1. Remote Patient Monitoring Ways to Control Costs, Improve Outcomes, Avoid Readmissions & Modify Patient Behavior

2. Long Ago, People Danced @ Concerts, Now They Video / Click / Share / Tweet Source: Left image 123RF.com. Right image amadarose.co.uk.

3. Smart Home

4. Telehealth & RPM in Coordinated Care

5. Why is Telehealth/RPM important? National/ State Challenges Health Care Workforce Shortage CME/EBP Lack of Coordination Hospital Viability Financial crisis Pay for Performance Penalties Poor Health Status High consumers, high cost Half $ spent on 5% population Patient disengaged

6. Patient-Centric Approach

7. Transforming Healthcare

8. Bringing the Health Care Team to the Patient

9. Telehealth in Mississippi

10. 165 telehealth sites of service (non-affiliated) 34 medical specialties 8 types of locations 7,669 telehealth encounters/month Continued growth in primary & specialty care services Community based partnerships have led to our success UMMC Center for Telehealth (September, 2014)

11. Analytics Bringing the health care team to the patient Specialty consults, ancillary services Remote Patient Monitoring Chronic disease management Care at Home Avoid Readmissions Avoid ER visits Personalized Health Wellness Wearables Health IT in Care Coordination

12. Tiered Health IT Approach Tier 1 Tier 2 Tier 3 Post Discharge Acute Setting Remote Patient Monitoring Acute or Outpt Setting RPM, Med Adherence and Video Home Visits IVR, RPM IVR, RPM IVR, Med Adherence, RPM, video visits Readmission Prevention Avoid ER Reactive Readmission Prevention Avoid ER Proactive/Reactive Chronic disease mgt, ^ follow-up/monitoring Readmission Prevention Avoid ER Proactive/Reactive Post D/C Pilot Diabetes RPM Pilot Population Health Personalized Health Care

13. Post Discharge Pilot Program 180 patients enrolled in IVR program (3 month period) 364 alerts (308 resolved by nurse) 56 (15.4%) alerted with intervention required 45 non-urgent 11 urgent Cost avoidance from 11 urgent alerts resolved ~$98,791 (based on $8,981 average admission) As readmission penalties increase, cost avoidance and savings increase

14. Improved Quality, Efficiency, Safety in hospital Safety in Transitions of care Improved outcomes- early recognition earlier intervention minimized complications decreased LOS Better Coordination of Care Improved Patient Management at Home to prevent readmission/ER visits Patient Empowerment What does RPM offer?

15. Population Health Diabetes Project in Mississippi

16. Access to Health Care, Education & Support Improve access to care for Mississippians with Diabetes Limited Access to Diabetes Specialists Limited Access to education/support for community physicians in the treatment of Diabetes Inconsistent use of evidence-based treatment guidelines Limited access for patient and family support

17. Population Health Diabetes Project in Mississippi

18. Integration of RPM, Telehealth & Care Coordination

19. How can we engage patients?

20. How does it work? Acute Physiologica l Monitoring Phase 1 Adherence Phase 2 Behavior Change Phase 3 Transition to Self-Management Phase 4 Phase 1 Monitoring signs and symptoms Phase 3 Disease process education Identify resources needed Support for changing behavior Phase 2 Learn new medical regimen Phase 4 Learn and model self-management behaviors Medication management; adherence to orders Demonstrate self-monitoring and response

21. Individualized Patient Care

22. Population Health Diabetes Project in Mississippi Using a remote care management (RCM) platform, participants have remote access to education and a team of specialists over a 12 month period. Daily Health Sessions Personalized Interventions Targeted Education Health Coaching Behavior Modification Patient Empowerment

23. Care Innovations Guide Virtual Care Suite Population Stratified by Risk

24. Empowering Patients

25. Mississippi Diabetes Telehealth Network 10-10-2014 Current Number of Enrolled Current Number of Active Guide Tablets Current Number of Scheduled Enrollments 24 19 6 Number of Scheduled Health Sessions Number of Health Sessions Completed 592 569 Number of ER visit Number of Hospitalizations Impacts 0 0 (1) A1C Down 8.8 to 8.0 % 96 Compliance 3-Eyes Identified with Retinopathy

26. Population Health Predictive Modeling Risk Stratification to customize care management service Target high impact patients Personalized care plans, interventions, and patient education Prevention Well Members Prevention & Disease Management Low Risk Members Disease Management Moderate Risk Members Episodic Case Management High Risk Multiple Disease States Complex Care Inpatient LTC

27. If you focus only on risk and cost, many individuals will look the same. Ruth 50 years old diabetes and hypertension Forecasted Annual Cost of Care: $15,245 3 inpatient days 1 ER Visit $1,528 for medications Maria 50 years old diabetes and hypertension Forecasted Annual Cost of Care: $14,993 3 inpatient days 1 ER Visit $1,568 for medications

28. Predictions empower you to see each patient as an individual in terms of risks.

29. The Whole Picture EMR Health Information Network/Exchange Pharmacy data Claims Data Remote Monitoring devices Wearable data Patient Reported data

30. Translate to Meaningful and Actionable Data Intervention

31. mHealth on the Rise The global mHealth market is poised to exceed $49.1 billion by 2020. Source: Healthcare IT News, mHealth Market scales to new heights based On a market report, March 4, 2104

32. Mobile technology Key to widespread adoption Studies show that people check their phones more than75 times a day* Leverage the addictive nature of smartphones and technology as a tool to engage people in their health and outcomes. Kleiner Perkins Caufield & Byerss annual Internet Trends report. 5/29/2013

33. Future Innovation Ideas Wearable technology Wellness initiatives will be the key and wearable technology can assist us in managing population health Wearable Technology

34. Home-based connected health to overtake hospital-based by 2019 By: Aditi Pai | Oct 14, 2014 The telemedicine market, which according to BCC Research is comprised of telehospital and telehome technologies, is expected to reach $43.4 billion by 2019 with a compound annual growth rate of 17.7 percent, according to a recent report from the firm.

35. Patient Testimony

36. ? Bridging the gaps in quality healthcare