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Yorktel Aims to Fix Telemedicine Woes

Video managed services provider Yorktel has parlayed the experience gained in the last five years providing in-room video conferencing endpoints into a first-of-its-kind managed video healthcare service that includes everything a healthcare system needs to connect hospitalized patients with offsite doctors and others.

The managed telemedicine service, called Univago Healthcare Edition (Univago HE), comprises hardware, software and licenses, and analytics and reporting.

All-In-One Telehealth

On the patient side, Yorktel has developed purpose-built wall systems and movable bedside carts as part of the Univago HE offering. These feature a hardened Unix-based codec; an anti-microbial enclosure; and the speakers, microphones, and other electronics needed for the telemedicine sessions, said John Vitale, SVP of product management at Yorktel.

The initial offering supports integration with ICU workflows, such as patient monitoring and telestroke assessment, with integration made possible via Univago APIs and SDKs. The video runs on Yorktel's established Univago cloud video platform -- which already handles about one million minutes of video conferencing per month globally, Vitale noted.

On the clinician side, Univago HE features a WebRTC-enabled application that facilitates browser-based video conferencing, as shown below.

Healthcare system telemedicine administrators can use the Univago HE portal to self-provision services and to monitor and manage their environments in real time. Technicians within the Yorktel video network operations center manage and monitor customer environments, as well.

To meet healthcare security and privacy concerns, Yorktel hosts the Univago HE service platform in hardened SOC 2-certified data centers, meets HIPAA compliancy (independently verified by Pivot Point Security), and has received ISO 27001 certification.

A New In-Room Model

With Univago HE, Yorktel hopes to move beyond the break/fix mode associated with today's in-room video conferencing systems, said Peter McLain, SVP of healthcare, at the company.

"If you're in a critical care ICU with patients who are very sick, you can't be going in and out of that room twiddling around with the equipment to get it to work. It needs to be installed and left alone to just run," he said. "We have to be able to manage it remotely."

And, should an equipment component need to be replaced, that can now be done in 10 minutes or less, McLain said. The wall and cart systems use hot swappable modular components stored onsite as part of the managed service offering, he added.

These are among the lessons Yorktel has learned and observations made in delivering more than 4,500 video conferencing endpoints to 200 to 250 hospitals in three dozen or so healthcare systems, in partnership with Philips, McLain said. When Yorktel got involved with telemedicine, it did what everybody was doing -- "grabbing off-the-shelf video technology, throwing it into the patient environment and expecting it to work," McLain said. But that technology really wasn't built to deliver on the demanding 24/7 requirements of clinical care environments like ICUs, he added.

Oftentimes, technicians would need to go onsite to unfreeze equipment, free up memory, or otherwise deal with system reboots, McLain said. Reliability affects usage rates, as clinicians lose confidence in telemedicine programs if they can't easily and readily dial into or out of a patient's room, he added.

This has been a deterrent to adoption. "There are a lot of health systems that are starting to move toward telehealth strategies, but for the most part they are still in pilots or have one siloed program, like telestroke. They haven't expanded because the equipment isn't reliable or dependable enough, or the user interface is still too complicated, and so there are a lot of carts sitting in closets right now," McLain said.

With Univago HE, Yorktel's goal is for the technology to fade into the background, so doctors can focus on their patients rather than having to fiddle around with technology and disrupt care, McLain added. Additionally, by enabling integration of multiple workflows, Univago HE will allow hospitals to reduce their use of single-purpose carts within hospital rooms. In a typical ICU room, you might have five different carts from five different suppliers running on five different platforms -- "it's just overwhelming to them, and they can't manage that at all."

ICU and Beyond

While Yorktel initially is offering Univago HE, introduced today, for ICU workflows, it intends to release additional workflows as well as hardware for all the other hospital rooms, too, Vitale said. That hardware will meet a lower price point for mass deployment, he added.

Yorktel has been showing Univago HE to existing customers since the spring, and has been conducting alpha and beta testing throughout the summer. General availability is slated for later this month, Vitale said. Yorktel is estimating that it will have upwards of 500 system deployed this year, and 3,000 next year, he added.

To put the opportunity into perspective, Vitale said Yorktel is involved in about 5% of ICU beds in the U.S.; its partner, Philips, has about 15% of ICU beds in the U.S. "So even with them, that's about 10,000 beds, and there's still about 85% of the market that's untouched." Additionally, he noted, for every one ICU bed, a hospital typically has 10 beds in other units.

Yorktel is offering Univago HE in a per-bed monthly subscription model that includes all equipment, services, software licensing, applications, and workflows. This opex model more accurately matches how hospitals are paid for their services, Vitale said.

In addition, Univago HE ultimately will be able to support outpatient or post-acute workflows as well, so eventually somebody could just download an app or go to a Web portal rather than using the in-room hardware, Vitale added. "Hospitals can create a vision and expand their telehealth programs without having to worry about extensive cost and reliability they've been worrying about today."

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