Telehealth Defined, Explained and

Explored

Zachary Bujnoch Frost & Sullivan Senior Industry Analyst

Telehealth

Sanjay Bahel Infosys Client Partner

Medical Devices

June 14, 2011

2

Today’s Presenters

Zachary Bujnoch,

Senior Industry Analyst, Telehealth

Frost & Sullivan

Sanjay Bahel,

Client Partner, Medical Devices

Infosys

3

Focus Points

Telehealth Defined

Telehealth Matrix and Spectrum

Telehealth Explained

Challenges

Telehealth Explored

Case Studies

Infosys Focus Point

Topic

4

Poll Question

What is your overall opinion on the state of Telehealth?

• Highly Favorable – What’s the hold-up? Telehealth programs

should be in every state along with intense Federal support

• Moderate – There have been some positive outcomes; I still want

to slowly introduce telehealth programs and concepts, observing

results

• Cautious – I need to see some substantial and straight forward

cost savings before I give my full support of telehealth

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Telehealth – Healthcare’s Road to the Consumer

• Remote Monitoring

• Disease

Management

• Wellness Systems

• Activity Monitoring

• Medication

Dispensing

Telepresence

Visual Collaboration

Teleradiology

Distance

Learning/Simulation

e-Health

m-Health

Personal Health Records

(PHR)

Mobility

Home

Health

Video Tele-

health

IT Enabled

Solutions

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Telehealth Matrix

Customer

Focus

Professional

Consumer

Industry Focus

Information

Communication

Technologies

Healthcare

Traditional Healthcare

and Telemedicine

Consumer/Non-healthcare

Approaching Telehealth

Core Telehealth

Source: Frost & Sullivan.

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Telehealth Matrix Discussion

Professional

ConsumerInformation

Communication

Technologies

Healthcare

Traditional Healthcare

and Telemedicine

Consumer/Non-healthcare

Approaching Telehealth

Core Telehealth

Source: Frost & Sullivan.

Y Axis – User Focus

The higher vertically on this axis

the more focus the market has

on high end professional

markets

The lower vertically on this axis

the more the market is focused

consumer driven offerings

X Axis – Industry Focus

Moving left horizontally on this axis increased the focus on the

information communication technologies (ICT) industry

Moving left horizontally on this axis increased the focus on the

traditional healthcare industry

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Telehealth Matrix Discussion

Professional

ConsumerInformation

Communication

Technologies

Healthcare

Traditional Healthcare

and Telemedicine

Consumer/Non-healthcare

Approaching Telehealth

Core Telehealth

Source: Frost & Sullivan.

Core Telehealth (Medium)

Here is largely where the

opportunities for revenue

growth healthcare

transformation reside.

Solutions in this area provide

significant healthcare to

patients with minimal

involvement by trained

healthcare professionals. Consumer/Non-healthcare Approaching Telehealth (Light)

This area contains offerings heavily focused around fitness

and wellness with almost no healthcare professional

involvement.

Traditional Healthcare and Telemedicine (Dark)

The area of traditional healthcare and telemedicine is heavily professional and healthcare focused, and primarily

focuses using “tele” applications to extend traditional healthcare services over a distance.

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Telehealth Matrix – Telehealth Markets

Customer

Focus

Professional

Consumer

Industry Focus

Information

Communication

Technologies

Healthcare

Traditional Healthcare

and Telemedicine

Consumer/Non-healthcare

Approaching Telehealth

Core Telehealth

Source: Frost & Sullivan.

EMR/EHRHIE

Tele-pharmacy

Remote Video

Consultation

Simulation/

training

Mobile Health

Software

Mobility/Tablets

Mobile Info Gathering

& Delivering

Patient Portals

Wellness Systems

Health Coaching

Remote Vital Signs

PERS

Activity Monitoring

Wellness Apps

Tele-Imaging

ECG Monitoring

Sleep Apnea

Fitness Apps

PHR

Diabetes

Monitoring

Robotic

Telepresence

Mobile Telemedicine

Medication

Dispensing

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Professional HC Consumer

Telehealth Professional vs Consumer Spectrum

• Understanding who the customer is, is essential in assessing a client on this spectrum

• Understanding where your solution is or wants to be, is essential in understanding the value of a product

Reimbursed

FDA Approval

Direct Payment

Source: Frost & Sullivan.

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Professional HC Consumer

Telehealth Technology Spectrum

• Technology is an enabler for success, but the tipping point for

success is increasingly becoming exceptional sales support,

partnerships, and being service oriented

Reimbursed

FDA Approval

Direct Payment

Source: Frost & Sullivan.

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Market Challenges

1 How do you reimburse for diverse, complicated systems?

2 Various complicated regulating bodies possibly in conflict

3 How do you change behavior and the unique needs for the elderly

4 How does this make me a better doctor?

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User Implementation Challenges

1How do you keep your technology up to date and functional in the

fast moving information and communication technology world?

2 How to you train users and then keep that user up to date?

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Telehealth Market Case Studies –

Remote ECG (MCOT/ACT)

Overall Market Characteristics

• Mature, traditional HC market

• Direct reimbursement

• Highly competitive market

• New telehealth technologies

(MCOT/ACT) utilize the continuous

monitoring of Holter and the extended

time period and mobility of event

Note: All figures are rounded; the base year is 2009.

Source: Frost & Sullivan

Key Take Aways

• Moving traditional healthcare markets to telehealth is

possible and profitable, but requires extensive

experience and expertise in healthcare systems and

reimbursement

• New telehealth products and services created

significant upselling opportunities and growth

Remote ECG Key Metrics

• Revenue grew 57% from 2005 to 2010 in ECG

Event Monitoring due to the introduction of

MCOT and ACT services

• Price points for MCOT/ACT were over four

times traditional event monitoring services

when first introduced and are still more than

double in 2010

• Obtained CPT code for MCOT/ACT in 2009

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Telehealth Market Case Studies – Personal

Emergency Response Services (PERS)

Overall Market Characteristics

• Non-traditional HC market

• Out of pocket consumer costs

• Direct customer focused market

• New, more sophisticated monitoring

technologies are generating new

growth by justifying higher price

points

Note: All figures are rounded; the base year is 2010.

Source: Frost & Sullivan

PERS Key Metrics

• The largest of all telehealth markets

in revenue

• Consistent double digit revenue

growth

• Increasing price points due to

increasing inclusion of more

advanced telehealth technologies

Key Take Aways

• Adopting consumer service models to telehealth is possible

and sustainable through healthcare referrals and “fear”

based marketing but heavy use of traditional consumer

tactics will limit opportunities in healthcare applications

• New telehealth products and services created significant up

selling opportunities and growth

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What is Remote Health Monitoring?

Source: Adapted from Center of Technology and Aging

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Infosys Remote Health Monitoring Solution

Infosys Digital Smart

Home Gateway

Infosys Health

Management PlatformWeb Portal

(Information Access) Source: Adapted from

Center of Technology and Aging

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Infosys Digital Smart Home Gateway

Economical

• Low power consumption

• Small form factor

• Embedded wired and wireless and technologies

Configurable

Gateway

• Configurability -from disease specific state to wellness

• Remote Updates

Tracking Health

Readings

• Convenient Tracking of Health Data

• Interface with several Patient-worn devices

Designed For

Compliance

• Standards

• Regulatory

• FCC

• ROHS (Hazard)

• Environment and Noise compliance

A Dynamic and Intelligent Medical Devices Gateway. Providers can interact and customize therapies to

patient’s specific need.

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Health Management Platform and Web Portal

Device

Manufacturers

• Device Monitoring

• EMR / PHR Interoperability

• Remote Programming

Payers

• Integrated view for care plan manager

• Create new health plans

• Incentive calculation

Pharmaceutical

• Medication Compliance Management

• Disease management services

Providers

• Physician portal to view integrated device data

• Rule based Clinical Alerts

• E-Consultation with Patients

Other Features

• Customizable Branding

• SaaS based offering

• Integration with social media sites (Facebook / Twitter, etc.)

Interoperability Layer

Payer Health Vault /

GoogleHealth / Dossia Clinical Data Repository EMR / EHR

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CASE STUDIES

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US Cardiovascular Solutions Company: Design

and Development of Remote Monitoring Solution

Situation:

Pioneer in wireless cardiovascular solutions

focused on digital healthcare through the

confluence of medical devices,

telecommunication and IT sought to develop a

system for remote patient monitoring

Business Value:

Allowed the client to focus on more strategic

aspects of their business - Algorithms

Supported creation of key elements of the

design history and other documentation

required for FDA approval

Infosys Solution:

A physiological monitoring device attached to

the patient that talks to a gateway over Bluetooth,

which transfers data using wireless

communication or ZigBee

Development of key system components,

enabling the monitoring of vital patient

parameters remotely

Develop complete solution for the gateway

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Global Sleep Apnea Devices Company:

Patient Data Management Solution

Situation:

A leading manufacturer of products for the

diagnosis and management of sleep-disordered

breathing solutions sought to re-architect and

develop a system for patient data management

system

Business Value:

Expedite product introduction to market by

creating a global, flexible, platform based

architecture

Significant reduction in development and

testing costs to support any new device family

without requiring major system changes and

testing effort

Supported in achieving the US FDA for 510(k)

clearance for the product

Infosys Solution:

This product is used to collect patient data

remotely and transmit it using cellular network

interface or standard telephone line

Solution definition for a flexible platform based

architecture enabling the verification of patient

compliance and diagnosing Apnea and Hypopnea

via clinical reports

New product design, development, verification

and validation testing

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Poll Question

What are your organizations plans to develop a Remote Health

Management Solution?

• Currently have a Remote Health Management solution

• Planning within the next 12 months

• No plans

• Not applicable

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