Report Title: Telehealth Application Details Run Date and Time: 2020

Telehealth Application Details Page 1

Report Title: Telehealth Application Details Run Date and Time: 2020-06-19 13:45:07 Eastern Daylight Time Run by: COVID Service Account Table name: x_g_fmc_c19_telehe_grant_application

Telehealth Application Number: GRA0004283 Applicant: Chelsea Chunn Applicant National Provider Identifier (NPI): Applicant FCC Registration Number (FRN): 0028442317 Lead HCP: PeaceHealth Data Universal Numbering System (DUNS) 076633189 Lead HCP HCP Number: Number: # of HCPs: 1 DATA Act Business Types: M - Nonprofit with 501C3 IRS Status (Other than an Institution of Higher Education) # of Funding Line Items: 28 Service Area: Nationwide HCP Numbers:

Contact Information Contact Name: Chelsea Chunn Position Title: Community Health Operations Manager/AOR (Authorized Organization Representative) Street: 1115 SE 164th Avenue City: Vancouver State: WA Zip: 98683 Email: [email protected] Phone: 3607292002

Services and Conditions

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Patient-Based Internet-Connected Remote false Monitoring: Other Monitoring: false Video Consults: true Voice Consults: true Imaging Diagnostics: false Other Diagnostics: true Remote Treatment: true Additional information on Medical Services to be provided:: PeaceHealth invested in and implemented a significant number of telehealth solutions into our healthcare system in an effort to create more beds for COVID-19 patients, and to reduce unnecessary coronavirus exposure to patients and providers. PeaceHealth through its critical access network serves remote and rural populations for which telehealth has been an essential function for managing Covid-19. The telehealth services offered are outlined below.

Voice Consults: PeaceHealth launched telehealth services with voice consults between patients and clinicians to serve an immediate need in alternative visit types across all primary care and specialty clinics, eliminating the need for patients to come into ambulatory settings for routine and diagnostic care. Project efforts for the roll out of voice consults focused heavily on enhancing and optimizing existing systems and technologies while gaining efficiencies in workflows and supplying users with the devices and equipment needed to carry out these visits.

Video Consults: With the stabilization of voice consults and growing demand for telehealth solutions across the network, PeaceHealth continues to transition to video consult service offerings for primary care, specialty care and care coordination. Investments were made in software to conduct the synchronous video consultations and offer patients a more comprehensive visit in the virtual setting.

Currently, over 50% of care through the employed physician group is provided through these virtual consults. The solution is, and will remain, especially important for servicing our high risk and underserved populations. Telehealth has enhanced PeaceHealth’s ability to provide expert consultation to various hospitals within the health system. While COVID-19 is at the forefront of most healthcare systems, this technology will continue to transform our approach in the care we provide through our specialty service lines.

Remote Treatment: With 51 medical and surgical specialties provided across our locations, ongoing treatment of chronic conditions cannot stop for our patients. Telehealth solutions such as those integrated into My PeaceHealth, Epic, and those deployed through our video and voice consultations have allowed us to continue treatments for our patients.

Other Services/ Chat: My PeaceHealth, the PeaceHealth’s MyChart in Epic, has launched secure chat for communication between patients and their caregivers. The functionality allows care teams and their patients to send HIPAA secure text messages within Epic in real-time from a desktop computer or mobile device. The solution can also be leveraged among providers, coordinating care for patients in real time, securely. Would you treat patients without COVID-19 Yes symptoms or conditions?: Would you treat COVID-19 patients directly?: Yes Emergency / Urgent Care: true Mental Health Services (Non-Emergency): true Other Infectious Diseases: false Routine, Non-Urgent Care: true Other Conditions (Explain Below): false

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If you will treat patients without COVID-19, explain...: The grant funding will be used to help health care providers deliver connected care services to patients at their homes so that we can treat non-COVID patients virtually, this reduces the number of visits to emergency departments, urgent cares and walk in clinics, improving hospital and provider capacity to respond to COVID-19.

The use of telehealth in our ambulatory space ensures our patients in our primary care and specialty care spaces are still being seen regularly, ensuring we can continue to assess their health, and identifying risk before they would have an emergent need that would send them into an acute care setting requiring in-demand resources.

Across all practice settings, telehealth has significantly impacted the use of personal protective equipment within our healthcare system. We have been able to decrease the number of direct contacts with our patients, without sacrificing quality care, enabling us to reserve PPE for the increased demand in those resources for COVID-19 patients. Additional information on specific conditions to be treated::

Purpose and Intent What are your goals and objectives for use of the COVID-19 Telehealth Funding?: PeaceHealth’s mission is to promote personal and community health. The goal throughout the implementation of these telehealth solutions across the organization is to support patients in their routine and specialty care needs as well as develop platforms for continued care coordination and case management.

The COVID-19 Telehealth Program Funding would be used to continue in the design, development and deployment of additional telehealth solutions to create an infrastructure that enables PeaceHealth to balance the ability to deliver high-quality, timely care, while providing additional capacity for COVID-19 patients, reducing exposure for our care teams and patients, and closing the healthcare gaps for underserved populations in our communities. What is your timeline for deployment of the proposed service(s)?: The northwest region felt the impacts of COVID-19 early, and consequently launched telehealth solutions as quickly as possible to serve their patients and mitigate any disruptions to ongoing care and treatment plans.

Telephone visits were launched as an immediate response to the need for alternative visit types, going live for primary care and specialty clinics in mid-March, 2020. With the continued increase in demand, and shifting preference for video visit types, a comprehensive strategic growth plan was developed.

Video visits were launched for primary care clinics on April 13, 2020. The first phase of video visits in specialty care clinics followed shortly thereafter on April 21, 2020. The phasing is continuing through May 21, 2020. The final round of phasing will be the launch of On-Demand video visits, the PeaceHealth solution to virtual Urgent Care, set to go-live on May 29, 2020.

While this strategic growth timeline was designed to fill an immediate need for COVID-19, the development will not end with the containment of coronavirus. Instead, focus will turn to how we will continue to keep telehealth moving forward meeting our patients in the places, with the services, most convenient for them. What metrics will you use to help measure the impact of the funds used? : Metrics we will track will include, but may not be limited to: •Volume of telehealth patients seen per day, per platform (voice consults, video consults) •Volume of non-COVID-19 patients treated via telehealth •Monitoring of concurrent transactions between patients and providers to track provider capacity How has COVID-19 affected HCPs in your geographic area (e.g, county)?: Across the communities we serve, COVID-19 has threatened our healthcare infrastructure, supply chain and workforce resources. In efforts to ensure our health system capacity was able to meet the projected needs, we took steps to mitigate the treat and ensure we had adequate resources to treat any potential COVID-19 surge while deploying processes, ensuring we maintained the safest practices possible in continuing to deliver essential services to maximize the health of the patients we serve.

Steps included postponement of non-essential surgeries and procedures, limited in-person medical care that could be postponed or managed virtually, and reduced office-based consultative care.

Patient across our service areas are turning to virtual solutions for their care needs, a trend that will likely exist and continue to grow following COVID-19 containment. To ensure we are able to meet the access needs, we have deployed methods to reach patients in new ways. Have you been under pre-existing strains? If so, please describe such factors.: Five of the ten medical centers in the PeaceHealth network are critical access hospitals, making us a staple in otherwise largely underserved, vulnerable communities. This also means, that COVID-19 has placed added strain on populations across our service areas facing pre-existing challenges.

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Ketchikan, Alaska has a poverty rate of 12.4% and the greater area is deemed an area of frontier by the state of Alaska. Per the US Census, 14% of the population identify as solely American Indian or Alaskan Native alone.

Cottage Grove, Oregon has a poverty rate of 21% and Florence, Oregon has a poverty rate of 16.73%. According to the US Census, 11% of the Cottage Grove population identifies as Hispanic or Latino, and an additional 5.1% identifies as two or more races. The statistics are notable, after preliminary research shows disproportionate impact of COVID-19 on underserved and minority populations in the state.

Sedro-Woolley, Washington has a poverty rate of 19.9%, and a population that has over 16% identifying as Hispanic or Latino with an additional 7% as two or more races. While Friday Harbor, Washington’s poverty rate is slightly lower at 13%, the population identified in similar makeup on the latest US Census, with just under 16% identifying as Hispanic or Latino, just under 11% identifying as other races and an additional 4% identifying as two or more races. Do you plan to target the funding to high-risk and vulnerable patients?: Yes If so, please describe how.: Telehealth services will support the continuation of routine and specialty care for patients across the PeaceHealth networks. Of our service areas, five medical centers are dedicated to serving high-risk and vulnerable patients. Telehealth services will allow this population to continue accessing healthcare remotely, while limiting their exposure to COVID-19. Please provide any additional information to support your application and : Do you request confidential treatment of supporting documentation?: Yes

Funding Request Total Amount of Funding Requested: $1372613 Are you requesting funding for devices?: Yes Are the devices for the health care provider's Yes use?: Are the devices for patient use?: No How are the devices integral to patient care?: The devices PeaceHealth has purchased and will continue to expand on are integral to patient care, by increasing quality and ease of care, closing care gaps through reaching at risk populations, increasing safety for both the patient and staff, reducing non-infecting patient exposure to COVID-19, increasing the amount of beds available for COVID-19 positive patients, reducing PPE usage, increasing the number of patients PeaceHealth can serve, and ultimately helping in delivering in PeaceHealth’s mission to promote community health.

Certification Certified and Submitted by: Chelsea Chunn Certified Date and Time: 2020-04-30 17:02:25 Certifier Full Name: Chelsea Chunn

Related List Title: Health Care Provider List Table name: x_g_fmc_c19_telehe_health_care_provider Query Condition: Associated Application = GRA0004283 Sort Order: Number in ascending order

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1 Health Care Providers Estimate d Addition Number al County Is the Total of Associat PDF ▲ ed Informat in which Is Lead Facility Patient Street Facility FRN HCP NPI State City Eligibilit Patient Patients ion on address a Number Name Number y Type Populati to be Applicat Patient is HCP? Hospital Estimate Address on Served ion Estimate located ? Info by : Funding Request

HCP000 PeaceHe 0028442 WA Vancouv (5) not- 1,294,69 507,462 GRA000 Clark Yes Yes 1115 SE 8034 alth 317 er for-profit 8 4283 County, 164th hospitals Washingt Avenue on

Related List Title: Funding Request Details List Table name: x_g_fmc_c19_telehe_funding_request Query Condition: Associated Application = GRA0004283 Sort Order: Number in ascending order

28 Funding Request Details Description of Number of Months Date [Purchased ▲ Quantities(For Total One-Time Total Monthly Associated Number Service(s) and/or Category Devices) Expense Expenses for Recurring or] To Be Application Device(s) Monthly Expenses Purchased

FDR0010732 iPads offer a Devices 50 $20780 2020-03-31 GRA0004283 convenient way to communicate with our patients and fellow care teams across the enterprise, using secure streaming and messaging technologies as identified by the organization and our EMR system. With the growth in demand to connect with our patients outside of exam rooms, the need for

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Description of Number of Months Date [Purchased ▲ Number Service(s) and/or Category Quantities(For Total One-Time Total Monthly for Recurring or] To Be Associated Device(s) Devices) Expense Expenses Monthly Expenses Purchased Application

alternative workstations and continued connectivity is essential. With the mobile nature of iPads, there exists the opportunity to connect with patients and other providers in all environments.

FDR0010733 Monitors are a Devices 100 $26882 2020-04-02 GRA0004283 fundamental piece of the workstation for our providers in delivering real time, telehealth solutions for our patients. This piece of equipment will ensure real time, quality communication between care teams and our patients. With the increase in demand for communication in other settings than exam rooms, the need for more work stations is essential. Each site has dedicated care teams with specific patient populations, making the need for unique resources critical.

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FDR0010734 These monitors will Devices 100 $26882 2020-04-03 GRA0004283 support the growth in workstation development for telehealth solutions at PeaceHealth, reaching underserved populations, mitigating risk to non-COVID-19 positive patients, and reserving PPE for the care teams that need it most. Upon the containment of COVID-19, these workstations will continue to be dedicated to the development of our telehealth solution offerings.

FDR0010735 These laptops offer Devices 50 $75087 2020-04-03 GRA0004283 providers an opportunity to stay connected to their most complex patients across the medical group, and continue to serve new patients with a need for consultative services.

FDR0010736 Telemedicine kiosks Devices 100 $266882 2020-04-04 GRA0004283 with attached monitors to provide inpatient monitoring telemedicine capabilities as well as outpatient telemedicine services for the St John Patient population.

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FDR0010737 Telemedicine kiosks Devices 100 $26882 2020-04-05 GRA0004283 with attached monitors to provide inpatient monitoring telemedicine capabilities as well as outpatient telemedicine services for the St John Patient population across all service lines, departments and specialties. The reach and opportunity for growth is endless.

FDR0010738 iPads offer a Devices 30 $9954 2020-04-07 GRA0004283 convenient way to communicate with our patients and fellow care teams across the enterprise, using secure streaming and messaging technologies as identified by the organization and our EMR system. With the growth in demand to connect with our patients outside of exam rooms, the need for alternative workstations and continued connectivity is essential.

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FDR0010740 iPads offer a Devices 30 $9954 1010-04-07 GRA0004283 convenient way to communicate with our patients and fellow care teams across the enterprise, using secure streaming and messaging technologies as identified by the organization and our EMR system. With the growth in demand to connect with our patients outside of exam rooms, the need for alternative workstations and continued connectivity is essential.

FDR0010741 iPads offer a Devices 30 $9954 2020-04-07 GRA0004283 convenient way to communicate with our patients and fellow care teams across the enterprise, using secure streaming and messaging technologies as identified by the organization and our EMR system. In the inpatient setting, iPads allow us the opportunity to continue to monitor our patients while reducing exposure, limiting the use of PPE, to reserve these resources for COVID-19 patients.

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FDR0010742 With the increased Devices 2020-04-16 GRA0004283 demand for appointments outside of the traditional exam room, there comes the need for additional provider work stations. These internet connected devices will help support that need in a given clinic.

FDR0010744 Internet Connected Devices $148306 2020-04-16 GRA0004283 Devices, Desktops, to be used to provide higher quality care with fewer interruptions due to bandwidth to patients or our Oregon network.

FDR0010745 Zoom, ZoomCare, Information Service $1666.67 12 2020-04-16 GRA0004283 offers a tremendous solution and opportunity for us to connect with our patients and fellow providers across the enterprise, and within the community in real time. In order for this platform to be most effective, we need the workstations and devices to support all of our providers to be connected and able to use the solution.

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FDR0010746 Wireless Dongle Internet $2940 2020-03-20 GRA0004283 assist in supporting Connectivity Service connectivity for providers offering telehealth solutions to their patients, regardless of their environment, bandwidth or demand on the network at the time, in a secure manner.

FDR0010747 Webcams and Devices $16720 2020-03-27 GRA0004283 headsets are critical to the delivery of care, real time in the virtual environment for our patients at PeaceHealth. They will be used to deliver consults, support the continuation of care and delivery of remote treatment and in collaboration across our networks for complex patient cases.

FDR0010748 Monitors are a Devices 10 $23400 2020-04-03 GRA0004283 fundamental piece of the workstation for our providers in delivering real time, telehealth solutions for our patients. This piece of equipment will ensure real time, quality communication between care teams and our patients. With the increase in demand for communication in other settings than exam rooms, the need for more work stations is essential.

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FDR0010749 These monitors will Devices $31356 2020-04-09 GRA0004283 support the growth in workstation development for telehealth solutions at PeaceHealth, reaching underserved populations, mitigating risk to non-COVID-19 positive patients, and reserving PPE for the care teams that need it most.

FDR0010750 Monitors Devices 50 $13441 2020-04-15 GRA0004283

FDR0010751 These monitors will Devices 50 $13441 2020-04-15 GRA0004283 support the growth in workstation development for telehealth solutions at PeaceHealth, reaching underserved populations, mitigating risk to non-COVID-19 positive patients, and reserving PPE for the care teams that need it most.

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FDR0010752 Monitors are a Devices 50 $13441 2020-04-15 GRA0004283 fundamental piece of the workstation for our providers in delivering real time, telehealth solutions for our patients. This piece of equipment will ensure real time, quality communication between care teams and our patients. With the increase in demand for communication in other settings than exam rooms, the need for more work stations is essential. With populations across states, varying needs, differing specialties and extreme levels of care coordination, having dedicated resources at the local network level will allow the quality of care to stay at the level our patients have come to expect.

FDR0010753 Webcams and Devices $4189.00 2020-04-16 GRA0004283 headsets are critical to the delivery of care, real time in the virtual environment for our patients at PeaceHealth. They will be used to deliver consults, support the continuation of care and delivery of remote treatment and in collaboration across our networks for complex patient cases.

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FDR0010754 Headsets and Devices $2793 2020-04-16 GRA0004283 webcams may be leveraged across this network for inpatient monitoring, coordination of care in telehealth remote treatment solution offerings, and in other video telehealth service offerings.

FDR0010755 Headsets and Devices $3072 2020-04-16 GRA0004283 webcams are a vital part of telehealth delivery across all of our primary and specialty care service lines-- offering providers and chance to speak and monitor patients real time.

FDR0010756 Webcams and Devices $2793 2020-04-16 GRA0004283 headsets are critical to the delivery of care, real time in the virtual environment for our patients at PeaceHealth. They will be used to deliver consults, support the continuation of care and delivery of remote treatment and in collaboration across our networks for complex patient cases.

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FDR0010757 Webcams and Devices $2793 2020-04-16 GRA0004283 headsets are critical to the delivery of care, real time in the virtual environment for our patients at PeaceHealth. They will be used to deliver consults, support the continuation of care and delivery of remote treatment and in collaboration across our networks for complex patient cases.

FDR0010758 Headsets & Devices $2793 2020-04-16 GRA0004283 Webcams to support the synchronous communication with patients via telehealth service offerings.

FDR0010759 With the increased Devices $161209 2020-04-16 GRA0004283 demand for appointments outside of the traditional exam room, there comes the need for additional provider work stations. These internet connected devices will help support that need in the Bellingham provider groups.

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FDR0010760 Laptops - Longview, Devices $130888 2020-04-16 GRA0004283 MG Telehealth solutions. For those at our Longview location, telehealth solutions look different, and the ability to be portable is essential. With limited work space but ever growing demand in offering remote patient care and telehealth solutions, laptops offer our care teams a way to stay connected in real time and through follow up.

FDR0010761 Laptops - RBA Devices $120421 2020-04-16 GRA0004283 These laptops offer providers an opportunity to stay connected to their most complex patients, and a population that is often at risk. Laptops serve as the first step in the implementation of telehealth solutions for this provider group.

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