Telehealth Presentation Dealer Conference

1. Telehealth Presentation Dealer Conference

2. Standard Disease Management Office Visit Office Visit July January January Office Visit • Lose Wt • Exercise • Lose Wt • Exercise • Lose Wt • Exercise Why Doesn’t This Model Work?

3. Reality Diabetes Treatment Office Visit Office Visit Office Visit July January January • Lose Wt • Exercise • Lose Wt • Exercise • Lose Wt • Exercise ER Visit or Hospitalization $$$$$$$$$$$ ER Visit or Hospitalization $$$$$$$$$$$ Reality… modifying long-standing diet and exercise habits is difficult and most patients cannot sustain any short-term gains So, they do nothing and end up in an Emergency Room or are admitted to the hospital from complications of the disease

4. VRI Disease Treatment Office Visit Office Visit Office Visit July January January • Lose Wt • Exercise • Lose Wt • Exercise • Lose Wt • Exercise DAILY VITALS MONITORING INTERACTION WITH CASE MANAGER AND CLINICIAN Monitoring & time sensitive interaction increase compliance; reduce unnecessary hospitalizations & ER visits; and refer patient visits to less costly treatment venues. ER Visit or Hospitalization $$ ER Visit or Hospitalization $$ Need for Institutionalized Care

5. VRI Turnkey Services • Equipment Installation/logistics – We are one of the few companies in the US that can install and maintain equipment across a large footprint. No longer do you need to store on your shelves. • Vitals Monitoring – We maintain our own 5 Diamond medical only monitoring center and currently monitor 50,000 customers. • We ensure that patients take their vitals. If they don’t, our monitoring center is alerted and we call the patients to ensure adherence. If they don’t respond, we can, if necessary get clinical professionals and or other caretakers involved. • Upon exceptions to the vitals data, we call the patient to ensure that they are not in need of medical attention. We then call a clinician or caretaker to notify them of the exception so they can respond as appropriate. • Financing – We allow you to rent equipment and therefore you can scale your program without large upfront capital commitments. • Data Integration – We can integrate this data, alerts, and actionable items into an online medical record. Given VRI’s monitoring expertise, we are one of the few companies that can offer a full range of services

6. VRI Equipment • Blood Pressure and Heart Rate – We use the A&D Medical 767PC , one of the best validated blood pressure monitors available. Blood pressure is most often used with patients that have congestive heart failure and hypertension. • Weight Scale – There are a number of different models used that connect directly to our telemonitoring unit. Scales are most effective in controlling obesity in diabetes patients, detecting early warning signs for CHF, and hypertension. We can provide a wired or wireless version • Blood Glucose – We are compatible with 90% of the glucometers on the market today. Therefore, the patients does not need to switch glucometers to participate in the telehealth program. • 02 Saturation (pulse oximeter) – Worn on the fingertip of the pointer finger, this device determines the level of oxygen in the blood. VRI supports the widest portfolio of products in the industry and EASY TO USE!!

7. VRI Monitoring Process (General) Reminders Notification of non-adherence event Exception Monitoring Live reminder if signal is not received within expected time Follows notification hierarchy based on patient specifics Monitors for data readings outside of pre-set limits Contacts patient to validate that technology is functioning properly Provides non-clinical reminder function to self-management program Enables responder to provide just in time coaching to reinforce behavior change Notifies designated responder that exception has occurred Responder initiates real-time behavioral coaching Real Time Data Improved Clinical Outcomes Reduced costs of CM/CCM interventions and program administration 7

8. VRI’s Care Management “Laboratory” • Being hands-on Care Managers with telemonitoring devices is a key VRI CQI driver. • VRI invested in telephonic nurse care management for a client MCO’s diabetes population in South Texas. • Our experience: Average HbA1c decline of 1 point over 5 months 8

9. Telemonitoring vs IVR (for Heart Failure) Source: VRI Technology with 200 patients 9

10. Studies of CHF Telemonitoring Impact [1] Benatar D, Bondmass M, Ghitelman J, Avitall B. Outcomes of chronic heart failure. Arch Intern Med 2003; 163: 347-352 [2] Dimmisk SL, Burgiss SG, Robbins S, Black D, Jarnagin B, Anders M. Outcomes of an Integrated telehealth network demonstration project. Telemed JE Health 2003; 9:12-23 [3] Finkelstein SM, Speedie SM, Potthoff S. Home Telehealth improves clinical outcomes at lower cost for home healthcare. Telemed JE Health 2006;12:128-136. [4] Jerant AF, Azari R, Nesbitt TS. Reducing the cost of frequent hospital admissions for congestive heart failure: A randomized trial of a home telecare intervention. Med Care 2001;39:1234-1245. [5] Lehman CA, Mintz N, Giacini JM. Impact of telehealth on healthcare utilization by congestive heart failure patients. Dis Manage Health Outcomes 2006;14:163-169 [6] Scalvini S, Capomolla S, Zanelli E, Benigno M, Domenighini D, Paletta L, et al. Effect of Home based telecardiology on chronic heart failure: Costs and out comes. J Telemed Telecare 2005; 11(suppl 1):16-18. 10

11. Screen Shots Dashboard Search Functionality

12. Screen Shots Extensive Chart and Graphing Features

13. Target Markets

14. Target Markets

15. Questions?