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TELECAREA telemedicine solution for the treatment & management of chronic patients at home

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SLIDEDECK CONTENT• EWII in Brief

• Your Trusted Telemedicine Solution Provider

• About EWII NetCare Platform• Accomplishments• Product• Patient groups• Experiences and monitoring equipments

• NetCare Product Market Fit

• Implementation

• Our core Value Proposition to Clients

• Use Case Examples

• References

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EWII IN BRIEFA company with 150 years of history

One of the 250 largest enterprises in Denmark and

more than 600 employees. HQ located in Kolding.

Main business is doing utilities in close cooperation

with the municipalities and the public sector

EWIIs supplies electricity, district heating, fiber

broadband, and drinking water

Plays an active role in development of future

solutions within energy, e-mobility and life science

with strategic focus on IoT and making

business with a purpose

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GROUP OVERVIEW

EWII

Common Group Functions

Installatio

n

Fu

el Cells

Po

wer

Bro

adb

and

Co

olin

g

En

ergy

Pro

du

ction

Telecare

Water

Heatin

g

Mo

bility

Traditional utilityNew technology

development companies

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YOUR TRUSTED

TELEMEDICINE SOLUTION PROVIDER

10+ years of experience in Denmark & UK

Professional, medical device

developed with clinical staff in Denmark

Our NetCare software is a mature

technology with proven

clinical and economic effects

We have a proven track record

helping hospitals and

municipalities implement

telemedical services

All chronic diseases covered i.e.

COPD, CHF, diabetes, stroke, liver mal function etc.

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YOUR TRUSTED TELEMEDICINE SOLUTION PROVIDER

70.000 +

Accomplishments since 2006 - more than:

4000 +

Patient unit and monitoring equipment adjusted according to requirement

Virtual visits/consultations

Patients treated by virtual monitoring

35.000 + Annual real time measurements

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EWII NETCARE PLATFORM

ABOUT THE PRODUCT

NetCare

Questionnaire

Monitoring

Video calls

Group video callsThe products is called NetCare is an administrative interface for monitoring and handling citizens in the remote patient system

On top of this you can add:

The system is developed in cooperation with doctors and clinical staff according to clinical standards

EWII Telecare is the telemedical solution provider with the most extensive experience delivering telemedical solutions to the Danish market

Questionnaire – e.g. screening of larger groups of citizens (early detection of critical illness, diagnostics, daily health care monitoring)

Monitoring – measurement of specific health care data on patients in their own home (e.g. pulse, lung capacity, oxygene saturation)

Video calls – e.g. on screen visits: doctor's consultation, psychological therapy, individual rehabilitation

Group video calls – e.g. rehabilitation of patients in own homes in groups

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STRUCTURE IN THE EWII TELECARE PLATFORM

NETCARE COMPONENTS

VideoCare MoniCare RehabCareQ-

MapCareLogiCare GeriCare

Intervention-

Care

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PATIENT GROUPS

1. Patients in need of rehabilitation

• Psychotherapy

• Physiotherapy

• Group training

2. Patients with chronic diseases

• COPD, lung malfunction

• Liver malfunction

• CHD, heart malfunction

3. Patients with hypertension

4. Patients with diabetes

PATIENTS WHO IN GENERAL NEED

continuously monitoring of health data

frequent consultations with clinical staff

monitoring of health statistics in order to prevent (re)hospitalization

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PROBLEM SOLVING AND EXPERIENCE

Monitoring (In connection with e.g. COPD,

diabetes, heart failure, liver failure and more)

Rehabilitation – alone or in groups

Virtual Consultation calls for elders, handicapped and

more

Psychiatric consultation/treatment

Digital surveys (as a part of the patients

own treatment)

Nutrition and cognitive support

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Example of Monitoring Equipment

It is possible to add other devices to the NetCare solution!

Temperature ECG Blood Pressure

OxygenMeasuringWeight Spirometer

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PRODUCT MARKET FIT – NETCARE PLATFORM

Secondary

Primary

SECTORPATIENT GROUP/

FOCUS AREAPATIENTS

CONDITION

Mild

Severe

Municipality services / GP

Hospital

ACTUAL NEED

VideoMonitoringQuestionnaires

Geriatric patients

Liver failureSevere COPDHeart failureDiabetesStroke

RehabilitationGroup

rehabilitation

Mild/newly diagnosed COPD

Newly diagnosed heart failure

Care visits

Motivation

Dialogue

Cognitive support

Psychotherapy

Video and possible monitoring

Video and monitoring

MonitoringQuestionnaires

Monitoring +health services

Early Detection and prevention

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ANALYSIS

Goal/KPIVision

Demographics

Time consumption

Diagnosis group

MATCHING DEGREE

Resources and

competencies

-Processes

-Staffing

-Visitation

IMPLEMENTATIONEducation

Hotline/support

Implementation course

Coaching

Equipment choice

Follow up procedures

Execution

FROM ANALYSIS TO IMPLEMENTATION

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EWII TELECARE

- A solution provider

EWII Telecare is a solution provider,

whereas Opentele Health is a software

provider. The experienced customer can

choose to configure their own solution by

picking and selecting thru the offered

possibilities. While the more inexperienced

customer might prefer a customized set-

up, which also covers processes,

competences, resources logistic etc.

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ENGAGEMENT MODELFrom stratification to intervention

COPD

Diabetes

CHF

Asthma

Hypertension

Obesity

Woundcare

Liver

PregnancySE

VE

RIT

Y

Monitoring

Coaching

Video Rehabilitation

Psychotherapy

Physiotherapy

Video Consultation

Visit from clinician

Diagnose

Hospitalisation

Doctor’s consultation

Medication

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IMPLEMENTATION WE DELIVER

• Management and consultancy services- The analysis of the barriers and the enablers for optimized use and matching degree of telemedicine.- Specifications of solution requirements- Assistance with establishing call center- Education of outgoing staff- Evaluation of back office medical setup- Evaluation of service level- Assessment of user groups suitable for telemedicine- Assessment of medical staff suitable for telemedicine- Evaluation of ROI on a telemedicine solution- Conversion of political strategies into practical solutions

• Logistics services- Delivering/picking up the telemedicine solution at end user’s homes- Education of end user- Assuring functionality of hardware and connectivity at the user’s home- Making sure the user is confident in the use of the application- Fast delivery of patient equipment.

• Enhanced Hotline and onsite support- Hotline towards end-user and medical staff – guidance in use of user application, connected devices, medical staff’s application- User manuals directed towards both medical staff and end users (based on the specific solution at hand and the specific workflow

related to each customer’s setup)- Onsite support in user’s home

• Customer tailored applications- Our system is designed to be easily customizable, so that the specific needs of both end user and customer (e.g. a hospital) will be

met. We can design the solution in dialogue with our customers in order to deliver a tailored system from A-Z- Our system is modular – so that we can configure the system in each case to fit the purpose- We have ten years of experience in designing user friendly applications that can be used by patients in difficult life situations.

Simplicity is key.

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IMPLEMENTATION WE DELIVER

• Enhanced all-in-one homecare client

- The client app is designed to provide all needed functionality in one easy

to use app

- Health monitoring (data from Bluetooth connected devices or

manually entered)

- Video conference

- Interactive content (hospital’s news, the user’s appointments, live

streaming of e.g. rehabilitation instructions)

- Customizable modern user interface

• Enhanced all-in-one clinician portal

• The portal is designed to provide all needed functionality in one easy to

use webapplication

- View of user’s health statistics (e.g. pulse, oxygene saturation,

blood pressure)

- Customaizable modern UI

- Calendar/ appointments

- Logistics (ordering of a user hardware delivery)

- Group conference call

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BUILD, OPERATE & TRANSFER - HOW TO GET STARTED

Analysis of organization

needs

Specifications of solution

Deliverymanagement

Preparing call center

Service level for outgoing

logistics

Establishinghotline

Education of outgoing staff

Education of medical staff

Assessment of user groups

Evaluationand effect

Evaluation of service level

Evaluation of ROI

Adjustments

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OUR VALUE PROPOSITION TO CLIENTS

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OUR VALUE PROPOSITION TO CLIENTS

Stay healthy: early detection and preventionMonitoring of own health (”self mastery” and life style changes)

Prevention (possible intervention / life style changes)

Early detection of chronic diseases

PRODUCT: Questionnaire and knowledge platform on tablet/phone + Medical Centre monitoring

Monitoring of light conditionsEarly diagnosed patients in risk for developing cronical diseases

Supervision of conditions in patient’s own home

PRODUCT: Questionnaire and knowledge platform on tablet/phone + monitoringdevices + Medical Centre surveillance

Monitoring of heavy conditionsPatients with cronic diseases with temporary need for hospitalisation and surveillance

PRODUCT: Questionnaire on tablet/phone + monitoring devices + Medical Centre surveillance through video conference

Patient monitoring enables staying healthy at home

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Rehabilitation and patient empowerment

Rehabilitation in groups & communities

COPD patients, stroke patients and others

Prevention of rehospitalisation

Increased feeling of life quality

Social interaction with patients in same situation

Videoconference system at home + Medical Centre

trainer

Patient empowerment (coaching)

Cronical ill patients, patients with mental diseases

Coaching and psychological treatment in patient’s own home

PRODUCT: Videoconference system at home + Medical Centre

clinical staff

OUR VALUE PROPOSITION TO CLIENTS

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PAYMENT MODEL

Basic fee to gain access to the administrative, telemedical system (NetCare, including hosting and support) XX € pr. month pr. user & citizen

Add on software modulesQuestionnaires XX € month pr. patient

Monitoring of health statistics XX € pr. month pr. patient

Video call XX € pr. minute

Video conference call XX € pr. minute

Add on consultancy services to make solution operational based obBOT-model: Build, operate & transfer

Flexible platform value + cost structure = A SOUND ROI & BUSINESS CASE

THE

QUESTIONNAIRE IS

FILLED IN BY THE

PATIENT

Posture

Q&A

DataTime

THE PATIENT

SENDS

FORM

AND/OR

MEASURE-

MENTS TO

DATABASE

A NURSE

REVIEWS DATA

& INTERVENE

WHEN NEEDED

IF CRITICAL

GO TO

HOSPITAL

NURSE OR DOCTOR CALLS PATIENT

FOR MONITORING ANDVIDEO CONFERENCE

A DOCTOR

DESIGNS A

QUESTIONNAIRE

Posture Q&A Data

MONITORING CENTRE WORKFLOW USE CASE EX.

A TARGET

GROUP IS

DEFINED

IF CRITICAL, THEN

MEASUREMENTS

IF NOT CRITICAL, NO

MEASUREMENTS

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WORKFLOW USE CASE EX.

TASK: handling of larger number of patients/customers

segmentation + adding of telemedical functionality according to needs

• The Telecare system sends out questionnaires for 100.000 persons

with specific symptoms

• The system receives data and based on these 95% of the persons will

be 'cleared' of need for further interaction

• 5.000 persons will receive devices for further telemedical monitoring /

or they will be asked to enter data into the system. Data will be sent

automatically to the clinical patient journal

• Patients will be categorized based on the severeness of illness

• 100 will be offered video consultations – doctors will evaluate the

patient's condition

• 60 of these will be visited to physical consultation at hospital

CHF DiabetesCOPD

60 patients in need for

physical consulations /

treatments

Questionnaire for

100.000 customers

Segmentation

95 % of customers in no need for monitoring

Monitoring

of 5.000 customers

Video

consultations

with 100

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TELEMEDICAL COPD TREATMENT USE CASE EX.

Patients: possible COPD patients in GOLD 1: citizens with relevant symptoms of lung failure

Admission: Patients are admitted to the solution by the community hospital

Technical solution: online questionnaire to be filled in by the patient on a mobile phone or tablet or computer.

Medical service: none

Workflow: if the patient’s answers resultin a critical stage of lung failure, the patient will be asked to move to stage 2 (automatical response from the system)

STAGE 1: questionnaire

Patients: lung patients with a more critical health caresituation, evaluation based on questionnaire (GOLD 2-3)

Admission: based on questionnaire

Technical solution: Oxygene saturation device and EWII application for mobile phone or tablet

Medical service: oxygene levels are monitored by COPD-nurses at a call center at the communityhospital. If values and questionnaire answers gives alert, the patient is asked to move to stage 3

STAGE 2: monitoring

Patients: severe COPD patients that would beadmitted to hospitalization without the solution

Admission: call center

Technical solution: Spirometre, Oxygenesaturation device and EWII application with video solution for mobile phone or tablet

Medical service: Spirometre blows are monitoredby doctors or COPD-nurses at call center. Video consultation with doctor or COPD-nurse.

STAGE 3: monitoring and video

100 % (100.000 CITIZENS)

1% (100 CITIZENS) 0,5% (50 CITIZENS)0 CITIZENS

TO BE HOSPITALIZED

Business case #3Business case #2

Business case #1

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REFERENCESREAD OUR CASE STORIES AT: HTTPS://EWII.COM/EN/INTERNATIONAL/TELECARE/PATIENT-STORIES

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HOSPITALS• Hospital of Aarhus Mindfullness for COPD patients i.e. larger group

of patients in qualitative research study

• University Hospital of Odense Monitoring of chronic diseases (2006 – 2017, 4000 consultations, video and measurements)

• COPD monitoring

• Liver malfunction monitoring

• Hearth malfunction monitoring

• Hospital of Bispebjerg Group rehabilitation of COPD patients

• Geriatric acute team ‘suitcase’

• Pallitative video conference room

MUNICIPALITIES• Virtual consultations for elderly in their own home

• Group rehabilitation

• Psychological therapy sessions

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RECOMMENDATIONOdense University Hospital

EWII Telecare has developed and operated the telemedicine solution for CODP patients at OUH for more than 9 years:

“Telemedicine to match personal attendance:

With telemedicine, citizens will be offered a treatment on par with direct attendance. Furthermore, the treatment will be available anywhere and anytime – contrary to personal attendance.

This is one of telemedicine’s advantages. We will also achieve a situation, where a large part of the population will have the means to handle their own healthcare services. Then we can use the remaining resources for those who need the extra attendance. This will release resources”, says

Peder Jest.

Peder Jest, Medical Director at OUH

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RECOMMENDATIONOdense Municipality

EWII Telecare has developed and operated the telemedicine solution for Odense Municipality through more than 3 years:

“Tele health care is a focus area for Odense Municipality.

We work to give elderly and disabled the best possible care, and at the same time Odense has made a good environment for companies that create the health tech solutions of tomorrow.”

“EWII Telecare is a company in Odense, that I am quite proud of. They were among the first who made useful telecare solutions, and now I look forward to establishing this public private initiative between partners in Odense and partners in Tianjin.”

“Denmark has 100 years of experience with a high quality efficient healthcare system.

We will be glad to share our experiences and knowledge, so that the Chinese people can get the benefits of ‘The Scandinavian Healthcare Model’.”

Anker Boye, Mayor of Odense Municipality

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OVERALL COMPONENTS

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HOSTING

Currently the video servers can be hosted locally at EWII and the NetCareportal (including services and database) is hosted on Microsoft Azure. Cloud environment

APPLICATION SECURITY MODULE(user access and rights management)

NetCare uses IdentityServer, which is an OpenID Connect and OAuth 2.0 framework containing:

- Single Sign-on / Sign-out- Access Control for APIs- Federation Gateway (Azure, Facebook, Google etc.)

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THANK YOULooking forward to do business with you

Mads Wojtynka, MSc.

International Sales Director

mawo@ewii.com / 0045 25406637