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Telemedicine Overcomes Healthcare Challenges
- 2. THE HEALTHCARE DILEMMA
2Sun Knowledge © 2015-16 Private & Confidential
*According to a study by the Robert Graham Center.
Expanding
Provider Shortage
The U.S. is expected to
need 52,000 additional
primary care physicians
by 2025.*
Prolonged Patient
Wait Times
Steadily increasing due
to the national provider
shortage
Increasing
Healthcare Costs
Providers are primarily
located in metropolitan
areas but patients are
spread throughout the
country which increases
healthcare costs.
- 3. INCREASING PATIENT WAIT TIMES
9
7
9
8
24
12
21
23
0
5
10
15
20
25
30
Atlanta Miami Philadelphia Seattle
Average Wait
Times(Days)
City
Average Wait Times for Family Practioners in Metropolitican Areas
2009
2013
3Sun Knowledge © 2015-16 Private & Confidential
- 4. 4
NATIONAL AVERAGES
Metro Area Per 5 Specialties
Average Wait Time in
Days Per Metro Area
Boston
227 45.4
Denver 118 23.6
Philadelphia 103 20.6
Portland 97 19.4
Minneapolis 96 19.2
Detroit 89 17.8
Washington, D.C. 89 17.8
New York 84 16.8
San Diego 81 16.2
Seattle 80 16.0
Atlanta 70 14.0
Houston 70 14.0
Miami 68 13.6
Los Angeles 61 12.2
Dallas 51 10.2
Total Cumulative Average 92.3 18.5
CUMULATIVE AVERAGE WAIT TIME IN DAYS, 2013
Average patient wait times set to double
in the next 5 years.
4Sun Knowledge © 2015-16 Private & Confidential
- 5. TELEMEDICINE IMPROVES ACCESS
The Hidden Supply of Provider Availability
→ Telemedicine can unveil a hidden supply of unused provider availability that
currently exists.
Eliminate Geographic Barriers
→ Telemedicine connects patients to providers throughout the state without travel
time or additional cost regardless of patient or provider location.
5Sun Knowledge © 2015-16 Private & Confidential
- 6. CASE STUDY
The Commonwealth Fund, Feb 2014
→ Implemented telemedicine Programs for Long Term Care Facilities
→ There was a significant decline in hospitalization rates at facilities that were deemed
“more engaged” with the telemedicine service; hospitalization rates for this group
declined 11.3 percent.
→ Based on the reduced hospitalization rates of the more-engaged facilities, Medicare
could expect an average of about $151,000 in savings per nursing home per year. The
annual cost of the telemedicine service was $30,000 per nursing home, suggesting
that there could be $120,000 in net savings per year.
6Sun Knowledge © 2015-16 Private & Confidential
- 7. CMS TELEMEDICINE EXPANSION AUG 2014
The Medicare telemedicine Parity Act of 2014
→ Improves telemedicine coverage in Medicare
→ H.R. 5380 creates a phased approach over four years to expand coverage of
telemedicine- provided services and remove arbitrary barriers for Medicare
beneficiaries
The provisions include:
→ Gradual removal of geographic restrictions to patient care
→ Coverage for telemedicine healthcare services that take place in home and walk-in retail
health clinics
→ Remote patient monitoring (mHealth capabilities)
→ Chronic Disease Management
7Sun Knowledge © 2015-16 Private & Confidential
- 8. CMS TELEMEDICINE EXPANSION AUG 2014
“Deloitte predicts this in 2014, there will be 100
million eVisits globally, potentially savings over $5
billion when compared to the cost on in-person
doctor visits.”
“The Mayo Clinic announced a new telemedicine
pilot project as part of its overall effort to reduce
healthcare costs, with private kiosks – 10/3/14”
8Sun Knowledge © 2015-16 Private & Confidential
- 9. THE SOLUTION IS TELEMEDICINE
“Towers Watson expects a 68% increase in the number
of employers offering telemedicine in 2015-
Telemedicine could potentially deliver more than $6
billion a year in health care savings to U.S. companies”
"ObamaCare, Doctor Shortage To Spur $2 Billion
telemedicine Market"
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- 10. HOW DOES SUN KNOWLEDGE WORK?
STEP-1
Create a Profile
STEP-2
Confirm your
Appointment
STEP-3
Attend the Consult
STEP-4
Pick up your
Prescription
Simple 4 Step Process
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- 11. CREATE A PROFILE
Provider
→ Submit the provider enrollment
package to Sun Knowledge.
→ Complete one-time webinar training
offered M-F throughout business
hours.
Patient
→ Create a profile including your
demographics and insurance
information.
→ Using the Sun Knowledge App, take a
picture and upload your current
insurance card
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- 12. CONFIRM APPOINTMENT
Provider
→ Add availability to your calendar
→ Chose how many and what types of
patients you would like to treat.
→ Confirm, deny, or reschedule
incoming consultation requests.
Patient
→ Find your current provider or choose
a different provider within your
insurance network.
→ Click on a time that works for you and
request the consultation.
→ Receive confirmation from provider
that your request was scheduled.
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- 13. ATTEND THE CONSULT
13Sun Knowledge © 2013-14 Private & Confidential
Provider
→ Sign in, click on the “Start
Consultation” button and see your
scheduled patient!
Patient
→ Sign in, click on the “Start
Consultation” button and see your
scheduled doctor!
- 14. PICK UP THE PRESCRIPTION
Provider
→ Use our EMR or your own EMR to
ePrescribe the medication and send
request to the patient’s nearest
pharmacy.
Patient
→ Pick up your prescription at the
pharmacy or have your pharmacy
deliver your prescription directly to
you!
14Sun Knowledge © 2015-16 Private & Confidential
- 16. WHAT SETS GOTELECARE APART?
→ Health Insurance Processing
→ Pre-auth Collections
→ Flexible Technology Capabilities
→ Cloud-based platform is customized for client goals
→ Online Scheduling
→ Synchronization with EMR/Practice Management Calendars to show real time
availability
→ Customer Support and Administration Services
→ Client On-Boarding Operations
→ We assist in complete implementation unique to client goals.
16Sun Knowledge © 2015-16 Private & Confidential
- 17. → See your provider quickly and easily
→ Video conference with providers and specialists through an iPhone, iPad or
Laptop.
→ Patients can utilize insurance plans
→ Patients can leverage their health plan to meet with in-network, board
certified physicians 24/7/365.
→ Stay connected with your provider
→ Patients can reschedule appointments in seconds from the comforts of their
own home.
HOW GOTELECARE HELPS PATIENTS
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- 18. → Connect
→ Get paid for off-hour calls by using video conference platform through an
iPhone, iPad or Laptop to create a reimbursable claim.
→ Consult
→ Patients see their doctor and immediately schedule follow-up appointments
in seconds.
→ Collect
→ Provider can submit his own claim or GoTelecare processes the insurance
claim on the providers behalf and transfers the reimbursement to the
provider’s bank account.
HOW GOTELECARE ASSISTS PROVIDERS
18Sun Knowledge © 2015-16 Private & Confidential
- 19. → Reduce Hospital Re-Admissions
→ Utilize our telemedicine platform and/or provider network to have patients seen prior
to regularly scheduled office visits.
→ Decrease ER Wait Times
→ On-call providers can now treat patients from other locations or from home.
→ Maintain Patients in your Ecosystem
→ Treat patients through home healthcare agencies, outpatient clinics, and nursing
homes
HOW GOTELECARE CAN HELP HEALTHCARE ORGANIZATIONS
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- 20. → Medical Practices
→ Hospitals – General & Surgical
→ Nursing Homes & Personal Care Facilities
→ Home Health Agencies
→ Physical Rehab Centers
→ Public and Private Education Facilities
→ Pharmacies
→ Employers/Corporations
→ Correctional Facilities
→ Health Insurance Plans
WHO CAN IMPLEMENT TELEMEDICINE ?
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- 21. Top Diagnoses
→ Sinus Infection
→ Urinary Tract Infection
→ Bronchitis
→ Routine Follow Up
→ Psych Evaluation
→ Allergies
→ Flu Symptoms
→ Prescription Refills
→ Skin Rash
Electronic Prescribing
→ Electronic prescriptions direct to
patient’s nearest pharmacy or delivered
to patient home.
→ Connected to 55,000 individual
pharmacies and over 100 lab
organizations
→ Stage 1 and Stage 2 prescription drugs
can only be prescribed and refilled
during in-office visits.
WHAT CAN IT BE USED FOR?
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- 22. Specialties
→ Psychiatry
→ Neurology
→ Endocrinology
→ Urology
→ Internal Medicine
→ Family Practice
→ Dermatology
→ Rheumatology
→ Wound Care
Qualifications
→ Licensed, credentialed in the US.
→ Board Certified, Board Eligible
→ Malpractice proof for telemedicine is
mandatory
→ CV, NPI, DEA #s to ensure clean
background
Provider coverage in 46 States!
OUR PROVIDER NETWORK
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- 23. WHERE CAN IT BE USED?
23Sun Knowledge © 2015-16 Private & Confidential
- 24. Private Health Insurance Plans
→ Plans are choosing to cover telemedicine without state legislation mandates.
→ For example, in the state of Wisconsin, the following health plans voluntarily chose to
reimburse:
→ Blue Cross Blue Shield
→ Group Health
→ WEA Insurance Trust
→ Wisconsin Physicians Trust
→ Wausau Insurance
WHERE CAN IT BE USED?
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- 25. → Provider Accountability
→ Telemedicine Regulations
→ Insurance Reimbursement
→ EMR/ Platform Compatibility
GOTELECARE QUALITY CONTROL MANAGEMENT
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- 26. Calendar Availability Policy
→ Provider can choose to confirm, deny, cancel, or reschedule appointments.
→ Update restrictions apply during current calendar week.
→ Policy protects both patients and providers.
Verified Patient Reviews
→ Once provider confirms consultation was completed, the patient can write a review
based upon Overall Experience, Bedside Manner, and Wait Times
→ Reviews will be removed if they include vulgar language, cost complaints, or specific
medical information deemed inappropriate.
PROVIDER ACCOUNTABILITY
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- 27. GPS Enabled Technology
→ Ensures patient is located within the state of their licensed provider.
→ Patient must be located within the state at the time of the consultation.
Insurance Coverage Comprehension
→ We created a proprietary directory of telemedicine insurance coverage data for
Medicare, Medicaid, & Private Insurance Plans.
→ GoTelecare maintains and adheres to the most current federal and state allowance
legislation.
TELEMEDICINE REGULATIONS
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- 28. HL7 Compatibility
→ Data transfer made easy
→ EMR (Emdeon) EMR (Provider)
OR
→ Platform EMR (Emdeon or Provider)
Previous Patient Hx
→ Patient face sheets can be upload for review by provider prior to consultation.
→ Current medical diagnosis, prescriptions, and recent medical activity are readily
available
EMR/PLATFORM COMPATIBILITY
28Sun Knowledge © 2015-16 Private & Confidential