UKRC Technology required to deliver nighttime teleradiology service Shannon Werb

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1 UKRC 2014 Technology required to deliver nighttime teleradiology service Shannon Werb June 11, 2014

2 Agenda About vrad Teleradiology Technology Platform approach Technology focus People and Process behind Technology Recruiting, Licensing & Credentialing, Operational Support, and Quality Assurance Subspecialization, Performance Management, Privacy & Security, Innovation Where is the Market Heading? 2

3 vrad Fast Facts We are the world s largest radiology practice: 400+ radiologists, 75% subspecialty trained Over 3,000 hospitals, health systems and radiology groups served 19,000 daily reads; 7 million+ annual studies The largest and only standards of care benchmarking platform (vrad RPC SM Index): 25 million+ studies, growing at 600k per month U.S.-based 24x7 operations and technical support center Ongoing investments ($50MM) and development of radiology innovation: 14 issued patents, 1 pending #38 on Information Week 100 for Winning Digital Strategy in 14 Frost Innovation Award for Imaging Analytics in 14 3

4 The vrad Platform by the Numbers Metric Item $50M+ Total Investment in Technology Platform 25M Number of Radiology Exams in vrad Platform (and growing) 21,725 Current 24 Hour Actual Study Volume Record 2,200+ Number of Hospitals Networked to vrad 28,000+ Discrete Imaging Sending Devices In Above Hospitals 500 Discrete Interconnected HIS/RIS/EMR HL7 Interfaces 14 Patents Granted 1 Patents In Progress 450 Radiologist Destinations for Interpretation (home/hospital based) 4.5 Gigabits Billions of Bits per Second of Current internet capacity 3.9 Terabytes Trillions of Image Bytes moved in peak 24 hour periods 4

5 Proven Scalability > 500k St/Month NHWK Volume > 450k St/Month 5

6 Room to Grow Overnight Trends Relatively Idle Days 6

7 Technology Enabled, Full Service Radiology 7

8 8 Virtual Practice Technology - Radiology

9 Evolving Technology Product Vision Integrated Technology Enabled Radiology Professionals Radiology from Start to Finish The Best Radiologists INSIDE Innovative Technology Diagnostic Image Viewer Integrated in vrad EC Integrated in EMR Data Normalization Operating Model Quality Discussion Operating Model Driven Onsite Radiology Solution Referring Physician Tools Web or Mobile Web EMR Mobile Get the Cases to Radiologist Measure, Report, Improve Next Generation Integrated Platform Modern Electonic Access To Results 9

10 Core To the Virtual Practice Patented Case Assignment Technology Rules-Driven Assignment Engine General MSK Neuro All Available Radiologists Best Available Radiologists General Neuro Internet Pediatric General 3 MSK Breast ASSIGNMENT Assignment RULES Rules License & Credential Subspecialty Facility Preference Current Worklist Depth Remaining Time Cardiac Neuro Continuous Evaluation For ENTIRE Practice Apply Rules to EACH Case Assign Additional Radiologists As Needed Nuclear General Cardiac 10

11 11 Integrated Technology Solution Customer Facing: Order Management System

12 12 Integrated Technology Solution Internally Operational: Operations Center Worklist

13 13 Integrated Technology Solution Internally Clinical: Radiologist Worklist

14 14 Integrated Technology Solution Internally Clinical: Radiologist Workstation

15 15 Integrated Technology Solution Customer Facing: Web Results Integrated Reports and Images

16 Integrated Technology Solution Internal Business Systems Internally manufactured and integrated business systems Licensing, Credentialing, Enrollment currently being replaced by COTS Physician Services Forecasting Scheduling Radiologist Compensation Client Invoicing 16

17 People and Process Behind the Technology 17

18 Expertise and Asset Portability The Details Physician hiring, motivating and retaining for efficient and quality care Rigorous clinical testing prior to hire Subspecialty focus State-of-the-art workstations and software tools for greater professional satisfaction 24x7 Operations Center Support Physician communication coordination (including follow up recommendations and addenda) with 1 number access All critical findings, trauma protocol, stroke protocol, other requests rapidly facilitated Real-time TAT monitoring Relieves physicians of non-critical tasks Dedicated IT team Licensing and Credentialing Affiliated physicians must be approved by each of the institutions for whom they read. Joint Commission-accredited since 2004; expedites the credentialing process Critical process to ensure proper and most cost efficient staffing coverage and specialist availability 24x7 Proprietary software tools to facilitate licensing and credentialing processes Quality Assurance Formal review committee following standardized process 100% preliminary report review 1% random final report review 18

19 Robust Operational Infrastructure Operations Center 24 / 7 / 365 live operations and technology support Real-Time Order Management Turnaround time management all orders monitored Always available to physicians, technologists and staff to minimize client administrative/non-clinical workload Communication One-stop, centralized physician communication coordination Direct access to radiologists via one phone number or online chat All critical findings, trauma protocol, stroke protocol, other requests rapidly facilitated Operations Center Snapshot Statistics for March 3, 2014 (24 hr. period) Number of studies handled: 15,566 Number of images handled: 1,237,743 Number of inbound calls: 858 Number of outbound calls: 2,200 Number of faxes: 2,200 Number of online chats: 450 Number of findings where we connected vrad radiologist to referring physician: 550 Technical Support Dedicated IT team available 24 / 7 / 365 Continuous monitoring of image transmission and internal systems 19

20 Subspecialize, License, Credential/Privilege Extensive Subspecialty Expertise in Off-Site Network Radiologist Licenses All 50 States Subspecialty # of Rads Body 79 Neuroimaging 51 Muscoloskelatal 35 Vascular 19 Nuclear Medicine 9 Pediatric 9 Cardiac 7 Women's Imaging / Mammography 4 Chest Licenses Licenses Licenses Licenses Less than 50 Licenses 20

21 Expertise and Asset Portability The Details Report Distribution and Subspecialist Utilization Secure connectivity and digitization, capable of rapid transmission of lossless images Automatic order routing based on modality, subspecialty requirements and criticality 24/7 consistency High-quality, thorough, structured report content Information Privacy and Security HSS compliant: encryption, data destruction and PHI security Global data backup and recovery Electronically monitored, secure access to corporate HQ and Ops Center Employee background checks for access to PHI Data Privacy Officer/HIPAA Compliance Management Performance Management Specific requirements for Emergent, Critical Findings, Trauma, and Stroke TAT Innovation 14 issued telemedecine workflow patents, with additional data normalization patents pending Ongoing improvements for efficiency, quality-control and client satisfaction 21

22 Where is the Radiology Market Heading? 22

23 [only from] A living library of statistically significant metrics that provide hospitals, radiology groups and health systems with objective comparisons of their imaging use to national averages and relevant peer groups. Derived from normalized, aggregated and anonymized data in vrad s radiology clinical database (25+ million imaging studies from over 2,000 facilities). Three RPC Indices released to date: CT in the ED Accounts for approximately half of all U.S. hospital admissions is a major driver of costs and a focus treat to street operational efficiency. Regional and state-specific metrics For use and effectiveness of CT imaging in EDs nationwide. Day In the Life of Radiology : 24/7 view inside a radiology department, using interactive infographics that show study RVUs* (Relative Value Units, which are a critical measure of an imaging study s economic value), modality mix, patient type and reading location by three distinct radiology shifts. Indices are free and for unrestricted use at 23

24 Rad Group 2.0 (RG2) vrad and You Fully-Integrated Growth Practice Model Improve Quality Lower Costs Provide Service Levels Operational Efficiencies Operations Center vrad Cloud IT Support QA Subspecialists Cloud Technologies IR Relationships Tumor Boards Onsite Radiologists Operating Plan Grand Rounds Women's Imaging

25 Q/A Contact Information Shannon Werb Chief Information Officer p

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