“Our Goal Is Simple, Putting People First In Everything We Do”

ICUcare is a health information systems software developer and telemedicine/telehealth solutions provider. ICUcare is

committed to applying innovative and technologically advanced solutions to the health care industry.

Advancements in medical technology are improving the quality of care and at the same time reducing the cost associated with the delivery of care like never before in the history of medicine. Advancements in Telemedicine beyond that of simply providing a video/audio link to connect physician and patient with a few medical devices for cursory medical diagnostics are making significant changes to a whole new way of delivering medical care.

The new patient-centered; medical records based; encounter management driven; clinical decision supported,

Telemedicine Solution - has come of age!

How Telemedicine can change the paradigm of Long Term Care and Assisted Living Medicine

Assisted Living persons struggle with mobility and often are completely dependant upon assistance from offsite care providers for any ambulatory activities.

Nursing Facility Facts:

• There are 17,000 nursing homes in the United States

• 1.6 million people live in nursing homes• More than 90 percent of current residents are 65

years of age and over. Almost half are 85 years or over.

• There are over 2.6 million falls annually in nursing home/assisted living facilities

• The total annual cost related to falls is in excess of 19.2 billion dollars

Routine transportation of residents to and from doctor’s appointments put the resident and nursing home facility at greater risk for injury and can expose both to financial hardships

Transportation Risks for the Resident

• Falls attributed to mounting and dismounting vehicle• Traffic accidents to and from destination• Skin tears and lacerations due to excessive

movement between bed and/or wheelchair• Broken bones, especially hip fractures from routine

transport offsite• Increased cost incurred by each resident to meet

rising fuel and vehicle costs

Transportation Risks for the Facility

• Increase in adverse events of residents• Higher staff costs• Increased insurance premiums for both residents

and staff• Cost of maintenance for extra vehicles or

contracted transportation• Exposure to increased liability offsite

On average, nursing/assisted living homes spend roughly $200* per resident, per month on transportation related expenses. That equates to $20,000 each month for a 100 bed home in transportation costs. Cutting

that by even 50% would save a 100 bed home $10,000 each month.

*Gerontology Monthly estimated costs for Nursing/Assisted Living Home with an average of 12 trips per year per resident

The role of Tele-medicine and eHealth in Nursing Home Settings• From Gerontology vol.47 #21: “Telemedicine was proven to be adequate service

delivery in up to 99% of routine medical visits, depending on specialty. In particular, savings were made through a 9% reduction in ER visits and 11% fewer admissions to an acute hospital ward in homes where telemedicine was utilized”

The Solution’s:

• ICUcare LLC, by way of its strategic partners, have the solutions – and the solutions are mobile and customizable providing Western healthcare delivery "equivalency of care" standards for patients around the world.

• ICUcare’s eHealth cloud-based medical records platform enables “continuity-of-care” of the patient anywhere-anytime with connectivity to board certified care providers 24/7, 365 days a year.

Healthcare IT Delivery Framework Over Satellite, Cellular and Cable

Federal, State, Private and Public Hospitals eDoc EHR Software & Web Based● Hospitals & Clinics● Acute Care Facilities ● Test & Diagnosis Centers● Live Consultation

Federal, State, Private and Public Hospitals eDoc EHR Software & Web Based● Hospitals & Clinics● Acute Care Facilities ● Test & Diagnosis Centers● Live Consultation

Federal/State Health Agencies Data Collection/Access Web Portal ● Admission/Discharge Monitoring● Comprehensive MG Statistics● Medical Community Statistics ● User Statistics (Clinical)

Federal/State Health Agencies Data Collection/Access Web Portal ● Admission/Discharge Monitoring● Comprehensive MG Statistics● Medical Community Statistics ● User Statistics (Clinical)

Health Delivery Community● Physicians ● Specialists● Nurse Managed Care● Knowledge Collaboration● Collaborative Conferencing

Health Delivery Community● Physicians ● Specialists● Nurse Managed Care● Knowledge Collaboration● Collaborative Conferencing

Rural Health Centers eDoc EHR Software & Web Based ● Exams & Routine Care ● Pre & Post-Natal Care ● Live Consultation

Rural Health Centers eDoc EHR Software & Web Based ● Exams & Routine Care ● Pre & Post-Natal Care ● Live Consultation

My eMHRWeb Portal

System Mgmt.Web Portal

Home HealthWeb Portal

Home Health Care Community● Wellness Living Program● Chronic Illness Monitoring and Management● Live Consultations● Medical Reference Info.

Home Health Care Community● Wellness Living Program● Chronic Illness Monitoring and Management● Live Consultations● Medical Reference Info.

Satellite Ground Station

INMARSAT Satellite

Ancillaries ● Pharmacies ● Radiology ● Laboratory ● Pathology

Ancillaries ● Pharmacies ● Radiology ● Laboratory ● Pathology

Confidential Information – ICUcare LLC

PhysiciansWeb Portal

New and Existing Fiber

eDoc EHRWeb Portal

HealthInformatio

n Exchange

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The Technologies

• ICUcare LLC has developed the world's first vertically integrated “HHS-ONC Certified” Telemedicine/EHR System Solution of its kind.

• Telemedicine technology and its mobility are already impacting the future of healthcare.

• ICUcare’s telemedicine platform can bring 21st Century Medical Care to any remote population located anywhere in the world.

The Technologies (Continued)

The eDoc® Telemedicine/EHR Video Conferencing Solution features several “much-sought-after” capabilities to include:

• “Encryption of all medical data including imaging in transit and at rest”!

• “Encryption of the video and audio streamsBetween two distant locations”!

• “Compression technologies that make possible streaming of HD Video using Inmarsat BGAN”!

Technologies (Continued)

ICUcare LLC has developed the worlds largest inventory of USB and Wireless Medical Diagnostic Equipment to include: Iris Scope, Dermatology Scope, Spirometer, Stethoscope and more.

Technologies (Continued)

ICUcare LLC can provide a variety of customized fixed or mobile solutions. Each of our customized eDoc® Telemedicine/EHR Systems includes an assortment of medical diagnostic equipment. All medical devices are fully integrated into the eDoc® Telemedicine/EHR Platform.

Technologies (Continued)

The Technology includes a large variety of integrated Ultrasonic

Probes to include: Abdominal, Opthalmology, Endocavity and Peripheral

Technologies (Continued)

The Technologies even include Rigid and Flexible Endoscopes as well as Digital Blood Analyzers or even portable at bedside X-Ray machines

The eDoc® Telemedicine/EHR Mobile Cart System represents the most technologically advanced Telemedicine or TeleHealth Solution on wheels.

The eDoc® Telemedicine/EHR System supports both Store and Forward or Live Video Conferencing Consultations.

With the addition of the My eMHR (Personal Health Records) Web Portal and the Physician's Web Portal, ICUcare has achieved the first truly vertical medical and health records-based system.

ICUcare LLC’s Total Telemedicine/TelehealthSolution – Introducing eDoc® Mobile Cart

The eDoc® Mobile Telemedicine/EHR System is perfectly suited for “any-where-on-location” medical services delivery personnel.

The eDoc® Mobile Telemedicine/EHR System just like it’s big-brother, eDoc® Mobile Cart supports both Store and Forward or Live Video Conferencing Consultations.

In the standard configuration, the case is a Platinum Roller Laptop Case with telescoping trolley handle and in line skate wheels. For extreme applications requiring something more rugged, an optional IP65 waterproof HPX Resin Case is also available.

“Anywhere/Anytime On-Location” Medical Services Delivery Solution – Introducing eDoc® Mobile

Medical Diagnostic Capabilities (Partial Listing)

Standard• Spot Vital Sign Monitor (BP, PR, Sp02, ECG & Temp.)• Electronic Stethoscope (Blue Tooth) • Combination Digital Video Iris/Derma Scope• Digital Video Otoscope• Digital Spirometer• Digital Intraoral Scope

Optional• 12-Lead ECG System• 18-Lead EEG System• Digital Video Oral Scope• Ultrasound Imaging Probes 3.5 MHz Abdominal 7.5 MHz Endocavity 7.5 MHz Peripheral 12.5 MHz Ophthalmology• Blood Glucose Meter

Other Uses of the Technology

• Training employees, residents and medical students across multiple home locations

• Allowing residents to connect to family members remotely• Video conference calls connecting multiple locations at

once (Encrypted and Secure)

How Do We Improve the Level of Health Care Services Delivered to Nursing Home Patients and Yet, Reduce Cost?

1. Implement use of the My eMHR Web Portal for all nursing home residents with initial physical examinations and subsequent medical encounters within the facility and visits to health care providers. Objective – to develop and maintain a comprehensive medical record on all residents.

2. Implement use of the eDoc® Telemedicine/EHR Solution providing a Robust Encounter Management System to include: protocols on common presented Chief Complaints. Objective – to provide board certified specialist developed protocols for use by all medical staff/care providers on location in such a way as to increase the quality and scope of health care services capable of being provided at the “point-of-care” thus reducing the need for remote physician support.

How Do We Improve the Level of Health Care Services Delivered to Nursing Home Patient’s and Yet, Reduce Cost? (Continued)

3. Implementation and use of the eDoc® Physicians Web Portal by any/all remote care providers whereby continuity of care is assured and the integrity of the patients medical records are maintained.

4. Implementation and use of eDoc® Statistical Analysis for Clinical Measures Program providing statistical data query on any demographic and clinical subset of information by customer, facility or other in such a way as to be able to provide analysis of measure results and outcomes. Common Goal or End Result of the above and Other – Reduce Patient Travel, Improve

the Final Outcome for the Patient/Resident, Manage/Mitigate Risk and Medical Service Cost Related to the Delivery of Medical Services to the Patient!

Recommended Solutions for Deployment

• Use of patients Personal Health Records Platform My eMHR by all resident/patients (Web Based)• Deployment of an eDoc® Solution (Cart or Mobile) at each Nursing

Home or Senior Assisted Living Facility (Software Based)• Deployment of Virtual Enabled Tablets with an instance of the

eDoc® Telemedicine/EHR for use by facility care providers• Deployment of eDoc® Physicians Web Portal solution at every

participating hospital center(s) and all participating remote specialist/physicians (Web Based)

• Use of ICUcare’s Statistical Analysis for Clinical Measures Program

● Nursing home Medical Directors can review comprehensive medical records to include imaging more readily and see more patients at a time via telemedicine, resulting in better care for residents and reduced cost per home for each Medical Director ● ICUcare LLC’s Telemedicine eHealth Solution not only reduces transportation costs and improves resident care through utilization of advanced medical informatics and associated technologies, it can provide competitive advantages when families are choosing homes for loved ones, while providing the best care available for each resident of your home

Benefits (Partial Listing)

● Nursing home Operators can increase revenues by implementing an in-house diagnostic procedures service offering for many of the routine medical services provided by outside service providers. This can be by achieved using existing human resources (with technical training) and minimum capital investment. The “technical-side” billing component for conducting an Abdominal or Vascular Ultrasound, 2-View Chest X-ray, CBC hemoglobin for review by remote physicians represents an untapped opportunity “Benefit” to the patient, the operator and resident care providers.

Benefits (Partial Listing)

Next Steps?

• On-site demonstration(s)• On-site visit to determine project requirements to include an

assessment of facility infrastructure capabilities (IT)• Meeting(s) with Facility Medical Director(s) and other

stakeholders (Clinical Requirements and Buy-In)

Thank You for Your Time and Attention!

ICUcare LLC2425 Highway 41 North Suite 204Evansville, IN 47711(812) 401-9920

www.icucare.comwww.globalcareintl.com