MedStar

MedStar Institute for Innovation 1 “Through television and telephony we shall see and hear one another as perfectly as though we were face-to-face, despite intervening distances of thousands of miles; and the instruments through which we shall be able to this will be amazingly simple compared to our present telephone. A man will be able to carry one in his vest pocket”

Nikola Tesla - 1926

MedStar Institute for Innovation 2 Videoconference rooms for business

AT&T unveils the Alexander Graham Bell filed a “Ikonophone” with audio patent to develop “an apparatus and partial video at the for transmitting vocal or other Chicago World’s Fair sounds telegraphically.” 1933 1990 Telehealth at 1876 MedStar

1999 2020

1879 1970 14 year old Charlie Mayo AT&T’s “Picturephone” 2007 2010 sets up a telephone link is commercially 1st iPhone Facetime from his family farm to his available, unveiled by father’s office in Rochester AT&T for commercial Minnesota, connecting service. Kicked off June patients in town to Dr 30, 1970, by a call William Worrall Mayo, between Pittsburgh making the first “on call” Mayor Pete Flaherty doctor available by phone and John Harper, Chairman of Alcoa

MedStar Institute for Innovation 3 The disruption relies on tech, but Telehealth is not about technology

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Taxonomy by Recipient and Timing of Service

Intended Recipient

Provider-to-Patient Provider-to-Provider B2C (business to consumer) B2B (business to business) 1 2 Common applications: • Scheduled primary care and specialists Common applications: appointments • Telestroke (SOC) • On-demand (urgent care) (AmWell, • TeleICU Synchronous Teladoc, Doc on Demand) (real time) • (QLER) • Pre- and post-op 4 3 Common applications: Timing of of InteractionTiming Common applications: • Secure e-messaging (Roman, • Hims/Hers) • Asynchronous • Remote patient monitoring • Teledermatology (time lag) • Wearables (e.g., Fitbit)

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Source: Market Innovation Center research and analysis. The questions we were always asked

How do I do this? Will patients really How do we get Can I do it from go along with this? paid? home?

MedStar Institute for Innovation 7 MedStar Telehealth Innovation Center

Overview Formally established in 2017, MTIC supports and coordinates telehealth activities across MedStar Health by providing: • Telehealth infrastructure • Best practices • Subject matter expertise • Project implementation • Programmatic operational support Building Telehealth Competency Success requires creating a shared understanding and distributed expertise relating to telehealth operations across a wide range of MedStar Health teams.

MedStar Institute for Innovation 8 Telehealth COVID-19 Response MedStar Leverages Telehealth Competency to Transform Care Delivery

MedStar Institute for Innovation 9 Telehealth COVID Operations & Redeployment

Initial Response Organize & Recover Optimize Sustain March-April May - June July-August September and beyond

• 100+ Personnel working • 70+ Personnel working • 50+ Personnel working • 250+ Personnel working on telehealth on telehealth on telehealth on telehealth • Begin consolidation of • Continue consolidation of • Continue optimization • 70+ Medical Student towards long-term Volunteers activities into larger telehealth activities and organizational units (e.g. optimize/document telehealth operating model • Telehealth COVID Incident support center) processes for • Focus on business casing Command Center sustainability and service-line level established • Scale up Telehealth Operations Support • Continue to mature transformation work to • Rapid development of Center (TOSC), scale support infrastructure for enhance telehealth capabilities to address back provisioning, full-scale sustainability of sustainability emerging needs training functions after eVisit and Video Visit • Implement remote • eVisit + Video Visit were heavy lifting done • Begin development of new monitoring and connected operational focus long-term telehealth primary care pilot • Inherently inefficient activities such as remote initiatives, begin planning operations, “building the monitoring and Connected for full-scale plane while flying it” Primary Care (FY21 AOP) • Provider provisioning, training and technology development/deployment were major activities

MedStar Institute for Innovation 10 Being Prepared for the Unexpected COVID-19 Telehealth Growth/Scale

MedStar’s investments in Innovation and Telehealth provided the foundation for transformation during COVID-19

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Connected Primary Care Initiative

Pain Point Pilot Activities

Provider Instant telehealth care for urgent issues Improve patient and provider access when limited PCP access satisfaction and operational Chronic Remote patient monitoring and guideline- efficiency by targeting common disease based treatment for hypertension via digital pain points and offering new monitoring platform services using technology Automated safe processing of prescriptions Refill via HealthFinch software (expands existing requests pilot)

Response to Timely, centralized response to critical or results urgent results

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My neighbor My neighbor My neighbor Nurse call My mom Nurse call back Insurance verification Scheduled appointment Labs ordered lab appointment referral Insurance verification Scheduled appointment

Start again Fixed ED MedStar Institute for Innovation 20 MedStar Institute for Innovation 21 Message my doctor

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