Opening Keynote: Replatforming Healthcare: New Rules for Disruption

1. Opening Keynote:Replatforming Healthcare:New Rules for Disruption 10th Annual Healthcare Unbound Conference & Exhibition July 2013, Denver, CO Vince Kuraitis JD, MBA Principal and Founder, Better Health Technologies vincek@bhtinfo.com Note: Additional content and attributions are available in the PowerPoint slides speaker’s notes at http://e-CareManagement.com/?p=2931

2. address books video cameras pagers wristwatches maps books travel games flashlights home telephones cash registers Walkmen, day timers alarm clocks answering machines The Yellow Pages wallets keys transistor radios personal digital assistants dashboard navigation systems newspapers and magazines directory assistance travel and insurance agents restaurant guides pocket calculators What do all these have in common?

3. Commonality:all being disrupted by smartphones

4. U.S. Smartphone OS Market Share2005 -- 2012

5. What lessons can healthcare learn from telecom?

6. Replatforming Healthcare:8 Rules for Disruption* • NETWORKS & NETWORK EFFECTS, not silos** • PLATFORMS, not just products • BUSINESS ECOSYSTEMS, not just business models of individual companies • PULL, not just push • PATIENT ACCESS & CONTROL, not just provider control of health records • STRATEGIC OPENNESS, not “Hoarding” of data and workflow** • PERSONALIZED CONTEXT, not just centralized locations • DIGITAL VALUE CREATION, not just physical value creation * working title of Vince’s forthcoming book, end of 2013 ** covered in today’s presentation

7. NETWORKS & NETWORK EFFECTS, not silos

8. In the Connection Economy, value will be created through: Digital connections Personal connections

9. A 20th Century View of Network Effects • Metcalfe’s Law – the value of a network grows with the square of growth in its user base • BEWARE! People on the network do NOT have equal value.

10. Network Effects:Hypergrowth Kicks in Past the Tipping Point

11. 21st Century View of Network Effects – Much More Granular • Multi-Sided platforms – increasingly common • MUST discern types of network effects • Direct (same-sided, cross-sided) • Indirect • Positive or negative • Potential for winner-take-all markets? • HOW TO LAUNCH NETWORK EFFECTS?

12. Network effects example: Patient Portal of Physician EHR... MDs Patients EHR Platform ...potential for 4 network effects

13. Let’s add a remote patient monitoring (RPM) app to the platform... MDs Patients EHR Platform ...potential for 9 network effects! RPM App

14. Where are we seeing network effects in healthcare...

15. A handful of community/public Health Information Exchanges (HIEs) • Many private HIEs (likely)

16. Potential for network effects.... • Alliances • Commonwell Alliance • EHR | HIE Interoperability Workgroup (NYeC) • Blue Button + • EHR platforms • QualcommLife 2net • MyDirectives • ...many others

17. One ear perked and listening...

18. Creating Network Effects: Launch past the atmosphere (tipping point)... ...or fall back to earth

19. Network Effects Action Items • Map the network (business ecosystem) • Understand/prioritize network effects • Strategize for successful launch

20. STRATEGIC OPENNESS, not “Hoarding” of data & workflow

21. Openness Strategies Disrupt Industries Is this you?

22. From Hoarding to Sharing:3 Phases of Industry Evolution • 1) Closed (default) • 2) Forced (Involuntary) Openness • 3) Strategic Openness: Openness as Competitive Advantage

23. Example: ACO/IDS patient leakage and open data networks • “Our network is leaky. 30-45%+ of patients go to outside providers.” • “We’re flying blind.” • “We need a strategy and a plan.” Options • Closed strategy • Strategic openness • “We’re at risk for care outside our network. Sharing data now makes economic sense.” • “In fact, we insist you accept our data and use it to improve quality & reduce costs.”

24. Leaky patient networks ER overutilization Out-of-network care providers Government policy pressure Patient demand Required by payer MU requirements View, download, transmit Shared care plans Specialty referrals Best analytics depends on best data Readmission avoidance Liability/malpractice pressures Privacy as a competitive differentiator Open source Care management Minimize anti-trust concerns ACO efficiency and cost savings. ACO differentiation Reduce reliance on HIEs Right thing to do! Use Cases/Business Models Promoting Strategic Openness

25. Healthcare promises to become the “ultimate” connection platform

26. Brief Bio – Vince Kuraitis • Vince Kuraitis JD, MBA is Principal and founder of Better Health Technologies, LLC (http://e-CareManagement.com). BHT consults to companies in developing strategy, partnerships and business models for clinical care and care management platforms/applications delivered in homes, workplaces, and communities. • BHT’s clients -- both established organizations and early-stage companies -- include: Intel Digital Health Group, Philips Electronics, Office of the National Coordinator (ONC) for Health IT, Amedisys, Joslin Diabetes Center, Ascension Health System, Samsung Electronics, Siemens Medical Solutions, Medtronic, Varian Medical Systems, Disease Management Association of America, and many others. • Vince brings 30 years health care experience in multiple roles: President, VP Corporate Development, VP operations, management consultant, and marketing executive. His consulting and work projects span 100+ different health care organizations, including hospitals, physician groups, medical devices, pharma, health plans, disease management, e-Health, IT, and others. • Vince speaks frequently at industry conferences and corporate events. He has been the opening keynote speaker at the Healthcare Unbound conferences between 2004 and 2013 and has spoken at about 35 conferences in the past 3 years. He has experience leading strategic planning retreats for Boards and physicians. • Vince’s experience includes: Principal, Better Health Technologies; President, Health Choice (medical call center), VP Corporate Development and VP Specialty Operations, Saint Alphonsus Regional Medical Center; Regional Director of Marketing, National Medical Enterprises (hospital chain with 100 facilities); Senior Consultant, Amherst Associates, national health care management consulting company. • His education includes MBA and JD degrees from UCLA, and a BS degree in business administration from USC. • Contact: vincek@bhtinfo.com, 208-395-1197

27. Pre-IPO Companies RMD Networks HealthPost Cardiobeat EZWeb Sensitron Life Navigator Medical Peace Stress Less DiabetesManager.com CogniMed Caresoft Benchmark Oncology SOS Wireless Click4Care eCare Technologies The Healan Group Fitsense Elite Care Technologies Healarium Established organizations Intel Digital Health Group Samsung Electronics, South Korea -- Global Research Group -- Samsung Advanced Institute of Technology -- Digital Solution Center Office of the National Coordinator for Health Information Technology Amedisys Ascension Health System Midmark Medtronic -- Neurological Disease Management -- Cardiac Rhythm Patient Management Siemens Medical Solutions Philips Electronics Joslin Diabetes Center GSK Disease Management Association of America PCS Health Systems Varian Medical Systems VRI Washoe Health System S2 Systems CorpHealth Physician IPA Centocor Clinical Groupware Collaborative BHT Clients