Med@Tel April 2011Roberto SchliesserVP Telemedicine SolutionseWave MDschliesser@ewavemd.com

eWAVE MD

VIRTUAL CONSULTATION PLATFORM

• About eWaveMD• eWave MD eHealth platform• Market overview• Remote Virtual Consultation• Workflow example• Business model

AGENDA

An international company developing web-based medical

applications since 1999.

Part of the eWave Group, an integrator and provider of

software solutions, employing 400 software professionals.

Our solution serves more than 1K physicians and 3M patients.

ABOUT eWAVEMD

ACCUMULATIVE EXPERIENCE

2001 - 2,000,000 patients PHR2003 – Large Scale Healthcare SOA implementation (IHE)2003 – Patient Information Kiosk2004 – Centralized Web-Based EHR (1,500 physicians)2005 – Remote Cardiac Diagnostics2006 – eWave MD spinoff2006 – PQRI & EHR for the USA Market (eHealth Made Easy)2007 – Home Based CHF Disease Management2009 – Remote Consultation (India)2010 – Full ONC Certification (Meaningful Use)

eWaveMD Unified

e-Health Platform

Home Care

Remote Diagnostics

eSched

EMR

Remote Virtual Consultation

Disease Manageme

nt

ARTEC(Advanced Rural

Telemedicine Clinic)

PHR

ONE PLATFORM, MULTIPLE SOLUTIONS

THE eHEALTH PLATFORM – PRODUCT LINE

OUR PLATFORM’S ADVANTAGES

• Fully browser-based platform to enable accelerated implementation of electronic medical record solutions

• Off-the-shelf software modules and accelerators

• Rule-Based Engine at the user level for maximum customization

• Multiple segment solutions

ONE PLATFORM: FROM DEVELOPING TO DEVELOPED WORLD SOLUTIONS

The platform supports a wide range of solutions, from basic needs in India to more complex

demands in the US.

eHealth platform “Progress Note” - US vs. INDIA

US - eHealthMadeEasy India - OTTET virtual consultation

3.4 billion people live in rural environments with minimal or no Healthcare infrastructure

WORLD STATUS

Source: Un World urbanization prospects 2009.

• Public health systems fail to deliver basic health services

• Lack of infrastructures

• Shortage of qualified medical personnel

• Wide target area with limited accessibility

• Uneducated manpower

RURAL HEALTH STATUS

The Target MDG’s and general goals: • Child health

– Reduce by two thirds – between 1990 and 2015 – the under-five mortality rate

• Maternal Health– Reduce by three quarters the mater

nal mortality rate

– Achieve universal access to reproductive health

– Achieve – by 2010 – universal access to treatment for HIV/AIDS

• HIV \ Infectious diseases – Reduce to half by 2015 and begin to

reverse the incidence of malaria and other major diseases

– Reduce to half by 2015 and begin to reverse the spread of HIV/AIDS

RURAL HEALTH STATUS - UN MDG

• Provide a new “Health Delivery Channel” for rural populations by enabling virtual medical services

• Improve availability and quality of medical care for rural populations

• Establish an environment for virtual medical services, which is easy and simple to implement and maintain

• Provide an IT infrastructure for additional medical services

• Create the infrastructure for a National Centralized EHR

OUR GOALS

“The Goal of the Mission (NRHM) is to improve the availability of and access to quality health care by people, especially for those

residing in rural areas, the poor, women and children.”

Provide primary health care based on eWaveMD Electronic Health

Record (EHR) and Medical Video Conferencing at the village level

Urban healthcare

Medical clinic in the rural

village

Communications (Cellular,

VSAT)

THE SOLUTION

Provide primary care services in rural areas using

• eWaveMD eHealth platform• Centralized control • Comprehensive Electronic Health Record (EHR)• Single data source

• ARTEC – Advance Remote Telemedicine Clinic

(at the point of care)• Medical Video Consultations• Integrated Medical devices• Consultation & Treatment workflows• e-Learning

THE MEANS

THE VIRTUAL CONSULTATION SOLUTION

WHAT IS THE ARTEC?

A proprietary hardware platform designed to provide remote consultation capabilities in a simple cost effective manner.

• Embedded Computer • Video Conferencing• Integrated Medical Devices• Integrates Communications• Simple to maintain • Low cost

Medical measurements

12 Lead ECG

Single Lead ECG

NIBP (Non Invasive Blood Pressure)

Blood Saturation (SpO2)

Body Temperature

Breathing Rate

Glucose meter

Precision weight scale

Pick flow (Spirometer)

THE ARTEC (ADVANCED REMOTE TELEMEDICINE Clinic)

Optional peripherals (Project

Dependent)

Electronic Stethoscope

X- Ray Digitizer

Pathology Microscope

Others* (Flexible platform)

COUNTRY

• Strengthen rural services • Controlled and

centralized data source• Nationwide statistics• Detects trends • Detects disease

outbreaks• Fraud detection and

prevention• Basic infrastructure for a

national EHR

PATIENT

• Immediate access to medical consultation

• Affordable medical services

• Immediate response • Time and money saving

THE VALUE PROPOSITION

“In 2009, the Indian government spent more money on transportation of rural population to the hospitals than on the

medical treatment itself” – Telemedicon, 2010

WORKFLOWS &

SCREENS

LOGIN PAGE

AGENT > HOMEPAGE

AGENT > PATIENT DEMOGRAPHIC

AGENT > INITIAL CONSULTATION

PROVIDER > HOMEPAGE

PROVIDER > INITIAL CONSULTATION

AGENT > INITIAL CONSULTATION CONT’

MEASUREMENTS WIZARD

PROVIDER > SECONDARY CONSULTATION

PROVIDER > SECONDARY CONSULTATION CONT’

AGENT > SECONDARY CONSULTATION

SUMMARY & PAYMENT

VIRTUAL ENCOUNTER WORKFLOW

eWaveMD Remote Virtual Consultation

Business Models

The NHR Mission is an articulation of the commitment of the Government to raise public spending on Health from 0.9% of GDP to 2-3% of GDP.

• Service model• Technology Operator \ Service provider• Responsible for the solution implementation and ongoing operations

– Setup and installation, training, maintenance and support – Customization and feature upgrades for both the platform and

ARTEC– Not responsible for the health services

• Based on down payment plus monthly fee per ARTEC station, regardless of the number of tests performed

• Sales model• Standard B2B sale model• Responsible for system setup

– Installations, knowledge transfer (train-the-trainer), maintenance and support

• Based on perpetual license, plus yearly maintenance

BUSINESS MODEL

• Choosing the best suited model depends on the following key aspects:

• Credit rating• Deal size• Local infrastructure and manpower

BUSINESS MODEL (CONT’D)

• Customer responsibilities:– Infrastructure (Primary Care Center)– Communication– Healthcare Operations (provider, nurses, technicians,

etc.)

• eWaveMD responsibilities:– Technology and know-how– Implementation services – Training– Quality of services rendered– Day-to-day support and maintenance– Financing – secure revenue stream

SERVICE APPROACH – RESPONSIBILITIES

Thank you !

• General– The ARTEC is designed to serve as a kiosk station in remote rural areas which lack modern

infrastructure. The design of the ARTEC must enable  the user to "carry" the device for long distances without additional human assistance or accessories\ tools .

– While working, the ARTEC shall provide a "comfortable " work environment, similar to working with a PC workstation or dedicated  kiosk, but at the same time, it should be easy to carry (in a suitcase or similar).

– The ARTEC should be able to absorb small shocks (such as when carried on the back of a motorcycle).

– The ARTEC Station should be modular to enable customized orders • Weight & Size

– Should be up to 6 Kg– Countertop design– Should be portable (reasonable size)

• CPU– Low power for use with backup battery for 6-8 hours – The ARTEC computing power shall be defined by video conference requirements. – (enable to run a full CIF HD video conference over a protocol such as H264 SVC).

• Power– 6-8 hours operation on battery– Connect external standard battery (12V)

• Battery Charge– Electricity – Solar panel

THE ARTEC REQUIREMENTS - I

• Medical devices– Integrated medical devices with optional assembly

(the medical devices integration to the system shall be in a similar concept to a hospital bed monitor).

– The following medical devices shall be Integrated in the Kiosk hardware. • Stethoscope • Blood pressure • Temperature• SPO2• ECG 1 lead • ECG 12 lead• Peak flow meter \ spirometer

– Supported for medical devices shall be configurable according to the customer's requirements (the medical devices shall be assembly dependent).

• Screen – Touch screen (optional)– 12”or higher with minimum resolution 1024 – 768 | changed to 10" for Kontron

• Memory – support video conference min requirements (SVC).

• Storage – Low power robust hard drive  (SSD)

THE ARTEC REQUIREMENTS - II

• Communications – Integrated communication with optional assembly for:

• LAN (Ethernet 10/100) • GPRS \ 3G HSPDA modem• WLAN • WiMax

• Parts and connectors  – USB 2 - Support integration with existing medical devices such as glucose meters, Portable x

rays, etc.– Serial Adapter – Medical connectors for the integrated medical devices: BP connector, SPO2, ECG …–  

• Operation System support – Linux– Win 7

• Printer (optional)– Thermal Printer  - internal

• Multimedia

THE ARTEC REQUIREMENTS - III

– Build in speakers (standard) – Earphone and Mic plugs – Build in Webcam – HD resolution

 • Security identifications (optional):

– Card reader– Fingerprint reader

•  • Monitoring and support

– Remote diagnostics for the ARTEC hardware (including peripheral)– Remote monitor for the ARTEC software – Remote monitor medical devices– Remote assistance

•  •  Environment conditions

– Should suit external rural conditions• High environmental temperatures• Humidity • Dust

THE ARTEC REQUIREMENTS - IV