In Touch Overview 1 April 06


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  • In Touch Overview 1 April 06

    1. 1. I n T ouch Health Extending Healthcare’s Reach Pioneering Technology Solutions for Healthcare Service Providers David Stuart, VP Int’l Markets
    2. 2. MeduNet Collaboration Complementary Tele-Medicine Devices <ul><li>Partnering with Intouch Health </li></ul><ul><li>(the leader in healthcare robotics) </li></ul><ul><li>to bring 18 years of robotic innovation </li></ul><ul><li>to the Saudi Arabia healthcare system. </li></ul>
    3. 3. InTouch Team History <ul><li>2002: Founded InTouch Health </li></ul><ul><li>Leadership Position in Remote Presence </li></ul>Control Station Remote Presence Robot
    4. 4. RP-6 & RP-7 Intouch Health founded by Yulun Wang, Ph.D. and his core development team, the world leaders in healthcare robotics
    5. 5. InTouch Team History <ul><li>1989: Founded Computer Motion </li></ul><ul><li>Leaders in Surgical Robotics & the Intelligent OR </li></ul><ul><li>(Computer Motion sold to Intuitive Surgical in 2003) </li></ul><ul><li>Computer Motion products developed by Yulun Wang, Ph.D. </li></ul>AESOP HERMES ZEUS & SOCRATES 1,400 + systems 2,000 + systems 65 + systems
    6. 6. Management Team <ul><li>Yulun Wang, Ph.D. – CEO </li></ul><ul><li>Michael Chan – VP Marketing </li></ul><ul><li>Steve Jordan – VP Engineering </li></ul><ul><li>David Stuart – VP Int’l Markets </li></ul><ul><li>Herb Von Winkelmann – VP US Sales </li></ul>
    7. 7. RP-7 in the Intensive Care Unit
    8. 8. RP-7 in Pediatric Medicine
    9. 9. Physician Rounding 2. Reviews patient status with nursing 3. Physician drives down hall to patient room 1. Physician logs into the robot
    10. 10. Physician ICU Rounding 4. duty nurse can accompany and update the physician on the patient’s condition 5. Patient visit as usual: review vital signs, concerns, and advance care 6. Physician & nurse discuss orders outside patient room
    11. 11. Hospital Applications <ul><li>Remote training & clinical support </li></ul><ul><li>Remote resident grand rounds </li></ul><ul><li>Surgeon mentoring within OR </li></ul>Academic Centers Partner Hospitals Education & Training <ul><li>24/7 critical care consultation </li></ul><ul><li>Remote patient management </li></ul><ul><li>Leapfrog compliance </li></ul>Intensivist Specialists Intensive Care Units Tertiary Hospitals Rural Hospitals Surgeons Internists Hospitalists Specialists Isolation Ward staff User/Customer <ul><li>Enlarge hospital catchment area </li></ul><ul><li>Reduce unnecessary transfers </li></ul><ul><li>Speed care delivery & improve quality </li></ul>Outreach <ul><li>Additional patient rounds </li></ul><ul><li>Weekend/evening rounds </li></ul><ul><li>Weekend/evening on-call response </li></ul>Med/Surg Patient Beds <ul><li>On-call response </li></ul><ul><li>Referral consults </li></ul><ul><li>Reduce human exposure to highly infectious pathogens </li></ul>Emergency Department Infectious Disease Control Customer Needs Application
    12. 12. ITH RP-7 Remote Presence Solution <ul><li>Immediate access 24/7 </li></ul><ul><ul><li>from home, clinic, another hospital, etc… </li></ul></ul><ul><li>Simultaneous access to Hospital clinical data </li></ul><ul><ul><li>PACS, labs, notes, paper charts, vital signs </li></ul></ul><ul><li>Advance patient care immediately , when that patient requires fast expert attention. </li></ul>
    13. 13. InTouch TotalView TM
    14. 14. ControlStation Dashboard
    15. 15. Intensive Care Units Med/Surg Wards Emergency Dept Doctor’s Lounge Doctor’s Office Home Clinic Doctor’s Office Hospital Hospital Deployment
    16. 16. Our Aging Society
    17. 17. ITH Value Proposition <ul><li>Enable physicians to… </li></ul><ul><li>... react quickly to patients with critical needs, </li></ul><ul><li>… more frequently consult, monitor, & round, </li></ul><ul><li>… improve patient outcomes and quality of care, </li></ul><ul><li>… improve hospital throughput, </li></ul><ul><li>...transfer knowledge more effectively, </li></ul><ul><li>… utilize technology to gain efficiency. </li></ul>
    18. 18. ICU Care Problem <ul><li>ICU is target of patient safety initiatives* </li></ul><ul><ul><li>High complexity & acuity </li></ul></ul><ul><ul><ul><li>16% of ICU patients experience human error in care </li></ul></ul></ul><ul><ul><ul><li>ICU mortality rate of 10-20% </li></ul></ul></ul><ul><ul><ul><li>High potential for serious LT disability </li></ul></ul></ul><ul><ul><li>High cost </li></ul></ul><ul><ul><ul><li>ICU care represent 1/3 of hospital cost </li></ul></ul></ul><ul><ul><ul><li>50-67% of ICU cost is concentrated in 10-15% of patients </li></ul></ul></ul><ul><ul><ul><li>Negative events = costly tests, medications, procedures, LOS </li></ul></ul></ul>*Institute for Healthcare Improvement, JCAHO, National Quality Forum, The Leapfrog Group, Michigan Keystone Initiative
    19. 19. RP-7 Robot Driver’s License
    20. 20. Customer List - 50+ robots <ul><li>Johns Hopkins </li></ul><ul><li>UCLA </li></ul><ul><li>UC Davis </li></ul><ul><li>Emory, Atlanta </li></ul><ul><li>Mission Hospital, Los Angeles </li></ul><ul><li>Oakwood Hospitals, Detroit </li></ul><ul><li>Hackensack Medical Center </li></ul><ul><li>Sentara Healthcare, VA </li></ul><ul><li>University of Texas, Galveston, Texas </li></ul><ul><li>Oregon Health Science Univ. OHSU </li></ul><ul><li>Shawnee Mission, Kansas • 5 robots </li></ul><ul><li>Detroit Medical Center • 10 robots </li></ul><ul><li>Parkview (Ft Wayne, Indiana) • 7 robots </li></ul><ul><li>California Pacific Med. Center, CPMC Sutter </li></ul><ul><li>Imperial College, London </li></ul><ul><li>St. Mary’s Hospital, London • 2 robots </li></ul><ul><li>San Rafaele, Milan, Italy </li></ul><ul><li>Acibadem Hospital Group, Istanbul, Turkey </li></ul><ul><li>Ethicon • 2 robots </li></ul><ul><li>Silverado Senior Living • 3 robots </li></ul><ul><li>Bitfone Corp • 2 robots </li></ul><ul><li>University of Tokyo </li></ul><ul><li>IRCAD/EITS of Strasbourg, France </li></ul><ul><li>Google </li></ul><ul><li>Cisco Systems • 2 robots </li></ul><ul><li>Booze Allen Hamilton </li></ul>
    21. 21. Johns Hopkins Patient Satisfaction Study “ Telerounding is a novel use of currently available technology that significantly augments patient satisfaction with post-operative care. This may represent a window into future patient care that gives patients increased access to their physicians. Providing an acceptable and timely mechanism for inpatient/provider interaction has the potential to decrease length of stay and morbidity.” LM Ellison, et al.: Telerounding and Patient Satisfaction Following Surgery
    22. 22. Remote Presence: Convergence of Communication & Transportation <ul><li>Phone </li></ul><ul><li>Video Conference </li></ul><ul><li>Remote Presence </li></ul><ul><li>Airplane </li></ul><ul><li>Automobile </li></ul>Communication Transportation
    23. 23. Beam Me Up!!!
    24. 24. The End <ul><li>Thank you ! </li></ul><ul><li>InTouch Health, Inc. </li></ul>
    25. 25. <ul><li>Optional </li></ul><ul><li>Backup Slides </li></ul>
    26. 26. Sentara ROI Model
    27. 27. System Architecture Home Office Emergency Department ControlStation RP-6 Physicians Lounge ControlStation Physician Office ControlStation Broadband connections Med/Surg RP-6 Internet ICU RP-6
    28. 28. Remote Presence <ul><li>ControlStation </li></ul><ul><li>Computer </li></ul><ul><li>Software </li></ul><ul><li>Camera </li></ul><ul><li>Microphone </li></ul><ul><li>Joy Stick </li></ul>Remote Expert <ul><li>RP-6 </li></ul><ul><li>Remote piloted vehicle </li></ul><ul><li>‘ Human like’ mobility </li></ul><ul><li>Two way audio-video </li></ul><ul><li>Pan, tilt and zoom </li></ul><ul><li>‘ Virtually there’ interaction </li></ul>Hospital Wireless Network Internet
    29. 29. Hospital IT Perspective <ul><li>Leverages current or planned IT solutions </li></ul><ul><ul><li>Not a redundant system </li></ul></ul><ul><li>Easy IT integration </li></ul><ul><ul><li>Leverages wireless & network infrastructure </li></ul></ul><ul><ul><li>Seamless EMR integration </li></ul></ul><ul><li>Step-wise & flexible deployment </li></ul><ul><li>ITH solution has broad application </li></ul><ul><li>(ICU, ED, Med-Surg floors) </li></ul><ul><li>Remote Presence can be highly effective with either EMR or paper records </li></ul><ul><li>Possible solution for Leapfrog </li></ul>
    30. 30. Physician Rounding
    31. 31. Sentara LOS Study Overview <ul><li>Six surgeons </li></ul><ul><li>Additive afternoon and weekend rounds </li></ul>19% 12 Discharge orders given via robot 29% 18 Patient discharge advanced due to robot rounds 65% 40 Patients receiving orders via robot 100% 62 Total patients visited Percent Totals
    32. 32. Market Size <ul><li>Hospital Market </li></ul><ul><ul><li>900,000 patient beds -> 30,000 RP-6s </li></ul></ul><ul><ul><li>90,000 ICU beds -> 9,000 RP-6s </li></ul></ul><ul><ul><li>5,000 EDs -> 5,000 RP-6s </li></ul></ul><ul><ul><li>> $2 billion annualized market </li></ul></ul><ul><ul><ul><li>RP-6 generates $4K/month </li></ul></ul></ul><ul><li>250,000 physicians -> 250,000 ControlStations </li></ul><ul><ul><li>$1 billion revenue opportunity ($250 mil annualized) </li></ul></ul><ul><li>Billion dollar long-term care market </li></ul><ul><li>Significant non-healthcare markets </li></ul>
    33. 33. Summary <ul><li>Strong Uniquely Qualified Team </li></ul><ul><li>Significant INITIAL market opportunity </li></ul><ul><ul><li>Strong/quantified value proposition </li></ul></ul><ul><li>HUGE Total market opportunity </li></ul><ul><li>Solid revenue & customer ramp </li></ul><ul><li>Strong IP position with unique technology </li></ul>
    34. 34. Hospital Information Landscape ADT -Patient Search -Admitting Phy. -Patient room PACS/RIS -MR,CT,CR,PET, US -Echo Cardio LABS -Clinical labs -Range parameters -Microbiology HIS (MPI) -Demographics -Payer Bedside Monitors -Vital signes -Wave forms, tables Physician Progress Notes DICTATION GOAL: CDR CLINICAL DATA REPOSITORY (EMR) Process specific applications CPOE Nursing Notes Pharmacy Charge capture Medication Orders -Contraindications Patient Billing & Collections Transaction Coding Physician Consult Report Physician Procedure Notes Vital Signs Meds (MAR) Intensive Care Parinatal/ L&D Cardio Care Med/Surg Care Respiratory Care OR & Scheduling Emergency Care
    35. 35. Hospital IS Landscape <ul><li>Many IT system ‘silos’ </li></ul><ul><ul><li>Evolving from paper to electronic </li></ul></ul><ul><li>Department/Process specific ‘silos’ </li></ul><ul><li>Moderate integration, especially non clinical systems – HL7 Standard has significantly increased integration </li></ul><ul><li>Several large IT providers </li></ul><ul><ul><li>McKesson, Siemens, Cerner, Keane, IDX, Quadramed, GE Medical, Eclpsys, Epic </li></ul></ul><ul><li>Most hospitals have several vendors in-house </li></ul><ul><ul><li>55% of hospitals use best product by applications (multi-vendor) </li></ul></ul><ul><ul><li>36% of hospitals are 1 vendor (smaller, rural hospitals) </li></ul></ul><ul><ul><li>9% Home grown software </li></ul></ul><ul><li>Large investment, very high switching costs </li></ul><ul><ul><li>Continued integration demands will fuel consolidation </li></ul></ul>
    36. 36. Healthcare Crisis <ul><li>Life expectancy increasing </li></ul><ul><li>Ratio of working to retired decreasing </li></ul><ul><li>Healthcare labor crisis is upon us </li></ul><ul><ul><li>Shortage of physicians, nurses, & caregivers </li></ul></ul><ul><li>The crisis will increase </li></ul><ul><ul><ul><li>Age 85+ will grow 38% by 2010 </li></ul></ul></ul><ul><ul><ul><li>The number of chronically ill will double </li></ul></ul></ul><ul><ul><ul><li>Availability of workers will decrease </li></ul></ul></ul>Healthcare Workers Need to be in “Two Places at Once”!!
    37. 37. Leapfrog IPS Standard (ICU Physician Staffing) <ul><li>Adult or pediatric ICUs are managed or co-managed by intensivists who: </li></ul><ul><li>Are present during daytime hours and provide clinical care exclusively in the ICU </li></ul><ul><li>At other times – at least 95% of the time </li></ul><ul><ul><li>Return ICU pages within 5 minutes and </li></ul></ul><ul><ul><li>Arrange for a FCCS-certified non-physician to reach ICU patients within 5 minutes </li></ul></ul>
    38. 38. Leapfrog IPS and Telemedicine <ul><li>Tele-intensivists can be used to meet the presence requirement when: </li></ul><ul><li>Ti manages and monitors care when intensivist is not on-site. </li></ul><ul><li>Ti workload permits assessment within 5 minutes of request. </li></ul><ul><li>Ti activity is proactive with patient reviews as appropriate. </li></ul><ul><li>Ti has immediate access to care plan. </li></ul><ul><li>Ti documents activities in the patient record. </li></ul><ul><li>Ti has immediate access to real-time clinical data. (Bedside monitors, labs, med orders and administered, notes, images, ECGs, etc) </li></ul><ul><li>Ti is able to see patient clearly and talk with staff. </li></ul><ul><li>Data links are reliable and secure (HIPAA). </li></ul><ul><li>Standards for remote care exist. </li></ul><ul><li>Written protocol to ensure good communications. </li></ul>
    39. 39. Intensivists KEY to Solution <ul><li>‘ Single most important factor in improving ICU care is using intensivists to manage ICU units’* </li></ul><ul><ul><li>ICUs where intensivists manage or co-manage all patients have documented a 40% reduction in ICU mortality </li></ul></ul><ul><ul><li>Less than 15% of ICUs have dedicated intensivist </li></ul></ul>*Institute for Healthcare Improvement, The Leapfrog Group, and others
    40. 40. Benefits <ul><li>Intensivist-centric ICU solution </li></ul><ul><ul><li>Deliver improved outcomes </li></ul></ul><ul><ul><li>Reduce ‘outliers’ </li></ul></ul><ul><ul><li>Reduce ICU costs </li></ul></ul><ul><li>Enables conformance to Leapfrog ICU Initiative </li></ul><ul><li>Technology allows inexpensive stepwise investment </li></ul><ul><ul><li>easy to initiate, expand as needed </li></ul></ul><ul><ul><li>Leverages existing IT expenditures </li></ul></ul><ul><li>Investment can be leveraged to other specialists and areas of the hospital </li></ul><ul><li>High physician acceptance </li></ul>
    41. 41. Hospital Challenges <ul><li>Consistently deliver high quality care </li></ul><ul><ul><li>Provide the right medical services at the right time and at the right place </li></ul></ul><ul><li>Drive efficiency gains through process improvement </li></ul><ul><ul><li>Maximize utilization of scarce resources </li></ul></ul><ul><ul><li>Create new capacity to meet growing demand </li></ul></ul>