JULY 25, 2019 THE MULTI-FACETED ROLES OF TELEHEALTH IN SENIOR CARE 2019 Ziegler Link∙Age Fund Symposium PRESENTED BY Grant Chamberlain Rob Rebak Dan Herbstman Ernie Ianace Managing Director CEO Co-Founder & CEO EVP Sales & Marketing Ziegler Forefront Telecare Third Eye Health VitalTech gchamberlain@ziegler.com rob@fftcare.com dherbstman@thirdeyehealth.net ernie@vitaltech.com B.C. Ziegler and Company | Member of SIPC & FINRA
MEET THE SPEAKERS Grant Chamberlain Rob Rebak Managing Director Chief Executive Officer Forefront Telecare Ziegler Healthcare Investment Banking rob@fftcare.com gchamberlain@ziegler.com Dan Herbstman Ernie Ianace Co-Founder & Chief Executive Officer EVP, Sales & Marketing Third Eye Health VitalTech dherbstman@thirdeyehealth.net ernie@vitaltech.com 2
FOREFRONT TELECARE – COMPANY OVERVIEW Rob Rebak Chief Executive Officer
THE PROBLEM: VERY LIMITED BEHAVIORAL HEALTH SERVICES FOR RURAL SENIORS • 75% of rural counties in the US (containing >20% of the US population) have no psychiatrists practicing • # of MDs continues to contract. NPs are expanding, but the geographical distribution is trending urban and away from rural areas • Federal and State Governments and State Medical Boards and facilities are recognizing the need to shift the clinical delivery models to support this changing clinical landscape – increasing support of Telehealth • Some rural hospitals and SNFs are struggling financially; innovative support is needed to meet the market need • Many rural facilities are currently passing on higher acuity senior BH patients for fear that they will not be able to care for them • Forefront’s objective is to enable higher census by supplying the BH professional resources needed to give facility operators the confidence that their staffing issues are solved for the long term 5
HOW IS FOREFRONT ADDRESSING THE PROBLEM? CUSTOMERS: Forefront focuses on meeting the behavioral health care needs where Senior patients go for their most acute care needs: – Skilled Nursing Facilities – Assisted Living Facilities – Hospital psychiatric Units – Psychiatric Hospitals – Hospital Intensive Outpatient clinics PROVIDERS: Forefront has established a network of medical practices, currently in 26 states and expanding to 31 states by the end of 2019, to give us the ability to contract with CMS/insurers and bill for professional services for our own providers TECHNOLOGY: Forefront has developed and provides to its partner facilities all the telehealth technology needed or will integrate with existing telehealth systems at no cost to the facilities. (i.e. – a rural SNF or hospital has no capital equipment to purchase or software to lease to enable Forefront providers to service their patients) 6
WHAT ARE THE BENEFITS OF FOREFRONT’S SOLUTION? Hospitals: – Forefront provides 24/7/365 On Call to respond to admission referrals and handle after hours patient care needs – Daily rounding for In-Patient Psychiatry units, IOPs, Psych Hospitals to provide maximum quality care and treatment monitoring, plus ASAP discharge processing – Full Unit Professional Permanent Staffing solutions for hospitals: • MD rounds treatment teams once per week; • NPs round daily to operate whole program or – Forefront’s current hospital partners have doubled their average daily census (ADC) in the first 60 days SNFs: – Service is FREE for SNFs – Forefront provides weekly rounding for both psych medication management and GDRs plus talk therapy as needed. – Forefront handles all insurance claims filing for our providers – Document use of antipsychotics or transition to other meds 7
FOREFRONT’S FOOTPRINT FOREFRONT’S FOOTPRINT SNFs Hospitals Clinics Jails 8
HOW WE PRICE OUR SOLUTIONS • SNFs are FREE in Rural areas – We supply all the technology – We supply all the professional staff – We bill Medicare and Medicaid for all services – SNFs supply just an internet connection and organize the patient flows • Hospitals are billed for On Call and Medical Director fee only. Typically at 30 to 50% of what they are paying now for less than 7 day coverage – We supply all the technology, or we will integrate with existing – We supply all the professional staff for 7 day coverage – We bill all insurance companies for professional fees – Hospitals supply just an internet connection and organize the patient flows 9
THIRD EYE HEALTH – COMPANY OVERVIEW Dan Herbstman Co-Founder & Chief Executive Officer
WHO WE ARE Technology and medical services organization focused on providing 24/7 telehealth coverage, tasked with meaningfully reducing hospital readmissions. Telehealth Technology – Mobile first with a telehealth focused EHR Physician Practice – 70 physicians and 6 nurses Five Years in Operation – Focused in post acute for three years HQ in Chicago – Offices in Boston, Dallas, and Austin Backed by Industry Leaders 11
THE THIRD EYE HEALTH NETWORK The largest telehealth post acute network in the United States. • 26 states covered • 250 centers connected • 300 centers contracted • 25,000 patients under care • 2,000 patient consults a week • 25% average reduction in RTH • 3X average ROI 12
WHY WE ARE DIFFERENT Intuitive Technology Physician Team Implementation Care Coordination and Support 13
THIRD EYE HEALTH APP 14
PHYSICIAN TEAM Connect to our physicians within two minutes of a request. • Specially trained doctors – post acute emergency medicine • House doctor model – same five or six doctors per center • Proactive visits – visit with all new/at-risk patients to start every shift • Rounding model – same doctor stays with patient through their shift • Complimentary to primary care – no billing interference 15
CARE COORDINATION Technology and care team work to eliminate care gaps. Nurse Coordinator Physician Technology Health System Relationships • Works with DONs and • Completes all notes by • Care coordination portal PCPs to identify high risk end of shift. to securely communicate • Work with hospitals to patients before every shift. • Communicates with • EHR integration, bi- define protocols and • Contacts all DONs and facility and PCP if needed directional interface workflow . PCPs to transition care of during care transitions. allows for real time view patients. of patient. • Communicates with patient family when needed. 16
IMPLEMENTATION AND ENGAGEMENT On the ground team working to continuously improve outcomes. • MD to MD conversation – in person program overview meeting to gain trust • In person training – training team led by former nursing home administrator • Account manager model – keep users trained, engaged, and happy • Weekly reporting and meeting – short weekly meeting to discuss utilization, engagement, value and hospitalization data • Marketing Support – help develop materials and content for health systems and patient/families 17
CUSTOMER BENEFITS Improved Clinical Care, Financial Benefit and Satisfaction • RTA Reduction – 25%+ reduction for average customer • ROI – 3-5x ROI based on bed hold reduction and reduction in VBP penalties • Partnering with health systems – marketing advantage for getting in and staying in preferred SNF networks – share data via care coordination alerts • Staff satisfaction and retention improvement – nursing team is supported with physicians available immediately and no night or weekend call for your physicians • Patient and family satisfaction – supported in-house for all care needs 18
VITALTECH – COMPANY OVERVIEW Ernie Ianace Executive Vice President, Sales and Marketing
Leveraging IoT, Big Data and Advanced Analytics to Lower Costs and Improve Outcomes for a Growing Population “The future is now….a fully integrated healthcare ecosystem.” 20
iQ – A COMPREHENSIVE CARE PLATFORM Digital Technology Transforming Connected Health for Seniors Data Inputs iQ Patient care smart platform BLE Medical Devices Personal Emergency Response Smart Home 3 rd Party Activities of Daily Health and Living Databases Wellness 21
UNPRECEDENTED INSIGHTS INTO SENIORS’ HEALTH DATA Improved Care thorough Continuous Actionable Data Bystolic 20mg Last Filled: 5/22/18 Prescriber: Lopez Atorvasta tin 20mg Easily input nutrition and Last ADL ActivityTags are placed exercise goals to promote Filled: Streaming data is in the home to monitor for subtle changes in behavior. 4/28/18 viewed by users, deviations in day to day Medication Prescriber: family and care activities. adherence through Thompson teams. Machine pushed reminders. learning and user inputs trigger alerts when vital signs are out of range. 22
SOS Alerts Automatic fall detection Panic alert button Voice controls for emergency voice call out Alerts are sent to caregivers via text, email, phone Vital Signs Heart rate Respiration rate *Adds wi-fi and LTE *GPS for geo-fencing Sp02 and geo-tracking ECG Step count, calorie count Additional Features Fully waterproof & sweat-proof so the wearable is never removed Untethered on wrist charging for 24/7 safety *Vitals are turned off for Optional 24/7 emergency services extended life battery *locking band for Medication reminders and messaging to the watch memory care patients Access control with BLE or RFID *GPS for geo-fencing and geo-tracking 23
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