and helps us set our direction in healthcare, while our commercial partners help with channel market introduction. Our employees have great camaraderie amongst each other with an all for one, and one for all attitudes. Michel: Our clients are able to manage their patients remotely. When we say manage, we really mean manage each and every aspect of healthcare, so patients receive one continuous episode of care thanks to the collaboration of all healthcare professionals using our platform to administer the care plan. We collaborate on workflows for patients if needed so the patient receives optimum care. Since we enable them to develop their care pathway as a part of our platform aTouchAway, it is a nonstop collaboration activity in order to get the workflow to match different Briefly tell us about the company’s future perspectives. Michel: We are looking to grow as a company and expand to other markets outside of Canada. We have deployed in the USA and UK and are looking to deploy to other continents as well such as Asia and South America. Globalization has meant that organizations want the best remote patient monitoring solution that fits their needs, regardless of where the headquarters are. What is the current scenario of the Telehealth Solutions Providers Segment, from your point of view? www.insightscare.com | July 2020 | 19

22. Why Adopting HIPAA-Compliant Telehealth is Critical Amid the Pandemic T patients, and family caregivers. Providers are using telehealth apps to quickly communicate critical information to their patients and safely continue the delivery of care during this time. Virtual visits and secure messaging enables providers to discuss patient progress, reinforce the care plan, drive compliance, and include family caregivers who may not be able to visit their social-distancing or quarantined loved one. elehealth is critical to providing care to patients while reducing the risk of infection and transmission of COVID-19 among medical staff, compliant platform that helps them facilitate virtual care today and continues to protect patients (and their organizations) in the near future. Despite personal use of ad hoc video suppliers, home health agencies should leverage a HIPAA-compliant virtual care / telehealth platform which ensures the end-to-end security of communications and also has measures in place to prevent the accidental or malicious compromising of PHI. A safe and secure platform is even more critical if/when a potential second wave of COVID-19 cases occurs in addition to an expected influx of patients as elective procedures cautiously resume. McKinsey & Company recently highlighted that patients and providers are on-board with telehealth. Adoption has skyrocketed with 46 percent of US consumers using telehealth vs. 11 percent in 2019. Providers have expanded the footprint of their practice beyond the traditional office and are now virtually seeing 50 to 175 times the number of patients than they did before. McKinsey estimates that up to $250 billion of current US healthcare spend could potentially be virtualized. Providers value HIPAA-compliant telehealth apps in order to safely continue care during the coronavirus pandemic and set themselves up for success as the country moves into the next phase of healthcare delivery. With virtual care, these forward-thinking organizations are able to safely engage patients by: • Conducting virtual assessments while the patient remains at home. It may challenging to initially differentiate between the flu and the coronavirus depending on the patient’s symptoms and hospitals may already be overwhelmed with new cases. • Conducting virtual visits with patients to ensure continuity of ongoing care in a safe, compassionate, and convenient manner. Virtual visits keep patients at-home and on track with their treatment while protecting staff who may have limited PPE. • Sending out COVID-19 updates to all of their patients so they continue to receive vital information regarding the coronavirus and preventative measures. Condition- specific messaging can also be sent out so patients can receive timely, educational information about their existing condition(s) and overall well-being. • Providing virtual access to their staff in order to minimize patients’ stress of feeling lonely or socially isolated especially if they are required to be home. • Continuing to care for patients who are denying in-person “I think the genie’s out of the bottle on this one,” CMS Administrator Seema Verma said in April. “I think it’s fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.” In mid- June, she penned a CNN op-ed piece and stressed that “telehealth will remain an important tool, but some areas of the country should also begin resuming in-person care for those who need operations, procedures, preventive care, or evaluation for chronic conditions.” As in-person care delivery starts to resume, patients will still expect to have more virtual care options based on their interest, usage and satisfaction with telehealth amid the pandemic. However, it is important to remember that HIPAA-compliant requirements have only been temporarily waived. Organizations need to ensure they have a HIPAA- www.insightscare.com 20 | July 2020 |

23. CXO Standpoint service whether at home or in a facility which is restricting in-person service. • Supporting the expected surge of patients recovering from elective procedures and caring for the community if/when a second wave of COVID-19 patients occurs. Amy Berman, senior program officer at the John A. Hartford Foundation, highlighted that one of the key benefits of a telehealth / virtual care communication platform is its ability to empower providers, patients and family caregivers. According to Berman, family caregivers are typically unpaid and provide more hours of support vs. paid caregivers; providers can use new technology help them and therefore reduce their mutual burden. Berman shared, “that is an essential part of what I see of the future of telehealth as well – not just the bells and whistles and all the gadgetry – but the ability to access – in a timely way – information.” Virtual care and telehealth are no longer seen as merely an innovative method of delivering healthcare; technology is now indispensable to protecting patients, staff, and PPE resources amid the coronavirus pandemic. In a recent Harvard Medical School blog, Lee H. Schwamm, MD, shared that “telehealth, the virtual care platforms that allow health care professionals and patients to meet by phone or video chat, seems tailor-made for this moment in time… The current crisis makes virtual care solutions like telehealth an indispensable tool.” He believes that the role of telehealth is vital to our country as “it can help flatten the curve of infections and help us to deploy medical staff and lifesaving equipment wisely.” About the Author AnnaMaria M. Turano is the Vice President of Marketing for Synzi. She was previously with Stratus Video as the Vice President of Marketing and led the effort to spin-off the Telehealth division and rebrand the new company as Synzi. Prior to her client-side roles, AnnaMaria co-founded MCAworks, a strategic marketing consulting firm advising Fortune 500 companies on developing growth strategies. She is the co-author of Stopwatch Marketing: Take Charge of the Time When Your Customer Decides to Buy (Portfolio: 2008) and a featured contributing author to Shopper Marketing (Kogan: 2010; 2012). This is a critical time for the healthcare of our nation and a watershed moment for telehealth. Providers are already caring for COVID-19 patients and now preparing to also ease the burden facing the hospitals in their communities. In order to effectively serve as the front line, all health care settings and professionals should embrace telehealth and its ability to safely provide clinical and compassionate care – when needed most during these times. As an industry, we collectively point out that the most obvious sign that telehealth is widely accepted is the dropping of the “tele” prefix. Regardless of how/when we reach the tipping point, telehealth is poised to move into the mainstream, optimizing outcomes for all involved. www.insightscare.com | July 2020 | 21

26. INTERVIEW WITH INSIGHTS CARE Delivering Quality Care at Home F pandemic and its unfathomable impact has startled industries across the globe. The current scenario of the healthcare industry is very fragile and tense due to the increasing corona virus cases. People are scared to visit hospitals for other health checkups apart from the Covid-19 symptoms. The fear of being infected by the virus has helplessly occupied in peoples’ minds. People have started to reach out to doctors or hospitals through digital mediums for the care they need. Due to this, a drastic acceleration towards telehealth and virtual care can be seen in the healthcare industry. acing the unexpected has become an inevitable part of our daily lives. The Covid-19 ROBERT KAUL CEO, Founder & President Cloud DX is one prominent name among many telehealth solution providers in Canada. It has been a frontrunner in the telehealth industry. The company has incepted major modifications to the healthcare systems. It has introduced various new and innovative ways of treating patients remotely. It has also built confidence among patients and is thus ascending the zeniths of success. Cloud DX founders Robert Kaul, Anthony Kaul and Dr. Sonny Kaul formed the company united by a vision to positively transform healthcare by reducing healthcare costs, by giving more people access to healthcare, and by making it easier for doctors to www.insightscare.com 24 | July 2020 |

27. provide care and improve patient outcomes. sign detection, wearable monitors, cough analysis, medication detection, augmented reality) • FDA and Health Canada approved products in market • Strong alliances with healthcare providers, payers, advisors, and government organizations Through the below interview with the Cloud DX team, let us get to know the company from the inside. Kindly brief us about the company. As the healthcare industry rapidly moves to embrace telehealth, virtual care and remote patient monitoring at scale, Cloud DX is a first-mover in the race to combine clinical grade data collection with a consumer-friendly user experience. What is the current scenario of Telehealth Solutions Providers Segment, from your point of view? The COVID-19 global pandemic has dramatically accelerated the industry’s shift to telehealth and virtual care. Hospitals in virus hot-spot areas are stressed beyond capacity frontline healthcare workers are dying in unacceptable numbers. Our mission is to create the worlds’ most effective, affordable, and easy to use digital solutions for virtual care, fully connected into modern healthcare systems to deliver superior results and improved patient outcomes. Our value proposition is simple and powerful: more data + better data = better outcomes at lower cost. “ Management of chronic illnesses accounted for more than 75% of worldwide healthcare costs in 2016, with heart disease (CHF), stroke and chronic obstructive pulmonary disease (COPD) named the top 3 global causes of mortality by the World Health Organization Our platform has been clinically proven to reduce hospitalizations due to COPD exacerbation by 80%, and emergency room visits by 36%. “ What are the distinct products and services provided by the company, setting it apart from its competitors? The Cloud DX Connected Health platform combines the best of telemedicine with remote vitals monitoring, patient surveys and smart notifications. It allows physicians, clinicians and care teams to virtually care for patients from hospital to home by automating monitoring of patient vitals including blood pressure, pulse rate, spO2, receive notifications should symptoms change, schedule a telehealth conference and implement pre-approved ‘action plans’ to help patients and their families proactively respond to changes in condition. 1 In 2016, CHF and COPD combined claimed 12.5 million lives around the world, or 22% of all deaths that year. These illnesses cost more, and take more lives, than all cancers put together. Chronically ill individuals are among the most vulnerable populations to the COVID-19 virus. The answer is virtual care - keep patients away from hospitals. According to a recent report by Deloitte: Fifty percent of executives believe at least a quarter of all outpatient care, preventive care, long-term care, and well-being services would move to virtual delivery by 2040. What are the key attributes that helped your company to overcome the challenges? • Strong and accomplished leadership team • Innovative product pipeline (vital Three out of four executives predict that industry wide investments in www.insightscare.com | July 2020 | 25

28. clinically proven to reduce hospitalizations due to COPD exacerbation by 80%, and emergency room visits by 36%. empowered and in control of their condition through regular monitoring of their vitals. This improves engagement in personalized health plans including medication adherence, which itself is a multi-billion-dollar annual problem. virtual health would be significantly higher (more than 25 percent) over the next decade than today. 94% expect that next-generation data and interoperability solutions will enable widespread data sharing; and 88 percent of executives predicted wearable devices will be integrated with care delivery, resulting in a more tailored, personalized virtual health experience for consumers. We believe that the use of virtual care solutions encompassing remote patient monitoring and telehealth in the management of COVID-19 patient, post-surgical patients and management can substantially reduce hospital re- admission numbers, improve hospitals capacity to do more elective and urgent surgeries, improve outcomes for the chronically ill, and reduce the spread of COVID-19 by keeping people out of the hospital. What would be your advice for the budding startups and entrepreneurs in the industry? Be tenacious. Believe in your vision. Treat your customers like gold. Learn quickly from your failures and be quick to adapt. +ve About two-thirds of surveyed executives thought that removing regulatory and payment barriers would accelerate virtual health adoption. Brief us about the company’s future perspectives. Expect to see a robust product pipeline from Cloud DX expanding our platform of offerings, scale up of manufacturing to meet growing demand, aggressive expansion into the US market and broader integration with EMRs. What are the benefits gained by your clients, what strategies you embrace to keep them engaged? Healthcare provider clients of the Cloud DX Connected Health platform are realizing all the benefits outlined above. In addition, patients feel more Cloud DX Connected Health Kits, remote patient monitoring and doctor- approved Action Plans allow patients and clinicians to intervene early to avoid exacerbations due to COPD and CHF - improving outcomes for these patients. Our platform has been www.insightscare.com 26 | July 2020 |

30. Telehealth Taking Modern Healthcare to the Next Level www.insightscare.com 28 | July 2020 |

31. Unlocking Benefits T competitive market, it needs to be pursued, stayed relevant, and adapted. This has forced us to reassess how our healthcare industry adapts remotely with the current rules on social distancing. he healthcare industry is constantly evolving from the way procedures are conducted every day from processing to storage, and dissemination of information to a broader patient population. Everybody is scared of change, but in order to survive in a Telehealth provides access to treatment beyond conventional medical facilities through the use of technology. Since the 1980s, telehealth has existed, but it has evolved and adapted to new technologies. Ever since, telehealth has become widely accessible in the world, with a range of tools and software that can exchange medical data in real-time so that practitioners can deliver www.insightscare.com | July 2020 | 29

32. care to previously under-served populations. It helps medical professionals to support patients and their families by bringing knowledge from around the world together and improving patient data collection and communication and leads to a more holistic care plan. have specialized services where they would otherwise not have been able to get them and save lives that might have been lost. Practical and Relatively Inexpensive Throughout the past, companies have never been reimbursed for telehealth programs, and they have failed to achieve momentum. Although that has traditionally been a drawback to telehealth, it is evolving for the better. More private benefits providers, along with Medicaid and Medicare, are repaying the benefit of telehealth. As a consequence, patients see it as a more effective, trustworthy method. In comparison, electronic gadgets such as Fitbits and Apple Watches, which come under the umbrella of telehealth, can be bought by the general customer for a minimal amount. These machines can also be helpful for a variety of purposes, from patients trying to shed excess weight to tracking underlying health problems and decrease potential treatment expenses. Quick Benefits of Telehealth • Offers patients non-critical care • Providing services to a larger base of patients in rural or under-serving communities, veterans, critical care, the elderly and in normal or emergency circumstances • Establish a contact channel to track patient progress easily and efficiently • Efficient patient information collection and transmission • Consult specialists all over the world Expertise to All The use of medical tools to monitor a patient’s health from a distance offers both patient and provider a new level of comfort. It can supplement in-person visits to a physician and daily visits to a physician to create a more detailed treatment plan. Additional treatment, otherwise inaccessible, may also be given. Maximizes Access to Mental Health Care Mental health care is one of the areas which get most benefited from the use of telehealth. Monitoring appointments with specific mental health issues, such as depression or anxiety, have no clinical testing, and have much to do with relating to the individual. By making the most of telehealth through video chat, patients are able to get a fast 10-minute appointment, to ease an urgent concern that may have spiraled into something more serious, to get a prescription, and to attend daily therapy sessions. Many insurance providers provide video-based behavioral health services, and other independent agencies provide simulated choices. This does not mean that the trips to the doctor’s office will not be completely removed. Instead, physical appointments and telehealth will operate together. The doctor who reviews and tracks a patient will know if the minimum requirements are met that a patient will receive appropriate treatment, including personal visits. If not, the doctor does not have adequate evidence to sustain their medical treatment. Specialized Care for All Telehealth’s greatest benefit is the potential to have direct and complicated access to care. For example, rural communities lack a more heavily populated healthcare infrastructure. Rural patients also have to spend hours seeing a doctor who is not practicable or feasible. Telehealth provides patients and clinicians an easy way of keeping in touch between appointments or visiting specialists that might not be able normally. Benefits that only Grow Everyone that uses the healthcare system will have a recovery program that involves telehealth in a form, or by direct access to the primary care doctor or more comprehensive services, such as daily visits to the therapist. As insurance providers begin to cover further telehealth care services, telehealth can only start to expand further broadly and beneficially, helping to improve the public health and well-being in both urban and rural populations. In the future, the vision of health care will be inseparable from telehealth. In fact, areas that are cut off by tornadoes, hurricanes, and other natural disasters will utilize telehealth for increased access to medical care. During recent disasters, emergency surgeons, neurologists, and other medical services have been willing to contact via Skype on the ground in the crisis area. This helped them to www.insightscare.com 30 | July 2020 |

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35. Stepping Up COVID-19 Leveraging Virtual Care for the coming Pandemic Virtual Healthcare is defined as any encounter between patient and provider for the exchange of information, treatment or diagnosis that is other than a face to face visit. This means providers engaging patients with secure electronic text messaging, phone calls or video calls if telemedicine platforms are available. Countries vary in their utilization rates for virtual care and a study by Kaiser Permanente in USA showed 60% of their patient encounters were virtual in 2017, while in Canada only about 0.3% of visits were classified as virtual. Now given the concern Covid-19 will place upon healthcare systems, virtual or video visits will be more important to protect front line healthcare staff and patients. Hospitals will need to attempt directing Covid- 19 suspect cases away from their ERs and relie upon designated assessment centers to tightly control infection prevention protocols in the community. Patients requiring medical access for routine visits or non-urgent matters, can easily be handled using telemedicine during the peak outbreak season. Dr Keith ThompsonMD FCFP is Adjunct Faculty Dept Family Medicine at Schulich School of Medicine and Dentistry in London Ontario, Canada. He is Chief Medical Officer for iTelemed, a startup company providing virtual care solutions and involved in Virtual House call research and development. C ovid-19 is the name given to the novel Corona virus first discovered in Hubei Province, China. The new virus has since been defined and at the time of this article, is responsible for over 90,000 cases of respiratory illness and has spread to every know region of the World. The ultimate infection spread rate is still evolving but currently stands at 2-3 persons infected from every known contact and mortality rates are approximately 2-3%, while patients over 80 yrs. of age mortality rates are 15% thus far. This article would propose a novel method of engagement using point of care testing, allocation to home based follow-up and potentially treatment with passive immune therapy that will likely be available before vaccines are created. The WHO has activated strategic planning and is offering assistance under pandemic preparedness to countries most at risk due to poor medical infrastructure or lack of medical resources. The concern is not only wide spread disease due to exposure into high density, developing nations; but that this outbreak will burden medical systems beyond their capacity to provide services. This is a concern for both developed and underdeveloped nations. IDENTIFY CASES IN THE COMMUNITY USING POINT OF CARE TESTING A South Korean company PCL, has Korean FDA approved rapid antigen test kits. These kits test for viral antigen using sputum from deep cough, or swabs from the nose and mouth. The sample is placed on a developer slide and after 10 minutes, using a UV light source, read as positive or negative. The kits currently listed at 25 USD per test, report sensitivity of 100% and specificity of 85%. The advantage is testing can be done easily in the community or in the patient’s home. This may allow regions to identify suspect patients by This outbreak, approaching pandemic proportions, has created an urgent need for innovative solutions to reduce community spread and identify those most at risk or requiring treatment due to severe illness. It is at times such as this that innovators will have opportunity to create new solutions to deal with Covid-19 using the latest technology and tools. One tool of special importance would be virtual healthcare. www.insightscare.com | July 2020 | 33

36. telephone triage and direct them to specific fever assessment centers or the kits may be dispatched direct to the home by community paramedics equipped with PPE. to target your vaccine against. This becomes an effort of complex bioengineering, modeling, and clinical trials on real world patients once a vaccine is in prototype form. Most experts believe a vaccine is at least one year away and the current rates of spread within some nations such as Iran, Italy and now South Korea, suggest wide spread disease much sooner than one year. TELEMEDICINE VISITS TO THE PATIENTS TESTING POSITIVE The patients testing positive will require triage to remain at home for the current 14-day quarantine period established under WHO guidelines. Patients that are seriously ill can be transported to regional hospitals, should they require respiratory support, deeper investigation or monitoring. The patients dispatched home would be assigned to home temperature monitoring, and if available, could be visited virtually by community nurses or physicians. The complexity of the home-based monitoring would depend upon the infrastructure available. Developed nations are already providing remote patient monitoring with vital signs, blood pressure kits, oximeters and weight scales, with ability to connect live to nurses or physicians available on the platforms. The intent of the home-based monitoring is to detect progression of chronic disease states such as Congestive Heart Failure or Chronic Lung disease. These platforms can easily be converted to provide the supportive monitoring needed for Covid-19 that produces pneumonia and respiratory distress. Early signs of fever and a drop in oxygen levels would be an early indicator a patient may have progressed and would be allocated to supplemental oxygen and/or hospital admission. The goal of the community assessment programs and early identification of potential contacts, is to isolate as soon as possible so patients do not pass the virus to contacts within their community. A point of care triage system leveraging a kit such as PCL Covid-19 and telemedicine protocols for follow-up, will greatly reduce the numbers of patients coming to hospital ERs looking for assessments. As the volume of infections in a community increases, the risk of unknown or asymptomatic carriers infecting the Hospital OP or ER becomes greater. Local public health units could leverage community educations programs to help patients understand if they have a fever, cough and/or have been exposed to someone with Covid-19, they should contact the local health authority and NOT attend to the hospital or physician office. They would be instructed from home to be assessed by specialized teams of infection control officers or be sent to the local fever assessment center closest to them. A company based in California called Bio Distributed, recently was featured in the Netflix documentary series called “Pandemic.” Dr Jake Glanville and Dr Sarah Ives have been working to create a single shot universal influenzae vaccine using their bioengineering protocols. Recently Dr Glanville and his team have now also focused on Covid-19. Dr Glanville believes that until an antigen vaccine is available, the other approach is to create a passive immunity vaccine. He believes it is possible to quickly replicate the antibodies our bodies make against Covid-19. Bio Distributed has a patented process that would allow bioengineers to build the antibody proteins first in the lab, then mass produce this antibody to fight viral infections already established in the patient's body. This antibody can in injected or infused for patients tested positive that are acutely ill. Medical protocol and directives will be required to determine the optimal time of antibody infusion, and also determine which patients are at risk of serious illness or risk of death. Mass productions of the antibody and regional distribution may make this solution available only to more developed nations in the beginning but more than likely released to Countries experiencing widespread disease and perhaps priority for the regions with most serious outbreaks. This passive immunity would likely allow earlier discharge from hospital, freeing up needed beds and reducing healthcare infrastructure burden. Since the current infections seems to be targeting seniors over age 80, these efforts for passive immunizations might be focused on patients with complex needs or those at greatest risk. This article is intended to stimulate discussion among leading authorities within the infectious disease community and hopefully create further collaboration on infection controls and treatments. The collision of ideas between innovators in various sectors of healthcare technology will be a fast track to solutions for the outbreak of Covid-19 and hopefully reduce the impact of what appears to be an evolving pandemic. NOVEL TREATMENTS ON THE HORIZON Companies are working fervently to create a vaccine for Covid-19. The challenge is knowing which part of the virus www.insightscare.com 34 | July 2020 |

38. INTERVIEW WITH INSIGHTS CARE Dr. Brett Belchetz Co-founder & CEO Maple www.insightscare.com 36 | July 2020 |

39. Leveraging Innovation and Technology for Providing Convenient Healthcare T experience healthcare. Through new tools and software, telehealth is being integrated in day to day life. Maple, a platform that connects patients with doctors in minutes through their computer or mobile device, is leading the charge in Canada, making healthcare more accessible across the country. he healthcare space is changing drastically. With the help of emerging technology, telehealth now plays an important role in shaping how people I’ve been an emergency room doctor in Toronto for over 15 years. Throughout the years, I’ve seen wait times grow longer and longer while precious resources grow scarcer. Many of my patients have no family doctor, and even those who do often can’t obtain an appointment for weeks. It has always upset me when I saw my patients waiting 4 hours or more to see me in the ER for basic family medicine type issues. They are usually losing out on a day of work or missing out on important life events. Sometimes they are exposed to the flu while waiting for something that could have been addressed in a few minutes on the phone. I always thought there had to be a better way. Dr. Brett Belchetz, the Co-founder and CEO of Maple believes that this combination of healthcare and technology will dramatically improve the experience of patients. He and his team have been working to make healthcare more accessible with a series of consumer facing and hospital focused technologies. To showcase these new healthcare platforms, we bring to you a unique interview with Dr. Brett Belchetz. A few years ago, I had a eureka moment after I gave three separate friends' medical advice by text message in a single week. All three of them were able to avoid a lengthy ER visit and a large amount of anxiety. What is Maple? How does it benefit patients and doctors? In my head, I thought “this is so unfair that my friends and family can access a doctor’s advice any time by text message, while most Canadians have to wait for hours in a waiting room.” My second thought was “wouldn’t it be amazing if we created a service that lets all Canadians contact a doctor the same way in minutes?” And thus, Maple was born. Maple is a virtual care platform that tackles some of the world’s most meaningful issues in healthcare, starting with timely and convenient access to doctors and other healthcare providers. Maple’s consumer-facing platform allows patients to connect directly with doctors in minutes from their smartphone or computer 24/7/365. How is the internet helping to shape healthcare and how is it enabling Maple to accomplish its mission? This system is also leveraged by employers, as a means of reducing workplace absences and increasing team productivity. In addition, Maple provides customized technology solutions for hospitals and clinics that are seeking to advance in the delivery of care. These systems include Canada’s first-ever telehospitalist platform, as well as ER-diversion technologies. At Maple, we believe that through technology and innovation, you should have access to healthcare professionals when and where you need it. You bank online, shop online, and work online. Why not access healthcare online? What are your contributions towards the company? What led to the inception of Maple? Our mission is to tackle some of the world’s most meaningful issues in healthcare, starting with timely and www.insightscare.com | July 2020 | 37

40. convenient access to doctors and other healthcare providers – so that you can feel better, faster. Describe the extraordinary journey of Maple so far. Where do you portray it in the years to come? Maple’s journey has been defined by solutions. When we launched in 2016, we saw ourselves as a purely consumer- facing platform, which would provide timely access to Canadians. Shortly after, a number of businesses approached us to ask about our corporate offering, so we crafted a solution tailor-made to their needs. Similarly, our hospital program was born out of the determination of the administrators at Western Hospital in Alberton, PEI, who needed to address ongoing physician shortages. Working hand-in-hand with them, we created Canada’s first-ever telehospitalist system. There are countless other issues that technology can solve in the years to come to make Canada’s healthcare system a world leader, and we will continue to address them. doors open at Western Hospital in Alberton, PEI through Canada’s first virtually staffed inpatient ward, has also been highly recognized by both the Government of PEI, winning its Department Innovation Award and Board’s Leadership in Quality and Safety Award in 2019. The program has also been recognized in the province’s Legislative Assembly in 2018. We were a finalist for the Canadian Health Informatics Awards in the Patient Care Innovation category as well — the response to the program was amazing. Describe the revolution that ‘Telehealth’ has brought to the healthcare industry. What are its effects? Health PEI the Telehealth is the future of sustainable healthcare delivery. It’s been shown that over 50% of healthcare issues can be addressed safely online, with higher rates of patient and provider satisfaction seen compared to in-person care. As our population ages, telehealth allows us to treat patients in the home, saving our precious and expensive hospital capacity for the neediest among us. What advice would you give budding entrepreneurs in the Telehealth space? Also, telehealth evens the playing field between rural and urban locales, allowing even the most isolated regions to have access to the top medical professionals in the world. It’s easy to get side-tracked by the pursuit of revenue and growth, so it’s important to always maintain your “north star” of why you went into this in the first place. For us, that’s to improve the health of patients in a sustainable way. We’ve been guided by this in all the decisions we’ve made and it served us well. Share with us the most remarkable customer experience along with awards and accolades. One of the most powerful customer experiences happened on a train traveling through rural Ontario. Hours away from any hospital, a person went into anaphylactic shock. They had an epi-pen, but being in shock, they couldn’t remember how to use it. The person traveling with them logged into Maple, video conferenced with one of our doctors for direction, and then administered the shot. In only took a matter of minutes, but saved the patient’s life. What are your future goals? Are there any exciting services in the queue to be launched? Since last year, we’ve been adding a number of specialties to the Maple platform, from dermatologists to lactation consultants. In the near future, we see Maple as the connecting platform, between all your healthcare providers, allowing you to connect with any type of practitioner through the platform which will act as a repository for all your health records to enhance continuity of care. Our telehospitalist program, which has been keeping the www.insightscare.com 38 | July 2020 |

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43. New Warriors Telemedicine THE FRONT-LINE WEAPON AGAINST COVID-19 www.insightscare.com | July 2020 | 41

44. I challenging, given the large distances and limited resources, Telemedicine has become a glimmer of hope to the worries. It has increased timely access to appropriate interventions, including access to services that may not be otherwise available. t’s a very stressful time for healthcare providers, for the community altogether, and for the lot of us. At such time, when providing in-person healthcare is taking into account people’s medical history and the severity of their symptoms. Alongside the use of Telemedicine for identifying high- risk patients, it is also being used for treating other illnesses during the outbreak. Additionally, treating corona virus patients isn't the only reason why that providers are turning to this technology. Due to scores of people across the country in isolation and quarantine, Telemedicine has become a way for patients to connect with their doctor about mental health as well. There has been a dramatic surge in cases of Covid-19 infections. Thus, to smartly address the concern, health systems are racing to adapt and even develop virtual services that can serve as their front line for patients. Rediscovering the Telemedicine adoption is really having its moment right now. On the front lines of the corona virus pandemic, medical practitioners and crisis providers are tapping into its digital mechanisms. Notably, while Telemedicine may have a spike in adoption, the corona virus crisis has forced startups offering commendable choices. Some companies that have been able to adapt their product and be incredibly fast and nimble are able to offer it free of cost to health systems. People can avail themselves to Telemedicine, whereas doctors can communicate with patients and track the spread of the disease. The system is being used to deliver home health care, particularly for patients who are at high risk because of chronic medical conditions or treat Covid-19 safely at home. By monitoring more patients virtually, the ability to limit the potential exposure of nurses and doctors who conduct operations would be possibly deterred. It's really exceptional to be able to see your doctor and not have to leave your house. Telemedicine companies say they are getting an increase in the number of calls from people. People are approaching the Telemedicine companies to know more about what they can do to minimize their risk of catching corona virus and those with worrisome symptoms. Though Telemedicine will not solve all the problems, it is well suited for scenarios in which medical practitioners can evaluate and manage patients. Many provider organizations are looking for better ways to use the tech to its full potential. The idea of using Telemedicine to prevent further spread of the virus is being adopted quickly. By using their phone or computer, patients are able to get guidance about whether they need to be seen or tested despite showing up unannounced at the emergency room or doctor’s office. Patients, particularly those who would be at high risk for a serious illness can also opt for a virtual visit while avoiding crowded waiting rooms and potential infection. Telemedicine could play a crucial role in reducing the mortality and morbidity of the corona virus pandemic. The online facility, accessible across the country and even beyond, will prove to be a blessing to those seeking medical assistance without getting infected or spreading the infection. People can get authentic information regarding their ailments by consulting a specialist. Also, if there are any early signs or symptoms of impending serious illness, doctors can guide the patients accordingly. One can not only monitor the vital statistics at home but also ensure that the readings are sent to the doctor via e-mail or message for them to suggest the new course of action. Thus to safely monitor patients at home, doctors are www.insightscare.com 42 | July 2020 |