TELEMEDICINE BASICS Telemedicine is the ability to provide

TELEMEDICINE BASICS Telemedicine is the ability to provide medical advice and treatment remotely

Joe A. Flores RN, MSN, JD APRN ENTREPRENEUR FOR TELEMEDICINE � Joe Flores is an attorney, nurse practitioner, health consultant , entrepreneur, former medical ethics professor, author and television host and producer. Mr. Flores has practiced health law in both state and federal court in Texas. His practice includes representing health care companies and has established and administered two multimillion dollar healthcare entities including home health and hospice companies. In his health career he has provided services to patients throughout the lifespan, military personnel and has worked at the world-renowned Texas Medical Center. Joe is a board certified Family Nurse Practitioner who can diagnose and prescribe in collaboration with physicians in Texas. Mr. Flores is a nationwide lecturer and author of articles including topics such as health care fraud and the field of medical legal consulting. Mr. Flores has also authored articles on topics as diverse as international trade and energy in Brazil as well as the ethics of human cloning. Joe is currently focusing his efforts on bringing telemedicine to rural and medically underserved areas throughout the world and is working US and LATIN AMERICAN COUNTRIES in joining engineers, technology, doctors and patients together. Joe can be reached any time by e-mail at joe@floreslawfirm. com or at 361. 887. 8670. JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 2

TELEMEDICINE A WORLD MISSION: ATTENTION APRN’S JOE A. FLORES, JD, MSN, RN Attorney and Healthcare Provider 361 -887 -8670 joe@floreslawfirm. com

NOTICE � The following educational opportunity does not constitute medical or legal advice nor does it constitute solicitation for business. The following presentation is to provide increased knowledge to those who seek to bring medical care to individuals who are geographically distant or medically underserved throughout the world. This presentation is also for those who desire the convenience of modern technology to aid in providing quality medical services to the masses. -Joe Flores JD, MSN, RN JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 4

GOALS AND OBJECTIVES In This Teaching Session The APRN Learner Will: Gain Knowledge on the TELEMEDICINE AND TELEHEALTH � Gain Increased Knowledge Regarding the uses of telemedicine and its applications throughout the world � Review Traditional Medical Delivery and Compare to Telemedicine � Learn Strategies To Implement Telemedicine � Increase Knowledge of Methods to Create a Telemedicine Model for All Human Beings Worldwide � Learn About the present and future of telemedicine for civilian, military and institutional applications � How APRN’s can gain financially from telemedicine while helping the underprivileged and preventing unnecessary emergency room and hospital visits JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 5

“Telemedicine is the Future” �Why is Telemedicine Not the Present? �Why are more patients not asking for telemedicine everyday from their doctor? �Why are doctors not using telemedicine to increase efficiency in their clinical practice? �Why is telemedicine not being used as a cost-effective method to follow up with patients after an initial face to fact visit? JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 6

Technology is Here and Has Been Here All Along �Historically Telemedicine has been around through the use of messengers that would bring medicine, notification of how to treat a person medically and through the use of various modes �Military Applications: Signals, drums, horns, flashing lights, banners, and flaming arrows gave warnings of plague, diseases and of medicine that was on the way to treat injured or diseased soldiers JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 7

Telegraph, Phone and Fax �With the invention of the telegraph much information could be shared to many people including medical information about plague, disease and the coming of physicians and other medical personnel �Through the invention of the telephone, doctors and nurses realized they could communicate vital data to their patients �For decades the fax was the way to communicate large amounts of medical data JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 8

Engineers Work with Doctors �Many Engineers have seen the advantage of creating computer programs to aid doctors and nurses through questions that the patient could answer on the computer �The technology then could be used to create an interview process with answers to many common medical provider questions along with video or pictures attached to the communication �The doctor could use the information to accurately diagnosis the patient �This technology in the 1980’s way before its time and was not widely accepted by the medical community JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 9

Engineers Have Simplified the Process for Doctors and the Medical Team �The technologies surrounding telemedicine have been solidly formed �Many of today’s engineers see the medical technology as very simple �A program can put up data on a screen such as pictures or use a video camera and use online forms �The challenge is to streamline the telemedicine deployment JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 10

United States and Telemedicine One Example �Telemedicine is expected to grow quickly through 2020 �High deductible insurance plans are one reason �Risk-based contracts and reimbursement cuts �Increased reimbursement and licensing for telemedicine �The switch to electronic medical records and the high cost of overhead for medical providers JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 11

Telemedicine Advantages for Physicians �Decrease Cost and Decrease Waste of Physician Time �The explosion of the EMR (Electronic Medical Record) has paved the way for additional technologies �With the EMR physicians can access medical records anywhere in the world with a secure internet connection �Patient data is then easily obtained at the same time by many medical professionals to provide positive outcomes to patients and increase efficiency JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 12

Examples of How Telemedicine Connects People �Telediagnosis-connect physician with patient �Telepresence-connect physician, optional telepresenter, and patient �Teleconsult-connect physician with another physician �Telemonitoring-connect physician or nurse with patient �Telesurgery-connect surgeon with patient during surgery JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 13

Telemedicine Uses in the Past and Present �Providing medical care in a warzone �Providing medical care to remote scientific stations and work areas such as oil rigs �Providing care in correctional facilities to prisoners �Providing care to military personnel through mass screenings using pictures and video as well as remote patient monitoring of vital signs JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 14

Telemedicine and the Internet �Patient education through texts, video, images �Medical images such as x-rays and scans �Real –time audio and video consultation �Vital signs and other measurements (ECG, temperature, blood sugar, weight, pulse oximetry, blood pressure �Engineers created increased data storage capabilities for large files and data JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 15

Present and Future Engineering Contributions �Increasing internet communication speed (bandwidth and latency) �Information storage (databases, object storage for large files such as images and video) �Back up servers for availability of data �Standard format transmission (MP 4, PNG, etc) �Security (encryption, password protection) �The Cloud-using virtual servers �Digitizing information (digital cameras, scanners, etc) JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 16

Computers are Everywhere �Average industrialized citizen has access to a computer or handheld device �Telemedicine 2. 0 is here �Telemedicine 2. 0 uses computing devices belonging to patients and physicians �Communicating over the internet �Using inexpensive equipment for gathering clinical data �Easy to use by the patient or physician without specialized training JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 17

Telemedicine 2. 0 Devices �Smartphone cameras �Digital stethoscopes �Opthalmoscopes (for eye exams) �Otoscopes (for ear exams) �Vital sign monitoring devices �Wearable biosensors �Many doctors are becoming “hybrid providers”- allowing patients to see them in person followed by or contemporary with the use of various devices JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 18

Main Categories of Telemedicine �Store-and-Forward, also known as asynchronous (patients fill out forms on the internet, take pictures of a growth on their skin) �Real-time, also known as live or interacting �Remote Patient Monitoring (RPM) JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 19

Store and Forward Telemedicine � Everyone is familiar with e-mail: You send a message and someone reads it later � In this method the doctor does not have to be present � The patient sends images, medical history, and other necessary clinical information � At a later time the physician or nurse practitioner reviews the data and creates an assessment, plan and diagnosis and sends back a response including prescriptions and instructions on follow-up care � Example: Dermatologists, using pictures and forms obtained from a patient can reach a diagnosis and plan of care with follow-up interventions as needed JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 20

Real Time or Interactive Telemedicine �Most people think of this category when they think of telemedicine �Speaking over the phone with your doctor or nurse practitioner is an example �Doctors can also do a secured line face to face encounter and be reimbursed for the visit online JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 21

Remote Patient Monitoring � Biosensors that can be used to monitor a patient’s biological signs � Currently being used for chronic diseases or specific medical conditions while recovering from surgery � Examples are blood pressure monitoring and blood sugar (glucose) � Heart rate, pedometer, sleep monitors and wearable respiration, brain activity and other sensor types are increasingly being used � Mental health screening JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 22

Advantage of Telemedicine �Can be convenient for the patient and doctor �Asynchronous communications including video and remote patient monitoring can evaluate a patient 24 hours a day �Education is key for the patient to understand that the doctor will be able to evaluate the various illnesses or conditions without having to be present even on an internet camera and that the patient privacy will be protected JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 23

Teleradiology-Where It All Began �Rise of technology of the 1990’s created a need for radiologists world-wide to be available to interpret xrays in distant places around the globe �The market for imaging has been growing 15% annually with only a 2% growth in new radiologists �Store-and-forward technology has helped increase productivity and allowed the industry to grow JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 24

Convenience and Access �From a patient’s perspective, convenience and access is very important �Telemedicine cuts down on office visits, wait time, and cuts the cost of travel for the patient and family member or other caregiver �Through technology patients can log in to a portal and visit their doctor while being monitoring remotely 24 hours 7 days a week JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 25

Time Saved by Medical Providers �The short time for a store-and-forward visit is a cost saver for a physician or nurse practitioner �An in-person visit is generally 10 -30 minutes �Asynchronous telemedicine takes 2 minutes to review, evaluate and act �Maximize practice efficiency and see more patients �Doctors can see the patient initially and then follow-up using telemedicine �Telemedicine can send reminders for the patient to visit on the internet, fill their prescription and for follow-up and discharge instructions in case of complications in order to decrease risk to the physician and more JOIN THE CONVERSATION BY VISITING importantly harm to the patient FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 26

Other Advantages of Telemedicine for Doctors �Detailed documentation using secured e-mail and video and audio with stored vital signs that can be reviewed any time and retained on large data bases �Educational Opportunities- Telemedicine can store the visit and information and medical students can review all the data and learn from the assessment, diagnosis and treatment without having to see that patient themselves. This can create greater learning opportunities without the time or cost involved for many learning institutions. JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 27

Barriers in Telemedicine �Patients becoming accustomed to telemedicine and physician response time �The cost of training staff and learning the technology �Medical Insurance Coverage �Potential conflict with being “on-call” �Integration with existing systems �Cost JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 28

Other Issues with Telemedicine �Insufficient Patient Information either by patient not entering the information or “skipping over it” on an online format �Solution: Follow-up. Telemedicine is only a tool and does not replace the patient being able to call the physician and see them face to face (through the use of internet secured communication) to ensure that the patient is still on the same medication and was satisfied with the telemedicine experience JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 29

REMOTE PATIENT MONITORING �Equipment to measure vital signs, blood sugar, weight, oxygenation and other critical measurements �Behavior monitoring can be used in mental health delivery to monitor movement, wandering, lack of exercise, or used to remind patients of an interaction or to prevent falls in the home �Personal fitness monitoring (how much someone walks per day and the effect on blood sugar, blood pressure or oxygenation) JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 30

Advantages of Remote Patient Monitoring �Patient and Physician Convenience �Decreased illness and death �Decrease hospital stays �Decreased cost of care �Early alerts to increased blood pressure, an elderly person about to fall out of bed, or lack of movement �Monitor heart rate, blood sugar, weight and oxygenation before a person becomes very ill JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 31

Remote Patient History for Analysis �The devices can track information digitally for years so that physicians can analyze the persons’ health and trends over time �How medicines effect the person over time �Which medical interventions worked and which did not �RPM allows doctors to see trends across different diagnoses and use this data to adjust their approach in an evidence-based manner to improve patient THE CONVERSATION BY VISITING outcomes JOIN FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 32

Hidden Benefits of Remote Patient Monitoring �Family and Patient’s Peace of Mind �Digital Audit Trail-reduced liability to the doctor due to stored information and ease to educate and consult with the patient �Allows the patient to become an active participant in their own care and to train to use devices that help make them feel in control JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 33

Negatives of Remote Patient Monitoring � Many devices to choose from � Patient inconvenience and feeling like “Big Brother” or the Government can watch their every move � Sensors may interfere with clothing or mobility � Much of the need for devices may be the decision of the children of the patient and loss of independence may be perceived by the patient � Monitoring device must be accurate and correlated to verify that measurements such as glucose, weight, oxygen levels and blood pressure accurate (nurse visit to the home periodically to verify use and accuracy) JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 34

Selecting a Vendor of Telemedicine �As in electronic medical records the move from paper to computer was slow and arduous and so is the move from the clinic to the home monitoring setting �Integration of systems must be present including the use of devices and the transfer of data to a cloud that the physician, or other health professional, and the patient can then access through a secured portal JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 35

Use a Vendor with Solid Technology �Use a company that stands by their product and has a solid technological foundation �Many organizations are not technologically based but are marketing based and do not really understand the product and thus concentrate on branding rather than efficacy �Engineers and doctors in a solid company work together for continuous quality improvement and belief in the product JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 36

Things to Look for in a Vendor �What is their performance record on fixing technological “glitches” ? �Customer Service Record �Is the product communicated clearly through all levels of management? �Does the engineer have a deep and varied technology background and can he get things fixed quickly from device to cloud to portal? JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 37

Customer Vendor Relationship �The relationship between vendor and customer is more important than the technology �Even with the best technology it is relationships and trust that matter �The vendor must understand the health care providers business and patient goals �The vendor must be dedicated to put the patient first over profits �“Take care of the patient and the money and profit follows” philosophy JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 38

Questions to Ask a Vendor �What is your experience with similar telemedicine deployments? �Do you have references from other customers? �How do you handle security and privacy? �Will you be able to handle the volume of my patients? �What other technology is on the horizon? �Customer support and warranty guarantees? �Does the vendor have qualified health care team members with experience to validate efficacy and patient and physician satisfaction? JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 39

Future of Telemedicine 3. 0 and Beyond � In 1924 in an article in “Radio News” a picture of a patient looking into a television with a stethoscope, real time heart beat and temperature sensors was shown with a boy looking at a doctor on television � Today this type of service is done regularly and has become a reality � Remote monitoring world-wide is the goal � Monitoring for post-operative care, pediatric care, chronic disease and care of the elderly is essential as the population ages in countries around the globe � In the future patients may choose to monitor their health from birth to death and profiles could be reviewed by your physician to optimize your life expectancy JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 40

Future Policies �Electronic Medical Records (EMR) must be secure and technologies must prevent “hacking” of records for destructive purposes �Additional Laws and Procedures May Have to Be Put in Place To Protect Citizens From Too Much Intrusion �People may need to be given the option of opting-in to monitoring or choosing not to participate �Public buildings are already monitoring biosensors and security JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 41

Future Medical Exams from Home �Head and Neck Exam �Abdominal Exam �Neurological Exam �Cardiovascular Exam �Pulmonary Exam �Psychiatric Exam �Dermatological Exam �Exam of the Extremities �Male or Female-specific exams �Laboratory tests �X-rays and Vital Signs JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 42

Future of Telesurgery � Haptic technologies provide physical feedback to the user by trying to recreate the sense of touch, motion, vibration, and other tactile senses � Haptic technologies are being used in today’s telesurgery systems � The use of Haptic technologies will increase in the Telemedicine 3. 0 are 2017 and beyond � Example: A surgery patient in California with a physician controlling a surgery robot in Houston, Texas. � Patients would be able to receive surgery from surgeons that are the top experts in the world without enduring unnecessary travel or time delays while receiving telemedicine monitoring as discussed in this presentation JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 43

Conclusion �Most medical practices will be using telemedicine 2. 0 by the year 2017 and most have already begun to transition to electronic medical records and some form of remote patient monitoring �Nurses, hospitals, home health agencies and other entities can assist the doctor to monitor this wide array of telemedicine services including engineers to enhance ease of use �AT FLORESLAWFIRM. COM we are striving to have engineers and technology meet physicians and patients in a positive manner and to get the job done right with positive patient outcomes and prevent disease and preserve the quality of life for all human beings on the planet JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 44

References � American Telemedicine Association. (2015, Aug) What is Telemedicine? [Online]. http: //www. americantelemed. org. /abouttelemedicine/what-is-telemedicine � Gunther Eysenbach, “Medicine 2. 0: Social Networking, Collaboration, Participation, Apomediation, and Openness, ” J Med Internet Res, vol. 10, no. 3, p. e 22, Aug. 2008, http: //www. jmir. org/2008/3/e 22/. � Justin Caba. (2014, Jan. ) Doctor’s Appointment Average Wait Time 18. 5 Days Across 15 Cities: Boston Patients Wait Average 72 Days or Dermatologist. [Online]. http: //ww. medicaldaily. com/doctorappointment-average-wait-time-185 -days-across-15 -cities -bostonpatients-wait-average-72 -days � Lyuboslavsky, Victor. Telemedicine and Telehealth 2. 0. A Practical Guide for Medical Providers and Patients. 2015. JOIN THE CONVERSATION BY VISITING FLORESLAWFIRM. COM. STAY TUNED FOR OUR FREE NEWSLETTER AND WATCH FOR OUR BOOK AND VIDEO SERIES IN 2017. ALL RIGHTS RESERVED. 45