7.30.2021
Event Recap

Future of Public Safety with Verizon First Responder Labs

By: 
Lake Nona 5G Team
The Future of Public Safety with “Verizon First Responder Labs”

About

Real-time technology is unlocking new solutions in public safety like remote medical monitoring, AR tools for first responders, and on-call medical assistance. In this conversation we talk with the Verizon 5G First Responder Lab who is exploring innovative technology that’s helping first responders act even faster in times of crisis. Building on our last conversation about smart technology for public safety, we explore how these emerging applications could operate in connected communities, and where else we’ll see them adopted in the near distant future.

Highlights

Efficiency –– The future of healthcare is going to be able to implement better communications that will allow first responders to accurately treat patients with efficiency and correct relocation. The end-to-end emergency response has great potential for improvement.

A Widened Lens –– Verizon’s 5G Living Labs have brought intersectional teams together to widen the lens for approaching healthcare and communication. By seeing multiple perspectives within the industry, it is possible to find innovative solutions moving into the future.

Accessible Healthcare –– Moving into the future, the goal is to provide comprehensive and fully accessible healthcare to anyone in the world by harnessing the abilities of technology to expand what is possible in the realm of treatment, whether it is acute or primary.

Highlight Video Coming Soon

Transcript

Cathy Lester  0:04  
Hello, everyone, and thank you for joining us on your Tuesday afternoon for part two of our public safety events series. Today's conversation with Verizon and Lake Nona, the future of public safety with the first responder labs will be an exciting conversation about the future of public safety powered by 5g. My name is Cathy Lester and I have the privilege of just sitting at the intersection of innovation, technology and healthcare for Verizon Enterprise Solutions. For those of you unfamiliar with Lake Nona and what this smart city is doing, Lake Nona is setting the stage as one of the first fully connected communities where technology based solutions are piloted among businesses, as well as thousands of residents. The Living Lab is powered by Verizon 5g ultra wideband, thus enabling real time data, data analytics and exchange across all sectors including health care, mobility, wellness, education and retail. Together, Verizon and Lake Nona are making it possible for enterprises to introduce innovation with more resources, less barriers, and helping to close the gap between ideation and real time application deployment. Today, we'll be discussing what that looks like as it pertains to public safety. The goal of the 5g Responder Lab is really to explore the boundaries of 5g technology to create and co-create new applications and hardware, and rethink what might be possible in a 5g enabled world. As part of Verizon's continued commitment to invest in public safety and the support of the first responder community, we've chosen five companies to take part in the fourth cohort of the 5g First Responder Lab. These companies are working together to accelerate the development of 5g solutions to address the common challenges along the entire EMF patient journey, from pre-incident and emergency response to treatment and recovery, all powered by Verizon's 5g ultra wideband. So without further ado, I would like to introduce our experts who are here to join the conversation, all of whom have extensive backgrounds in public safety and the technology sectors. So how about if we start with you, Alan, if you have a chance, could you introduce yourself? Tell me a little bit about your current role and the work that you're doing at Visionable?

Alan Lowe  2:31  
Oh, yeah. Oh, thank you, Cathy. Thank you everyone, and nice to meet you. So yeah, my name is Alan Lowe. I'm the chief exec and of the cofounders of Visionable. My background is that I worked in the UK national health system running cancer services for over 10 years. And what we did at Visionable, we created an advanced clinical collaboration platform which allowed physicians, nursing teams and the whole healthcare team to link video data in an unrestricted way. How we've applied that is in a number of clinical pathways. One example that relative to today is the stroke pathway from the pre-hospital admission to the treatment to the recovery and rehabilitation at home. So we do clinical pathway and digital enablement as a company.

Cathy Lester  3:25
It's fantastic. The work you're doing is really quite remarkable. Let's move on to Todd at Rave Mobility. Tell me a little bit about about yourself and the role that you're working.

Todd Miller  3:34  
Thank you Cathy, and thank you to everybody for joining today. My name is Todd Miller, SVP of Strategic Programs from Rave Mobile Safety. At the heart of it Rave Mobile Safety is all about connecting communities, enabling safety communications and collaborations. We believe that safety is a core human right. Everyone has the right to be safe where they work, live, play, go to school and congregate. And we think that technology is a big piece of that. In fact it's critical to process, so our mission at Rave is to provide a critical communication and collaboration platform that's trusted to help save lives across the world. We've worked with communities large and small from Chicago to Seattle, from the Nassau County, New York to Florida. And we're really proud to be a part of this project today. I'm looking forward to conversation.

Cathy Lester  4:30  
I love the idea that we're saying communication matters. We want to keep everybody connected, and is there a better mission than helping everybody stay safe? So I think that's awesome. Thank you. And how about you, Devin? Love, love, love to hear about what you're doing with dispatch health - a really interesting market space. Tell us a little bit about you and what you're doing.

Devin Paullin  4:49  
Thank you Cathy, and thank you, Todd and Alan, as with everybody. Very happy to be here and have the opportunity to speak to everybody and participate. My role and responsibility is I'm the Vice President of Commercial Strategy for dispatch health. And what I do there is really work to identify those unique partnerships of value that fall outside of our traditional relationships we have with health systems and with health plans, and at dispatch health. Joining this kind of group of disruptors on this call on this panel, our focus is really to build the most advanced level of care in the home, to take that care continuum today and extend it so that not just primary care, but for us being able to deliver acute, urgent non life-threatening care in the home. And to help relieve some of the stress that goes on in the hospital in the health system, where non life-threatening, non critical, but high acuity care needs to be had where it can be delivered in a more comfortable setting. And in the context of this, where this can be really unique and working with the partners is not everything that happens on scene in an emergency or disaster requires a trip to the emergency department, and what care can you provide on site. And that's the role being integrated with technology and communication that dispatch can fill in this partnership. We're very excited to be a part of this discussion.

Cathy Lester  6:11  
Oh, it's absolutely fantastic. I love the idea of it being disruptors. Because if there's a market that's ripe for change, it's definitely the healthcare space. Definitely what we can see in that pre-hospital care role. So before we kick things off, I just want to remind the audience that we are doing live Q&A - that feature is open, so feel free to drop your questions in. There's an icon on the right side of the screen to drop your quick Q&A in there. We'll get that taken care of towards the end of the conversation. So let's jump right into things. I'd love to hear from all of you about what you're seeing in the future of safer communities, public health, that whole public health ecosystem. How are you identifying the challenges that you believe are the biggest facing this particular EMF community? And how are you figuring out what's worth addressing? What are the big challenges that you think are best to be addressed? Alan we can start with you, what do you think?

Alan Lowe  7:14  
In the EMS community, I think it's the the ability to bring that expertise to the patient as soon as possible. I think you sort of see the split in different areas between rural and urban, and the challenges that they face in some cases, getting a vehicle across you know, I'm talking about you can imagine the traditional angry English countryside with cows going across and so on. So time is of the essence. And it's also when you get there there, it's the ability to bring that expertise immediately, ultimately, and then the other thing here is about emission avoidance. Do you need to take that patient to the hospital taking up a bed, taking up the ER, a triage team? Or could the patient be appropriately reset or re-seen in another location? So we're looking at the new models, pathways, and obviously, the ambulance piece, the start of number of pathways from stroke, to trauma to so on? I think the biggest challenge we are seeing is how can that get to patients caught in life threatening situations, upskilling the EMS team to use a more appropriate diagnosis, but also their mission avoidance piece?

Cathy Lester  8:32
I think that's absolutely brilliant. Thoughts on possibly to address one of the big problems that we're seeing in market now about work? Workforce shortages, workforce challenges? How do you see that actually being one of those issues that this will help focus on as well?

Alan Lowe  8:49  
I think that's the biggest challenge, you know, prior to COVID. It's the one thing people aren't talking about enough, is the global shot as your workforce is four and a half million at the moment, and it's set to get a lot lost. So it's crucial - how do you share that expertise appropriately and have total efficiency in the system? I think that unless these types of solutions that Devin taught the level as the solution to that problem, because you fast forward 15 years, there is going to be a different model of healthcare. Because there's no other way to do it.

Cathy Lester  9:24  
Yeah, not enough people. Oh, that's actually wonderful. Todd, how about you? What are you seeing in terms of the big challenges that that Rave is focused on and some of the big issues that you're prioritizing?

Todd Miller  9:36
What's interesting, Cathy, you touched on this - it's part of the introductory to this question. You talked about the ecosystem that's involved here. And I think that's a really important point to bring up. It is an ecosystem. But is it always treated like an ecosystem? And the answer today is no. We think that you need to bring these components together in a more cohesive manner. And I think that's sort of the beauty of 5g and what we're doing with the lab here, but from a rate perspective, what we saw are a bunch of siloed entities that all had the same goals, but different technologies, access to different types of information, even when dealing with the same patient. 911 doesn't know what the ambulance knows, doesn't know what the hospital knows. Why is that? Can we break down those barriers? And so for us, a lot of that is really treating it like an ecosystem, and ensuring that, well, here's the reality - we have the ability to collect a lot of data directly from the public things like health and medical information and rescue requirements, things that are pertinent within the emergency response, when they dial 911 in need assistance. But frankly, it's also really important to emergency management. And if there's going to be a wide scale disaster and they're going to be evacuating the public, wouldn't it be nice to know who has a medical dependency on electricity, right? So being able to share that type of information across the full spectrum of that ecosystem is really key. And so I encourage all of us, and I'm really excited to be part of this project, because it's all about knocking down those unnatural barriers, because again, we all have the same goals in mind, which is just like Alan said - we have to improve the end to end emergency response. There will be a new model of healthcare as we continue to break these barriers down.

Cathy Lester  11:28  
I think it's absolutely brilliant. I totally agree. It is about working together and sharing that information. Because I do think it's really insightful. When you say that this the one viewpoint of the patient, there's not one viewpoint of the patient. The only person who has that one viewpoint is the poor patient, right? Who has the least amount of capability of solving the problem. So interesting on that, Devin, tell me about what it is with dispatch on the challenges and the big issues that you're focused on, and where you see the biggest fix.

Devin Paullin  11:58  
I have very similar views in both areas that Todd and Alan describe. And I think I'll get very specific and add to that and which for us, where we see things today, the technology has to enable the ability for quick and urgent communication of need. I think we all agree with that. The 5g Lab is designed to help us do that. So you've got partners at various pieces in the workflow that need to communicate to deliver the patient information - what's going on, what needs to be known on scene, and all of that work is going to go on. Then there's a whole other aspect that we discovered, which is training at the individual level. We have to get people comfortable with changing their behavior. So for us even though it seems very simple, that oh, on the scene, you could have or in a home or in a particular medical emergency. Yes, having somebody like dispatch come in. And we come in with the vehicle, fully certified CLIA lab capability, we have an NP or a PA prescribing level practitioner, along with the medtech, we're bringing that full service in, sounds great, it makes a lot of sense. But it's the training upstream that allows somebody within a PSAP or that local SMS provider to know that, oh, I've got another partner. So instead of everything being immediate emergency transport, there's another decision I can make. And that is a people decision. That is a training decision, that is having discussion at the ground level in every county and every community and every market. So as much as technology enables what we're doing today, that's one core thing that we have to be very focused on, is the education and training and changing behaviors. That's very important to this, and we're very passionate about it with the team and partners. And we're having these types of programs run today - we're doing programs in Richmond, Virginia, and several other areas where we're actually working with local EMFs. We could possibly ride along with them, we could possibly be there to have them call us into situations where we remain on scene while they leave to attend critical emergency, life threatening situations and transport. So that's for us and then as the ecosystem evolves, I think as Todd was saying, for us, it's also diagnosing and putting that information back and getting to other partners who are addressing SDOH needs. So whether it's food insecurity or social isolation, it's getting that information and then working with other partners, getting that information to those who can help and assist down the road. Not just closing the loop, but also getting those potential patients and individuals to other key services they need. And that's part of the ongoing challenge and opportunity we're working in day to day.

Cathy Lester  14:02  
So I love that I've heard a couple big prevailing themes that are going through. It is an ecosystem, right? We must work together collaboratively to figure out how to solve these problems. And it's not just at the point of initial impact, right? Whatever that one initial event is, it doesn't stop just there. It continues down the entire lifecycle. Understanding how we all work together is pretty interesting. So it's a great segue. The rise in the first responder cohort program is pretty interesting. And this is a special grip, you are a special, special team. Because rather than looking at a common problem, we're looking at a common integration of everybody working together to figure out if we put all these things end to end. How do all the dominoes fall? So it's probably been really interesting for you all because everybody's kind of working collaboratively and co-innovating together. So what's it been like? What's it been like working with Verizon and the First Responder Lab? And where are you seeing the biggest impact of where you think things might be able to scale? Let's mix it up a little bit. Todd, tell me what you're thinking.

Todd Miller  15:44
Yeah, what I've experienced so far has been really fantastic. We don't always have an opportunity to collaborate with different organizations like this. So getting us all into the same virtual room, establishing what some of our end goals are in collaboration with Verizon has been fantastic. And I think for us, it's been very eye opening. We do something called Smart 911. It's all about delivering additional data to 911. So I mentioned before, it's photos and physical descriptions, health and medical information, rescue requirements. And we already have countless examples of where putting this information into the hands of 911 has made a real difference, but being able to tap into all these different portions of the ecosystem and being able to very easily start to extend this view of the patient, or the incident out to the field, enabling some of the technologies that we have here today has been phenomenal.

Cathy Lester  16:45  
I love that because you do get to see different aspects that you may not have had optics on before, without having that bad co-interaction. Then Devin, what do you think and because you have a really unique space too, since you can leverage a bunch of different aspects from all of the partners that are in the cohort? What's your experience been like?

Devin Paullin  17:03
So first, it's an honor to be part of the group and to be selected and to be able to play a role in a project and an innovation lab like this with Verizon. So one is you look at the environment that's created. So for folks wondering what's it like inside of this lab, and when we get together and work there, it's a very open discussion. This has been collaborative to the nth degree. It is very much taking all five of us and putting us in a sandbox, and then working to create the use cases together. We're creating the solutions and flow to those work cases together. Verizon is not sitting there coming in and going, hey, this is how it should be, you guys decide where you fit in. That's not how it is. It's - here's the situation we're in, work together to identify the use cases, work together to identify the different phases in which we may roll this out. And some of those phases could include a few partners, some of those phases would progress and include multiple partners. So we're all mature enough in the way we're looking for the end goal to know where should we play a role, and where should a particular partner opt out. All that discussion has been going on, and it's not rushed with this. They're very complex problems to solve. But we've been able to one - get the relationship started, identify the use cases, work through the phases, and now we're into the detail of true product definition and working with Verizon. And that to me and to our company has been a wonderful experience. It keeps us engaged in meeting terrific companies and has been a wonderful experience so far.

Cathy Lester  18:41  
Yeah, that's absolutely fabulous. I do love that in being able to look, I've sat in a few of those ideation sessions when we talk about how we're doing problem definition. And it's so interesting to see everybody's perspective. Everybody stands a little bit askew from a single pane of glass, so seeing all those inputs go together is really quite magical. Alan how about you? My friend from across the pond - we have you in virtually a lot but I know that you're expanding into the states as well. How's it been for you in the First Responder Lab?

Alan Lowe  19:12  
Yeah, I think that was the interesting thing, right? Because it was first of all a new country with differences culturally understanding health systems and so I was really surprised about was actually Verizon and their commitment to the health side. So I'll be honest, when you start out you think telecoms company communication, so on, but it was really you know, yourself, Cathy and others that I think we all align, including the customs around the patient. I think from all the organizations we all try to solve the same problems, as Todd says. And we all know that our solutions can't do them on their own, because they're the patient once it all steps together. And I use this sort of Amazon shopping model, you click a button and everything happens. That's what the patient wants. They don't care about the logistics or this or that. It just has to be seamless. And no one no one's really done that yet. Well, because I think until we walk as a collaborative organization with a single goal of the patient, I don't think we're going to get there. And I think as we come out of deep understanding of healthcare startups and so on, having this Verizon sort of infrastructure and scale also helps us look at look at the problem, but with more solutions available to us. And I think just working with the teams they have, and towards companies like you can just see where the value is immediately. There's no trying to position your product, it just is obvious where the fat is. And I think you can work with as many companies as you like, as long as they're willing to commit together and a single sort of solution. Great. I love it.

Cathy Lester  19:35
I think it's absolutely fantastic. So no conversation, you know, no video, no virtual conversation would be complete without a bit of a kick on the COVID side of the house. Because again, that's on everything that we have. So Devin, COVID changed many, many things in public health, right? We took all of our acute care providers and made them pop health experts pretty much overnight. We're like, ey, now you're population health management, let's see how that one goes for you. I'm interested to hear a little bit in what you saw about your response to all of the changes, to the rapid waves of change that we've seen with COVID. How has dispatch been positioning to that address?

Devin Paullin  21:44  
Prior to this, our company has been growing at a remarkable pace, not only from funding, but you know, today we're in 31 different markets, covering 19 different states, we'll be in over 43 in the United States by the end of the year, around that much. And that growth was continuing pre-COVID. What happened during the pandemic is one, there is a lot of work we did obviously from a testing perspective and just being responsive. We're in senior homes, we're working with senior living communities, we're working with individuals. So we're caring for folks all across the spectrum. We've done unique programs, we had to adapt to shift and work with different employers who are looking at unique testing programs, we did a publicly disclosed program with Delta in which we were helping participate in the testing and opening up the first commercial flights, we're opening back up from Atlanta to Amsterdam, you know, so there's unique things that we all adapt and pivot to, but the one thing that happened during that period of time, and this has changed a lot in healthcare, not only from a commercial standpoint, but from a payer and from a government standpoint, is this amplified the need for alternatives to in-facility care more than ever. So in home health, an area that may provide that service, that toothpaste is not going back into the tube ever from this point on. So what it did to develop faith, trust, and encourage expansion, and to encourage reimbursement models to expand all of that has been an amazing process to go through, not only the carrier delivering code, but what it's done to change focus on the business. So now there is a responsibility for all of us to continue to innovate, and create alternatives that deliver the highest quality of care. But those don't always have to be done inside the facility, whether it's an emergency response in this model, in which we need to have alternatives like dispatch, who can be there on scene to deal with non life-threatening emergencies and not send somebody to a higher risk facility situation that doesn't need to be there. Now, people are questioning those kind of things where they didn't before. We're seeing that even in the clinical research and clinical trial world, where the idea of a facility based trial is much different. Now we're willing to do things in a decentralized fashion, willing to let patients do some things at home. And the organizations that set the tone for that are open to that now, health systems, universities teaching, hospitals, everybody is willing to now look at alternatives for how and where care is delivered. And then it's up to companies and providers like ours to basically deliver the highest care we can in those situations. And then it involves obviously the linkage back and the communication of how do we get there? How does somebody make the choice to send in somebody like us, whether it's dispatch or another provider, and the integration and ability to quickly share that information through the continuum and enable the decision in the workflow. That's still where a lot of work and a lot of innovation can be had and that's part of what's going on in a microcosm in our pilot.

Cathy Lester  24:50  
I agree. So I'm looking at that intersection of of technology, the changing paradigms that we're seeing in care. Alan, you have a big focus on looking at specific pathways and the virtual concept about care anywhere. What are your thoughts on where that intersection feels like from a from a technology, public health virtualization? How does that feel for you?

Alan Lowe  25:14  
So I saw a couple of things during COVID. I think what we saw was the green light to innovation, if you like, so the budget tree, you know, that all the handbrake was taken off from budgetary process, rest, and so on. It's sort of created a "let's try things:" attitude. And one of the things that we put up with a virtual communication between COVID patients and the families at home, which normally in the prior COVID would have took five months to put in, and it was put in within three hours from actually testing it, putting it and it would just go across the system as we're coming out of it now. So I think during the last 12 months, it was pretty much, you know, get as much immediacy as possible point solutions, fix quick problems, so what we're seeing is, okay, we don't want to go back to the old world, if you like. So how do we do that strategically? Because nobody had time to do it strategically at the start of COVID. Right? And no, it's a case of, well, we've learned a lot in the last year. We've learned a lot about pace innovation. We've got some things wrong, you know, as a country, and I think we there's a lot of things we've got right. So I think where they're looking now is how can we deliver. So two things, which is the workforce issue has always been there, right? And the agenda to accelerate digital health has always been slow. This has sped it up. However, I think we're gonna talk about what it's like - we need to build this or emigrate center, that seamless pathway. And I think everyone's looking at everyone else to see who's going to do it. And who's doing it well, around the world. We're working in a number of continents. But I think people are looking now for what does it look like post pandemic? What it would look like, and everyone's looking to flagships and accelerators in programs, you know, who's currently doing it? Because the challenge of the innovation cap is you always about the evidence. You can't have evidence to innovation, you got to do the innovation to see the evidence, right. So it's a vicious cycle. But I am, I think, in a nutshell, for me, I think the innovators in healthcare around the world are going to start to see some of their solutions come into play, because people are more receptive to it now.

Cathy Lester  27:40  
Yeah, we did. COVID broke a lot of things. It changed where our care has been delivered, it changed how care was being delivered. And it changed how willing we were to consume different things in different places. And when you're faced with such a nasty situation, you got to do things quickly, fast and as safely as possible. And I think there's been some really interesting things on that side. And I completely concur. We're going to continue to see that advanced forward to Todd, how about you? What did COVID change for you?

Todd Miller  28:11  
COVID changed quite a bit, I think, for all of us. We came into 2020, a portion of our business helps keep K through 12 schools safe. We have a panic button application that you can probably see there. It's deployed on a statewide basis to all K through 12 schools in Arkansas, Louisiana, Oklahoma and Delaware. And we had a number of others planned. Well, all sudden, people aren't in school. And so school safety initiatives aren't as relevant, although, as we see now, as schools are getting back into session, unfortunately, we are having a return to normal, which means return to violence in some of our schools. But more specifically with some of the technology that we're looking at, as part of this program, it continued to be for us about connecting those stakeholders. One example is out of the state of Louisiana. The Department of Health and the governor's office and emergency management came to us early last year saying we've got a real problem. We have the need to communicate with the public on these very important COVID topics. We would love to get more information from the public so that we can tailor our communications and tailor our responses, but yet we've got five different groups going out and trying to communicate with the public and that's at the state level, forget you know, another 5 to 10 groups that are trying to do the same thing at the local level. And so they asked for us to find innovative ways to connect those different entities, so we launched a program in conjunction with the Department of Health and the governor's office to be their communication mechanism to be able to send text messages, emails, voice calls across Louisiana, in order to inform the public about changes in COVID status, but also at the very same time saying, hey, there's something you can do, click this link, and create a smart 911 profile so that if you dial 911, we can help you better. And so for the first time, Louisiana started to bring these entities together so that they could have a shared view of the world and start to leverage this data in new and innovative ways. So while COVID has certainly caused some heartache and pain, I think for all of us, it has also certainly driven innovation.

Cathy Lester  30:44  
I love that. So what I'm hearing is that ability to bring those key stakeholders together in all kinds of situations - disaster, public health, emergencies, that this is really something that's breaking down those silos and having a bigger view, right? We're opening the aperture.

Todd Miller  31:01
I think that's true Cathy. And I also think it's throughout the entire lifecycle of emergencies. It's not just when that 911 calls place, what are we doing leading up to that so someone doesn't have to dial 911? What are we doing, you know, as a community to prepare for that next disaster? Because guess what, folks? It ain't going away, right? Whether it's COVID or a hurricane, I mean, this is just what we deal with. So how do we do it better throughout the complete lifecycle?

Cathy Lester  31:33  
I love the way that Rave is adopting innovation to really advance public safety. So I love those use cases. They're absolutely fantastic. How about Devin? Thoughts on use cases that you're working on that are near and dear to the soul and culture of dispatch health? What are you seeing as the next big couple things coming down the pike?

Devin Paullin  32:02  
Yeah, so focus for us is so critical. It's the hard decisions that have to be made to decide what we pursue and what may have to wait. And so we're giving you a kind of window into that for us. We saw upwards of 250,000 patients in the home. But part of that is to get that to happen. Our ambassador team is endowing and intaking over half a million phone calls. Not everybody actually requires an in home visit or on site visits. So for us, it's continuing to look at how do we make that process? And some of this is technology related? How do we speed up and make that onboarding intake process better, quicker, faster, more painless? And then how do we look at that by each particular customer? So if it's the senior living community, if it's EMFs, and PSAPs, how do we make it so if you are able to make that decision, we make it technologically feasible, quick and painless, we make it an easy button for you? So that's ongoing work and research and development and things that we have to focus on to do, and it's different for everybody in that care continuum. The other thing is looking for what services are going to be critical that need to expand. So those of you who may keep up on dispatch, we just acquired an imaging company called PPX out of Minnesota, and that is specifically there to allow us to provide mobile radiography services in the home or on location. So whether that be ultrasound x-rays, that capability is going to be critical for us to continue meeting needs. When we talk about the pilot program here with Verizon and what we do in the lab for us to be more valuable, if we can do on site radiography work, obviously, for us, we become a more valuable partner for the patient. They're able to do that in the comfort of their home, or right there in a situation where it's needed and urgent and critical. And for us, it's maintaining those types of innovations. Also, advanced care. So the idea of hospital in the home is very hard to do. It's easy to say but hard to do, and complex. So having the right practitioners trained, being able to longitudinally work with a patient, not just acute care services, as we talked about, we're spending a lot of time working with health systems, modifying our care teams and workflows and pathway to deliver advanced hospital in-home care for patients with multiple co-morbidities and chronic conditions, and then working and collaborating to get that information back, of course, and work in sync with the health system that may be the main provider. So those are all kind of a set of core focused innovations, committed investments and work that we have to do, and I haven't gotten to all of them but that would just give you a taste of the things that we have to be excellent on at the end of the day. What we're doing is trying to make sure that our patient NPS score we've been averaging about a 95 or higher in health care. No matter what best efforts you have, in facilities, it's really hard to do something and get that kind of satisfaction and referral potential. So for us, we've got to do everything possible to make sure that stays high. And we're the choicee'r. We holding ourselves, and I think everybody in this pilot to the highest level of quality and care we can provide. And for us, it means making sure that those things we do just continue to raise our value in that equation.

Cathy Lester  35:24  
I love that. A happy engaged patient tends to have a better outcome. Right? So how do we figure out what that feels like? What is it? What is it looking like? So Alan, tell me this. I'm hearing a lot about accessibility and talking about what does it feel like to make sure that those services, not only communication, data sharing, but acute on-site, non-emergent care types of things that dispatches doing? What do you see in terms of visual delivering on health care, accessibility and those types of elements?

Alan Lowe  35:56  
Yeah, I mean that's sort of a mission statement, Cathy as you know - provide access and equitable health services. So no matter where you are in the world, you get access to those services. And that's what I've set out about the sort of rural split. So one of the things the UK, and I know it's amplified probably in the States, is that depending where you live, it's a bit of a lottery, in terms of what services you can access and what expertise you can have. So we see ourselves as leveling that playing field by bringing the connection from anywhere. The connections and the physicians and the cloud, and they can just be brought in to any location, whether it be the home, you know, so it's a sort of Doctor anywhere model, and what we're doing in this smart ambulance field. So we've got a lot of projects moving at the moment. And we do a lot with a physician, so we study the the EMS team - I keep trying to say the word paramedic - so yes, we spend a lot of time co-creating that we have a lot of EMF teams and our labs constantly. So we're looking at things like, as I said, you've got stroke, those maternity, those bonds, so many different applications. Well, it's just the ability to have the flexibility on a single platform. That's what the one thing that's constant at the moment, everyone needs just a slightly different user experience. So the tools like we're doing and the 5g, you've got everything in the single pane of glass. But if you need this tool you can pull it and if you need this tool, you can pull it out. And we're looking around, right down to the level of ergonomics, where does it set in the ambulance? What is the pathway that then enables? Because one of the challenges we have is probably the same in the States -there's a lot of sort of barriers that are nothing to do with patient count of financial work. Why do you take the patient to the hospital? Those models that are affected by this, though, I think that's going to be the bigger challenge. I think technically, we've talked about it, stitching it together so that it's a seamless experience where someone is accountable for that working. And it never becomes a hospital ask for technology and they say it's someone else's, and you end up in this net, the patient doesn't get service. But yeah, and then obviously, what I'm seeing and our world is that the ambulance is one of the doors for the system. And it's not the only door, but it's a door, right? And it's an important door. In those deaths depending on the country, all those different doors and the UK, there's only two - there was the GP and the ambulance, sort of two doors under the system. And so that's the model that changes things. And one of the things we're working on at the moment is - can you put mobile units and the big train stations so that they're digitally excluded, patients don't have to go to hospital? So it's basically an ambulance or a bag ambulance without the wheels effectively on the train station where it's manned by a physician. But it's starting to move to that commercial, you know, the Walmarts, and so on. But it's NHS or wherever the hospital system is approved. We are starting to see those partnerships around. So it starts in the ambulance, gets bigger and bigger and bigger. And it just becomes - access health care anywhere. But I think the big thing that I'm seeing around the world is healthcare is going to be delivered at home and closer to home. And the bank, acute tertiary hospitals going forward.

Cathy Lester  39:55  
Absolutely. I love the train station, and again the US market, you have a million choices. I can still go to the grocery store, right? Probably not for something serious. But if I have a snotty nose, I can actually take care of this pretty quick, right? So we're rocking around with this. But let's talk about time. Time is very impactful for some of these conditions. You mentioned a few maternal, stroke, burn - you you hit all the big ones that are very time and access dependent. Speed changes things. What are you seeing from either a cohort, and I'll open this up to all of us - what are we seeing in terms of how we are going to decrement the time that it might take to get to a level of care that is appropriate for the situation. Do we have thoughts on that one, about how speed and time change outcomes?

Todd Miller  41:01  
One of the things that we've seen time and time again, is that putting more information into the hands of 911 allows those decisions to be made about type of care, the type of first responder agencies that are that are going to occur. In fact, if you were to sort of draw a decision tree, and look at the path that an emergency takes, a lot of times it starts right there with 911 but with not a whole lot of information. And it's not until first responders arrive that they determined we've got the wrong equipment or the wrong personnel or whatever the problem may be. And that just does horrible things to delay their response. And we know that seconds save lives. And so again it's listening to that information and injecting it into that emergency process. That has shown a dramatic reduction in response times.

Cathy Lester  41:58  
Excellent. I think that's great. And then Devin, from your perspective, I think I feel like the ability to deliver care direct to the home is kind of  bypassing the entire acute care system, right? Because I can just take it right to the patient.

Devin Paullin  42:14  
And I think it's important when working with health systems directly, because we're there to be a complement to that system. And so if you think about it, and all of us have gone to an emergency department, right? We've been there, we've been there ourselves, we're taking our children there. And when you experience that you see what's going on, it's an overloaded staff of people trying to do the best they can where everybody's experience can be diminished, because what's mostly in there are not the situations the EDI is designed to treat. Right. So it's full of non life-threatening critical situations. So there's a business advantage to finding an alternative to that. And there's a patient service standpoint that's there, which is how can I drive up my ratings and scores by delivering the best experience that I can as a health system or as a payer or whatever. But it for us, it also goes back to just what we were discussing, and how we can make that choice available upstream. So in a single pane of glass model, and the way visuals work, having those choices there, and then working to train when we talk about local 911 and the PSAPs and working to let them know, okay, there's another choice. So CMS is working with this in their ET3 model and funding project that they've got going on. A very similar idea and concept that they've realized we can have at the 911 level - multiple choices. There could be a triage line that's set up in which those folks have the ability to decide whether to disperse non urgent care to a location, right? Is it social determinants of health related situations that we can address, or other and then get that back into the stream if it's needed. That's very important to us is to make sure we're staying connected. So technology enables the quickest decision possible. And for us, that allows us to obviously be on scene be able to do the best we can. Now giving a very fundamental example of how this helps - so right now, the go to reflex action is always 911. And if you work with local EMFs and you talk to people, if somebody's talking, I'm on it. Think about this - if you're a senior care facility and somebody falls in your facility, the immediate reaction is to call 911. Who goes there to stand somebody up? It's a critical break or something happens then yes, there's going to be transport but when you go there, they have to transport. So that patient to be stood up assisted and help them monitor in the home. The go to today is to take that person to the ED where they sit, they wait. They're suspect to potentially other infections, disease, there's all sorts of things that can happen. And you just look at senior care, right? That's an emergency 911 situation and there are other ways to do it. But it starts with the technology, the workflow choice and training that has to take place that we've been talking about. And some of those are elements within this project.

Cathy Lester  45:08  
That's a brilliant example, I have to tell you. As an EMT, I would tell you that unless you sign a refuse to treat, I'm taking you someplace and 9 times out of 10, that may not be where you need to go, right? You just might not be what's required. That hits very close to home. So Alan, I know that one of your passions is definitely around the stroke pathways, and how we're bringing in the right care teams to help diagnose because time is brain. Right, stroke is one of those usually unusual things. What are your thoughts on how we're seeing that in that stroke pathway, specifically about how time is is adapting?

Alan Lowe  45:49  
Yeah, and just my background before this was I ran a lot of frontline services and health care. And a lot of things we do is establish improvement pathway, which is about how to have efficiencies and technologies within those efficiencies. And one of the things that's a good example, we hear a lot Cathy, is the doctors say, you know, we used to spend 20 minutes with a patient. You put technology in and then we now spend 8 minutes with a patient. In 12 minutes, he put them into a system example where tech is wrong. Now today, the idea of stroke, what drives innovation is a necessity, right? COVID showed us that now in this country, we'd have a 40% gap of stroke clinicians, physicians. So we had an abundant platform where the golden window of three hours was not being met. What we did is we put together a few years ago, the first remote thrombolysis service where you just had to take the patient to the nearest hospital, and we would do another scan, we'd send out that physician and make the diagnosis we treat. And we've got that down to less than three hours. Now we've moved that further ahead into the ambulance. And give me an example, that jettison moment they've just done a piece with seven minutes from the 911 call to the scan to know that's when you've got the ultrasound CT scan and in the ambulance. Right. This is an example of you're going to save lives. Just one moment, you're going to save lives, right? You're going to save the economy billions in aftercare costs. Because if you look at the stats, I think in the US it's $46 billion a year in the UK, $7 billion. It's the second biggest killer in the world. So we are passionate about this pathway, if you like as an example of, you know, you can make a real difference. And we're working with everyone on this from the organization to the technology companies to the charity, same year, which is the brainchild of Emilia Clarke from Game of Thrones. So there's a lot of people that are really getting behind us to work strongly because, you know, it's morally it's right, financially it's right. And there's no reason why we can't do it now. There is no reason from a connectivity perspective, you know, things you can do on 3g, you can do more on 4g, you're gonna have the reliability on 5g. You don't have communication. I don't know if I told you, we just did some live surgery from literally a heart in India over satellite to Imperial in London for life support surgery. So my view is there's no excuse for not doing it. And I think it's appalling if it isn't happening.

Cathy Lester  48:49  
I think it's absolutely really good. And it's a great, another great example of 7 minutes, right? Because the aftercare costs for some of these are just staggering. It's a staggering impact to folks. So let's do this. Now we understand kind of a bit about the technology and a bit of where it is. Let's talk a little bit about where your technology is in play today, and a little bit of the challenges because again, I can't remember who said it, I should know this, that when you're doing innovation, there's an ugly circle, right? We want to know what the results are before we do the innovation and we want to find out what is the challenge of testing some of these things very publicly, because this is pretty big bet, right? We're saying hey, we're gonna try this, it's gonna change the world. So Devin you mentioned a couple markets that you're in. So tell us a few places where your your technology is rocking on and some of the challenges that you've seen moving forward.

Devin Paullin  49:46  
So I think for us where things have been rocking and rolling is the core of our service. We basically have five kinds of service lines that we're focused on today. So primary care is not necessarily what dispatch does, we can do those types of services but our focus is in that higher acuity lane that begins really after primary care for higher acuity situations on up to critical, life threatening, and those things that really need to go to the E. But we basically focus in number one, our acute care service line. So that's where we have an NP, PA, and a med tech going in tandem to a location. And that's available in all the markets we operate in today in the United States. So that's a bad foundation for us to grow on. The next line is a service called bridge care. So as we look for the identifying need, when we're looking at post discharge and follow up for those patients just coming out of post surgical situations at a hospital, that's where we can be that next 20-30 days for follow up. Okay, so that's critical for us. But that involves a different level of coordination longitudinally, back with the health system. So it's slightly different than the episodic acute care response. The next area is advanced care, which we're very committed to and working in tandem with some health systems and health and payers, in which we have now a fully longitudinal program that's delivering that type of hospital in the home advanced care. So that's where you're treating CHF patients, heart failure patients and you're doing that longitudinally. Not to just show up and treat, it's now sharp, and the level of care, the practitioner we have if they're available. And T, it's a slightly different situation, we utilize different EHR backbone for that operation as well, too. So it's a different process that we have to think about, but it serves a completely different market need and patient need for health systems and our payer customers. And then lastly which is growing with innovation, two things meet that you might not think would. So on the telepresentations, we've adapted our business so that we can bundle around. They tell a presentation programming partner, and what we can do in that situation, whether it's a health system, or another third party who's executing virtual primary care telepresentation operations, what we can then do is buckle that with providing a med tech, so our dispatch health med techs, or DHMTs, can go in and then provide the physical assist and surround for that particular telepresentation exam. So if you think of seniors, for instance, or those who aren't able to actually conduct a full virtual examination that you might have to do in the home or in another location, we can help do that. We can do the blood draws, we can do other aspects of the physical exam, which would be difficult for the patient to do on their own. And we can provide eyes on the scene that is an enhanced version. So you take telepresentation, and then you're able to really bolster it with having a med tech there to help round out the examination. And whether that's for follow ups or whether that's for internal examinations. It's a process in which we can even play a role to create a better telepresentation model. So we're doing that actively today. And that represents kind of the latest service line that we continue to expand. So those are the areas where our technology is doing well, we can do better. But what we've identified is the front end to that and how we bring patients in to get a lot of good work that we can do to get faster and quicker. And on the backside of that, what we do to coordinate that care back into the system, and who other partners we extend it to we can do more there.

Cathy Lester  53:24  
Perfect. I think that's absolutely brilliant. How about you Todd?

Todd Miller  53:27  
I think the talk tracker around innovation being tough, is accurate. And when we started online, and would call a PSAPs to talk about bringing in additional information via the internet, I probably got hung up on more than what it was - it was a crazy thought that you'd ever leverage the internet within the emergency response. And obviously, that has changed quite a bit. And so we look to work with innovative progressive communities. I'm proud to say we now have customers in all 50 states, but there are certainly some that tend to push the envelope a little bit more. Understand that this is a partnership. There is a need for innovation. And I think it was maybe Alan that said this, hey, there will be mistakes that are made, but we don't get there unless we try a few things. And so you're working with communities today like the city of Chicago - they use us for bringing in additional information tonight one, they also use us for mass notification. So if you live in the Chicago area and you get notices about COVID or, you know, weather events that that's us, but most recently they did a press release and they talked about a new innovative feature to allow residents to start to share maybe even more information. So registering things like their ring camera, so that safety can have access to the video. Or maybe just streaming video directly from your handset, you know, we can enable that too. So when we need to get eyes directly on a scene in a very short period of time, the first place that can happen is with 911. And so we continue to see innovative locations like that adopt this technology and continue to leverage it to ensure that we're closing that public safety gap.

Cathy Lester  55:26  
I love that analogy. I bet you gave us a couple of great examples about not only the telesurgery piece, but also the train station, but also another area of a use case that you found to be different, compelling, and near and dear to your heart.

Alan Lowe  55:39  
I think the potential actually builds on what Todd was saying in that the idea of the connected ambulances, you know, you bring an expertise into a vehicle. Now vehicles are expensive, right, you can have them everywhere, but everyone's got a mobile phone. And traditionally, in hospitals, you had these carts that would be wheeled from bed to bed, but the concept knows you can have a mobile phone, the earpieces and that upskills every healthcare worker in the world so you could literally patch them into our servers, we say - what do you need? - I need that, I need a stroke consultant, I need a mental health specialist, whatever it is, but all of a sudden, it's available 24/7, and I think that's going to be a game changer. And the sort of future Why? Because it's sort of you don't know what you're walking into, sometimes in healthcare, right. And I see the future of precision medicine being that is like, you know, talking about people with back pain, so they'll see a physio, now you could see the back specialist of that particular area. So I think you're going to start because if you look at the efficiencies of those types of models, the cost reduces dramatically. And if you look at I think we've talked about negative value transfer, which is just the patient being moved around the system constantly. So hot potato, right, the hot potato. So I think connecting everyone into the one system, where they can see the data call on the experts they need, and almost bring the bring the healthcare system to the patient is powerful. And we've got lots of different examples. Another one, we can't take credit for them, we just spend a lot of time with the users. And so the best ideas come from the user with the problem. Right? And so we're seeing a lot and like during COVID, we have that tablet that goes to the home that's got three things on it, call your doctor, Netflix. I think in a weird way, simplification is probably going to be the the thing that's going to scale fast, is what I'm seeing. But yeah, I think what an interesting point about where this consumer choice doctor takes over. When you talk about digitizing healthcare, if you could go anywhere in the world for your healthcare you can get it today, the expert. You're going to start to see that.

Cathy Lester  58:21  
I completely agree. We're just about at time, but we had a great question coming in. And it's an important clarity question. It says looking at all the capabilities that we have about minimizing the need for first responders. I want to level on that because as an EMT, I'm not minimized. I think what we're trying to do is empower with more technology coming in, how would you address that question that says some of these initiatives might be looking to replace or compliment or augment? Thoughts? Anybody have thoughts on how we're enabling the the EMT paramedic medical responder?

Devin Paullin  59:06
Just real quick? Absolutely. Especially from our standpoint, I'd say that this is not an either or, this is without a doubt, EMTs need to be on the scene in disasters, emergency situations, and all that without a doubt. What we look at is - can we be there as your partner so that if you realize that an on site or a care situation is better suited, that we're there for you, that we're accessible and we do it? Okay, but EMF needs to be there, that is without a doubt part of this project. So it's how can we be an augmentation? Because we're not there today, let's say how can we be there and how can we show up to best help you?

Cathy Lester  59:46  
Excellent. Now, I think that's well responded. So again, I know that we're at we're at top of our time so I want to thank Todd, Alan and Devin for an incredible conversation. You guys are so insightful and I'm so pleased that you're part of the the first responder program, it's really going to be magical. So stay tuned, we'll get some updates on that. This conversation we did record and it will be available next week for uploads if you want to share with communities. And if you'd like more information, you can actually visit our website at 5ginnovationlakenona.com. One really, really, really long word. Go for that. Again, gentlemen, it has been my pleasure and an absolute delight. I want to thank you very, very much. And we'll be talking to you soon from the next live from Lake Nona. Thank you very much.

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