INSTA Intelligence Technologies P Ltd Access My Doc

INSTA Intelligence Technologies (P) Ltd. Access. My. Doc A Telemedicine Solution

WHAT IS ACCESSMYDOC? A live video, audio and web based system that allows patients to receive medical care from a remotely located medical provider, i. e. “Telemedicine”.

General Telemedicine Process Flow

Features Access. My. Doc is composed of patient and doctor network: Connect to Medical provider Triage Questions for Sore Throat, Diarrhea and Nausea Patient medical history Patient adding physician to his network Patient Audit Trail (transaction log) Request for Appointment or Cancelling the appointment by patient or doctor Rx Request – Prescriptions Referral Request – Patients referring other patients

Features (contd. . ) Patient health forms Patient information and insurance details In case of emergency - contact information of patient relatives Billing questions to the staff Ask nurse a question Interfacing with Diagnostics – Lab results Provide consultation of a Super-specialty doctor from a distance through videoconferencing (3 rd party tool) along with exchange of medical records online Tele-Consultation

Reports Number of online visits performed – by all the doctors Number of Registered Patients Number of online appointments set – by a specific doctor Number of referrals Amount of money paid to a physician or for a specific period Illness Treated for the cases of Sore Throat, Diarrhea and Nausea Demographic of registered patients

Hospital Benefits ü Development of satellite locations § Rapidly develop an outpatient program § Feed inpatient stays § Extend into competitor’s geographical areas overnight ü Project Power using principals of “Medical Tourism” § Establish a Center of Excellence; State-wide recognition ü Strengthen Relationships with Provider Community § Creating revenue source for them

Hospital Benefits ü Provide care to patients located at: County Health Departments Hospital outpatients (ex. ER Departments) Physician offices Podiatrist offices Community Mental Health Centers • Two designations: o Originating site: where the patient is located o Distant site: where the medical provider is located § § § • At the originating site a licensed healthcare professional is NOT required

Access to mental healthcare in rural and Inner -City communities is a challenge? The challenges faced by our pilot organizations: • Availability of providers: especially for children • Distance/transportation problems • Abundance of cases

Telehealth/Telepsychiatry Solution Telepsychiatry component of telemedicine defined as delivery of psychiatric treatment remotely, using live video-teleconferencing equipment (VTC). Telepsychiatry has been approved American Psychiatric Association Psychiatric treatment via telemedicine can be as effective as when delivered during traditional outpatient appointments. The growth and success of telepsychiatry traditionally limited by the high cost of expensive VTC equipment and dedicated "point-to-point" data links – no longer exists.

Mental Health Clinic Benefits ü Increase access to mental healthcare providers for your patients ü Cost efficient-no penalty for “no shows” ü Provide care to patients at: § § § Nursing homes County Health Clinics Hospitals (inpatient and outpatient) Hospital based renal dialysis centers Physician or other type of practitioner offices Community Mental Health Centers

HOW IT WORKS WITH ACCESSMYDOC Determination made for Mental healthcare Remote provider evaluates case and determines if remote care is appropriate. Request for care placed in Access. My. Doc Accepts case; remote visit scheduled and performed

HIPAA CHECKLIST USED HIPAA Citation HIPAA Security Rule Standard Implementation Specification 164. 308(a)(1)(i) 164. 308(a)(2) 164. 308(a)(3)(i) 164. 308(a)(4)(i) 164. 308(a)(5)(i) 164. 308(a)(6)(i) 164. 308(a)(7)(i) 164. 308(a)(8) 164. 308(b)(1) 164. 310(a)(2)(ii) 164. 310(b) 164. 310( c ) 164. 310(d)(1) 164. 312(a)(1) 164. 312(b) 164. 312( c)(1) 164. 312(d) 164. 312(e)(1) Security Management Process Assigned Security Responsibility Workforce Security Admin controls Information Access Management access/audit trails Security Awareness Training Security Incident Procedures Contingency Plan Evaluation Business Associate Contracts and Other Arrangements Facility Access Controls Facility Security Plan Workstation Use Workstation Security Device and Media Controls Automatic logoff Access Control Audit Controls Integrity Person or Entity Authentication Transmission Security

GROWTH OF TELEMEDICINE ü Mandated in 13 States and Counting; 35 States reimburse for telemedicine via Medicaid program (within USA) ü Covered by Medicare and numerous Medicaid plans (within USA) ü Private payors are reimbursing for it: (within USA) § Blue Cross Plans such as: Anthem (California), Hawaii, Western Carolina, Well. Point, many more § United Healthcare § Aetna § Cigna NY, North ü Use in Emergency Rooms, especially for mental health patients ü Telepsychiatric satisfaction levels measured at 80% for patients and 90% for physicians in a study funded by the National Institute of Mental Health the Duke Endowment and “Although telemedicine has been around for years, it is gaining traction as never before. ” -New York Times, Business Day May 29, 2010

Emergency Room Module A major problem faced by hospitals are patients inappropriately going to the emergency room for illnesses that should be provided for in a primary care physician’s office Access. My. Doc’s Emergency Room Module enables hospitals to lower their cost associated with patients who use the emergency room inappropriately by utilizing remote primary care physicians and specialist to provide care, thereby freeing up valuable emergency room staff and resources for patients with life threatening illnesses.

ER Portal

Emergency Room: How it Works Patient visits ER for non-life threatening illness (i. e Acute Respiratory Infection) Information is collected about patient’s condition and sent to remote physician Physician evaluates information collected and determines if remote care is appropriate. Physician accepts case, remote care is rendered using Access. My. Doc Benefits of Emergency Room Module: ü Frees up hospital emergency staff to treat patients with life threatening illnesses ü Links up the patient with primary care physicians in an effort to avoid future inappropriate use of the emergency room

Outpatient Portal

HOW IT WORKS FOR INPATIENT CARE Specialist evaluates information collected and determines if remote care is appropriate. Inpatient requires specialty services not currently available at hospital; Information uploaded to Access. My. Doc Physician accepts case, Access. My. Doc terminal is placed at patient’s bedside for rendering of medical care

Patient benefits ü Live healthier lives because conditions are closely medical monitored ü Removes constraints due to geography or work conflicts ü Increases access to care; One Stop Shop for Services

Rural Care A major problem faced within the population is the lack of primary care physicians and specialist within rural and underserved areas of the country Access. My. Doc’s Rural Care enables patients in areas of the country that lack adequate access to primary care physicians and specialist to receive the critical medical care needed.

Rural Care Module - How it Works Patient located in rural or underserved area requires access to a primary care physician or specialist Patient with a nurse logs into Access. My. Doc and completes a medical request form Access. My. Doc notifies the remote physician of the services needed

Patient Portal Module Many physician offices are overwhelmed by the administrative functions required to successfully operate a medical practice. A major obstacle is the time consuming functions required of the staff to set appointments, answer general questions, fulfill prescription request, retrieve medical records and submit referrals Access. My. Doc’s patient portal module enables a patient to perform many of the time consuming yet important functions themselves.

Patient Portal Module Patients also save valuable time by using Access. My. Doc to interact with their personal physician’s office to: ü Set appointments ü ü Pay medical bills Request prescription renewals Request referrals Receive appointment reminders

Physician Portal

Benefits to Public and Private Hospitals/ NGOs Presence in remote areas with less investments Creating brand value Providing the same kind of support remotely Increase in patient network and bottom-line Medical Tourism Patients from US and other countries will be using our solution, and for final treatment and surgeries will travel to the destination Country