e-Health Industry Expectation

1. e-Health Industry Expectation July 22nd, 2014

2. Personal Connected Health AllianceEmpowering individuals to better manage their health Michael J. Kirwan Technical Operations Director PCHA and Continua May 2014

3. Empowering Individuals to Better Manage Their Health The world is moving to a focus on linking individuals with interoperable, personalized health solutions that meet their lifestyle needs.

4. Advantages of Personal Connected Health Consumers are not just linking health data to the Providers any longer • Potential to transform human health and healthcare delivery, and to reduce global disparities in healthcare access • Adds motivation and inspiration to health self-management by taking advantage of support networks in social media and other online forums • Capable of reducing the impact of chronic disease, which is responsible for the greatest portion of healthcare expenditures • Ability to shift from treatment focus to preventive care by making health self-management a part of everyday life • Allows us to enjoy life longer outside of traditional healthcare

5. Engaging Consumers at Every Stage of Life …and Providing Links to Family, Friends, Social Networks & Providers Health and Relief Pharma

6. PCH Creates an Information- and Inspiration-Rich Environment for Health Improvement • Consumers become engaged in health self-management • Links to social networks become a source of positive reinforcement • A secure line of communication is established between providers and caregivers outside the exam room • Consumer-collected data can enrich healthcare for individual patients and patient populations • Better use of resources, reduced cost, improved clinical outcomes…and health management incorporated into everyday life

7. The Goal: Improve Lifestyle Choices, Health = Non Modifiable Contributors to Disease = Modifiable Contributors to Disease Hu et al. Diet, lifestyle and the risk of type 2 Diabetes in women. NEJM 2001 Sep 13;345(11):790-7. Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000; 343: 16–22

8. Envisioning A Better Way: Weight Loss • Wearable trackers to monitor calories burned through activity • Apps for diet/nutrition advice and caloric intake, on smart phone and/or computer • Social networking for inspiration and competition (i.e., Jenny Craig, Biggest Loser), using online forums such as Facebook

9. Envisioning A Better Way: Gaming • Wearable trackers to monitor specific activity • New sensors to enable 3d tracking and movements • Already in use for Rehabilitation and Diagnostic purposes • Can be utilized to stimulate inactive or cognitive impaired individuals • Interoperability allows for this data to be collected by healthcare team

10. Envisioning A Better Way: Management of Rare & Serious Diseases • Disease-based forums (web, social media) for peer advice on treatment options and experience • Connectivity to providers via provider portal, for expert advice during diagnosis, treatment and follow-up Apps to find a clinical trial • PCH-enabled studies that use sensors, trackers and/or remote monitoring for data accuracy and patient convenience

11. Envisioning A Better Way: Care of Special Populations • Individual and online gaming for children/teens with chronic diseases • Apps to support connection to people with communication disorders, such as autism • Wearable sensors and wireless monitoring for elderly living independently • Remote monitoring by healthcare providers to augment parental care of a sick child or aging parent • Social networking for caregivers, i.e., Facebook book, online chat with the ability to share sensor data

12. Envisioning A Better Way: Clinical Trials • Direct involvement of the individual in the trial • Evaluate patient populations • Accelerate patient recruitment • More efficient and effective management of clinical trails, data collection and reporting • Better quality, more reliable data • Get new drugs to market faster

13. Envisioning A Better Way: Interoperability Compliance with global industry standards is proven to decrease time to market and reduce development costs: • Lower Design Costs: saves US$ 40,000-$80,000 in development costs per device • Faster to Market: decreases integration time from three months to just three weeks • Increased Efficiency: quicker, less expensive integration to EMR or HIE platforms • Forward/backward compatibility: longevity of devices • Easy to expand or add new programs/products with plug-and-play

14. Architecture to Enable PCH Personal Device Aggregation Manager Telehealth Service Center Health Records/ Networks Thermometer Pulse Oximeter Pulse /Blood Pressure Weight Scale Glucose Meter WiFi, 2G, 3G & 4G Cardio / Strength PHR Independent Living Activity EHR Peak Flow Personal Area Network (PAN) Interface Wide Area Network (WAN) Interface NHIN Health Record Network (HRN) Interface Medication Adherence HIE Physical Activity Electrocardiogram Insulin Pump

15. Envisioning A Better Way: Adoption = Adopting Continua = Local Work Group EU WG Denmark UK (NHS Worcestershire) Japan US WG US Veterans Administration & US Department of Defense Japan WG Middle East India WG SE Asia WG Singapore Brazil WG Australia WG

16. PCH: Why Now? • Consumer market is exploding • more than 97,000 mobile health apps are currently available; • each day the top 10 apps generate up to 4 million free and 300,000 paid downloads • New regulations and incentives transforming healthcare delivery, putting consumers at the center of their care • the Affordable Care Act features comprehensive health insurance reform to improve the quality and patient access to care in the US • Meaningful Use Stage 3 to address population health • Governments around the world demonstrating significant interest in adopting personal connected health (ex: Denmark, Norway, UK, UAE, Singapore) • the UK’s 3million lives initiative changing care delivery using connected health tools for citizens with chronic conditions • Globally, healthcare in crisis and world population aging

17. PCHA: An Historic CollaborationContinua Health Alliance, mHealth Summit & HIMSS • Global plug-and-play interoperability Design Guidelines and Product Certification program • Unmatched industry education, thought leadership and networking • International leadership in hospital-based health technologies • Worldwide presence to promote local, regional and national public policy, advocacy and market development

18. PCHA Mission Generating greater awareness, availability and access to plug-and-play, consumer-friendly personal health technologies to empower individuals to better manage their health and wellness, anywhere at any time.

19. PCHA Strategic Initiatives • Promoting education and awareness through events and outreach to all stakeholders • Facilitating adoption of global industry standards for user-friendly interoperability between devices; privacy and security • publishing annual Continua Design Guidelines for end-to-end, plug-and-play interoperability; certifying products • Ratified by ITU as global standard for PCH technologies • Defining the path to market by advocating for appropriate regulation and promoting investment • Supporting governments and health ministries seeking connected health solutions • Operating in nations around the globe to promote market development

20. The Time is Now PCHA will coordinate stakeholders in PCH and maintain a ‘consumer first’ position • It’s about the individual • The technology is available • Consumers are demanding it • Nations are implementing it • We can’t afford to miss this opportunity The Market will not grow until we reach interoperable solutions

21. Get Involved with PCHA! http://www.mhealthsummit.org/subscribe Web: www.pchalliance.org Email: ask@pchalliance.org

22. Thank You

24. Case Examples

25. Denmark’s National Action Plan for Telemedicine Scope • Secure collection, transmission, storage of personal health data from patients’ homes to healthcare providers across the country • Sharing of medical documents & images • Management of health records, medical appointments, etc. Objectives • Ensure end-to-end, plug-and-play connectivity of personal health devices; establish interoperability standards • Ensure personal health devices & services easy to deploy, secure & convenient for patients & providers • Reduce acute care stays • Enable elderly to live home independently • Develop chronic disease management programs • Expand use of telemedicine

26. Denmark: Centralized Approach to Standards Adoption • Mandated national compliance with interoperability standards (Continua) • Pros: • National healthcare IT conformity supports large-scale population health and creation of cost, operational efficiencies • Limited systems integration issues during rollout and subsequent changes in technology • Cons: limited regional, local influence over standards development; currently fewer choices in devices

27. UK Dept of Health: 3millionlives (3ML) Campaign • Based on evidence from the Whole System Demonstrator Programme (6,000+ person telehealth/telecare study) Goals • Improve lives of 3ML people with long term conditions, social care needs • Develop market, remove barriers to delivery (5 yrs) • Create environment to support uptake • Public/private cooperation to simplify procurement and commissioning processes for telehealth, telecare at scale • Put NHS and UK industry at the forefront of telehealth, telecare globally • Promote benefits of telehealth and telecare services to patients

28. 3ML: Regional Approach to Standards Adoption • All personal health device providers must comply with CEN ISO/IEEE 11073 • Contracting occurs on a local basis • NHS Worcestershire County and East Shires Purchasing Organization have voluntarily adopted Continua • Pros: localities maintain maximal control (device selection, cost) • Cons: healthcare IT infrastructure likely to require significant integration to achieve end-to-end interoperability at a national scale

29. Catalonia, Spain: Regional Approach Catalonia, Spain Population covered by universal healthcare with a mix of public/private providers Health Ministry funded ICT organization (TicSalut) coordinates standards, integrates health and social welfare systems 100% of hospitals use EHRS; 70% have mobile tools Device integration primarily based on Hl7 standards

30. Opportunities & Challenges for Big Data Opportunities • Adopt common standards for PHRs to enable data aggregation, tracking from multiple consumer devices • A starting point for big data, especially in decentralized markets • Agree upon type, definition and format of personal health data relayed from consumer devices to a medical records system • Ex: Health Records Network Challenges • Retail and home devices need common standards to enable consumer plug and play • Clinical workflow impact complicates standards adoption • End-to-end standards adoption

31. Personal Connected Health Alliance (PCHA) An alliance and collaboration focused on the vision of person-centered health and health care with a mission to deliver interoperable personal health solutions that foster independence and empower people to better manage their health and wellness from anywhere; at anytime. Interoperability & Ecosystem Enablement Global Access & Leadership Thought Leadership & Industry Connection

32. Clint McClellan PCHA Organization

33. PCHA Structure, Governance and Services • Single Member LLC with HIMSS as sole Equity Holder • Operating agreement defines constitution & duties • Board of Managers: • - Sets strategy • - Defines objectives & organization • - Plans budget • Up to 15 Managers elected from Continua Promoter ParticipantsCurrent board carries over into BoM • 5 Managers appointed by HIMSS • Exec. Vice President represents LLC • 1 Manager represents in HIMSS WW • Operational sub-structure • Operating agreement defines duties • Council manages: • Guideline development / releases • Certifications • Working groups • Events & content • Up to 15 Members elected from Continua Promoter Participants • Director acts as COO • Vision and Mission stays unchanged • Brand will continue unchanged • WG’s structure are the same • WG’s charters & processes remain • Membership dues and benefits stay intact • Current Continua members will become PCHA participants automatically 33

34. Small Changes • We are dropping the Health Alliance portion of Continua Health Alliance – now referred to as Continua • Marketing-wise – We refer to Continua as …a Founding member of PCHA… • Continua name still represents the Guidelines and Certification • Continua logos to remain the same and integrated into the PCHA logo

35. Website Changes • New PCHAlliance.org website • Continua website will remain separate as we have specific functionality to maintain membership and voting processes. • Continua site undergoing a phased approach to integrate with PCHAlliance look and feel. • Adding new features • Comment section • Online request for Guidelines

36. Past Events What: mHealth Summit Europe When: May 6 – 8, 2014 Where: Messe, Berlin Info: http://www.himssme.org/ • Continua was a supporting organization • Speakerships What: Continua Spring Summit When: May 8 – 10, 2014 Where: Berlin, Germany • First co-located mHealth Summit and Continua Summit

37. Past Events • What: eHealth Forum 2014 • When: May 12 – 14, 2014 • Where: Anthens, Greece Info: http://ehealth2014.org/ • -Continua was a supporting organization • What: mHealth Summit Middle East • When: May 28 – 29, 2014 • Where: Abu Dhabi Info: http://www.himssme.org/ • First Continua Connects Event • Continua was a supporting organization

38. Save the Date! Continua Summer Summit August 26 - 28, 2014 Montreal, Canada

39. Upcoming Events • July - JWG visit (Chuck and JWG Chair) • August - Shanghai Bluetooth event • Sept – 15-18 HIMSS AsiaPac mHealth event • 17-18 Sao Paulo mHealth event • Oct – Partners Connected for Health • Dec – 7-10 mHealth Summit DC • 9-12 Continua Summit

41. mHealth Summit Components • 400 Exhibiting Companies • Intelligent Medical Home Pavilion • Startup Showcase • Comprehensive Sponsorship Program • Targeted Pre-conference and Co-located Events • 5 Keynotes Delivered by Industry Leaders • 3-Day Core Conference Program • 2-day, Co-located Global mHealth Forum • Continua Technology/Interoperability Showcase • Continua Member Summit

42. Global mHealth Forum

43. Past Keynotes and Executive Spotlights

44. Past Sponsors

50. BoD Approved! Emerging Markets Incentive This emerging markets incentive qualifies new members from either a developing region or from a small company. Developing Region Small Company • A company may qualify if: • less than 20 full-time employees (in all company divisions). • Less than $4M annual gross revenues. • Less than $4M in total assess (as indicated on balance sheet). A company may qualify by being a company originating out of a defined Developing Area (OECD GDP of less than $15K per Capita). • Qualifying Benefits • Company pays only $1000 for their first year, $2,500 for their second and full Contributor costs in their third year of Continua membership. • Company receives one free listing fee (subject to the listing fee only and excludes the testing fee). • Company may participate in Continua Plugfests and Continua Connects (subject to existing fees). • Company in the Developing Region category will receive all Contributor membership benefits except they are limited to a maximum of 2 participants at each Summit. Leadership roles are also not available to this category. • To sign-up, please contact Continua Administration. • Admin@ContinuaAlliance.org