Pro-PLUS Sp. z o.o. Complex telemedical solutions globally Prepared by: Agnieszka Tomczak

1. Pro-PLUS Sp. z o.o. Complex telemedical solutions globally Prepared by: Agnieszka Tomczak 17th March 2015

2. ABOUT Pro-PLUS • Pioneer of telemedical solutions in Poland and worldwide • Producer of innovative devices, software and services for telemedicine • Gold Medal at the International Exhibition of Innovation in Shanghai • Cooperation with leading cardiology institutes and hospitals in Poland • International telemedical project TeleInterMed: 10 thousand patients diagnosed with Pro-PLUS devices • Participation in Strategmed I (cardiological tele-rehabilitation at home) • Main entity in governmental projects (eg. with National Center of Research and Development) • Several projects implemented for Polish army • 90% shares of Polish telemedicine market

3. ABOUT Pro-PLUS We listen to the needs of medical environment We providereadytelemedicalsolutions for medical environment We create business models We createtechnologicalsolutions

4. POTENTIAL OF Pro-PLUS • The market for telemedicine is developing rapidly. In 5 years it is predicted to grow almost three times. The services are and will be the main part of the market (about 60%), followed by the devices and software (each 17%). • Pro-PLUS is a dynamic, modern company with 22 years of experience, unique know-how and recognisable trademark, both on Polish and foreign markets. • After many years of independent development in 2013 the company gained the investor – ANNT Investment S.A., which took the company to new paths and ensured stable growth. • At the moment the company realizes the plans agreed with the Investor, getting ready for the expansion to foreign markets, introduction of new devices and offering new services.

5. BIGGEST CLIENTS OF Pro-PLUS • Nation-wide Medical System in Indonesia • Inter Business ‘91 Ltd. from Bulgaria • Institute of Cardiology in Anin, Poland • Crakow John Paul II Specialist Hospital, Poland • Telemedycyna Polska S.A. • Polskie Centrum Telemedyczne • MedGo Sp. z o.o.

6. Pro-PLUS WORLDWIDE Examinations Satisfied patients Cardiac rehabilitation after heart attack

7. Pro-PLUS The main area of our activity is cardiology and monitoring of the elderly. Mobile, remote, easy-to-use ECG solutionswithadditionalmodules (weighing scale, blood pressure monitor, saturation sensor and glucose meter) Web based Telemedical Platformwhich collects medical data and enables B2B and B2C relations Medical services provided by Monitoring Center

8. Pro-PLUS PRODUCTS

9. Pro-PLUS PRODUCTS • Embedded communicationmodules:GSM, Wi-Fi, Bluetooth • Interactive communication with external modules: weighing scale, blood pressure monitor, saturation sensor, glucose meter • Additional features: • VOICE • geolocation • geofencing • fall down sensor (patient’s body position detection) • indoor location (IBEACOM)

10. ADVANTAGE OF Pro-PLUS • Small, convenient and easy-to-use devices • Flexible hardware platform with various communication options • Secure and reliable data transmission • Components with API for easy integration with existing hospital systems • Dedicated R&D team for Fast Time to Market projects • Strongly motivated team, engaged in developing new solutions

11. EHO-MINI EVENT-HOLTER

12. EHO-MINI EVENT-HOLTER

13. EHO-MINI EVENT-HOLTER

14. EHO-MINI EVENT-HOLTER View of the ECG examination sent from the device to Telemedical Platform:

15. EHO-MINI EVENT-HOLTER Recording of single cardiac incidents • EHO-MINI event-holter with up to 5 minutes reverse buffer (depending on settings) • 2- or 3-channels • 6 synchronic leads: – limb leads: I, II, III, aVR, aVL, aVF i/lub –Any 2 selected precordial leads: V1-V6 • Built-in electrode cable (3 or 4 electrode cables, using disposable electrodes) • Working time: 72 hours (transferring 10 recordings in 24h) • Battery charging: 3 hours

16. EHO-MINI EVENT-HOLTER Recording of single cardiac incidents • Sample rate: 250/samples/second • Resolution: 10 bit/sample for each channel • Transmission: GPRS through built-in digital modem • Transmission speed: 9600-32000 b/s GPRS • Frequency range: 0,05-100 Hz • Power supply: Li-lon 4,2V battery; 680mAh; 2,4Wh • CMRR >70 dB • Input range: 15µVac do 15mVac • Weight: 100g with battery • Compact device size: 85mm x 54mm x 17mm

17. EHO-MINI EVENT-HOLTER The device can be optionally equipped with following modules: • voice – enables remote doctor-patient communication, providing the doctor with the posibility of rapid intervention • geolocation (GPS) – allows to locate the position of the patient during transmission • geofencing – so-called „safe zone”, within which the patient can move. When the patient crosses the safe zone, the alarm signal is sent to the nurse or caretaker (for patients suffering from Alzheimer’s disease) • fall down sensor – the device can send a notification with GPS position to the Monitoring Centre (only for the devices with built-in GPS module) • automatic record of ECG examination triggered by the measurements from the external sensors, e.g. pulse oximeter – the device continuously monitors the level of saturation and pulse, and after exceeding the levels set up by the doctor automatically performs ECG examination (with reverse buffer), which allows to determine the background of saturation disorder (sleep apnea)

18. EHO-MINI LIVE-HOLTER Automatic recording of incidents Modification of EHO-MINI device enabling automatic ECG recording without participation of a patient. ECG is recorded every 3 minutes and sent automatically to Telemedical Platform (directly to the Monitoring Centre).

19. EHO-MINI REHABILITATION Tele-rehabilitationathome • EHO-MINI rehabilitation with programableprocess of rehabilitationsession (depending on individualarrangements) • 2- or 3 channels • 6 synchronicleads: – limb leads: I, II, III, aVR, aVL, aVF – and/or: any 2 selectedprecordialleads : V1-V6 • Buit-in electrodecable (3 or 4 electrode cables, usingdisposableelectrodes) • Workingtime: 72 hours (sending 10 recordings in 24h) • Battery charging: 3 hours

20. EHO-MINI REHABILITATION Tele-rehabilitationathome • Samplerate: 250/samples/second • Resolution: 10 bit/sample for each channel • Transmission: GPRS throughbuilt-in digital modem • Transmissionspeed: 9600-32000 b/s GPRS • Frequencyrange: 0,05-100 Hz • Power supply: Li-lon 4,2V battery; 680mAh; 2,4Wh • CMRR >70 dB • Input range: 15µVac do 15mVac • Weight: 100g with battery • Compact devicesize: 85mm x 54mm x 17 mm

21. EHO-MINI REHABILITATION The device can be optionally equipped with following modules: • voice – enables remote communication doctor-patient, providing the doctor with the posibility of rapid intervention • geolocation (GPS) – gives the possibility to locate the position of the patient during transmission • geofencing – so-called „safe zone”, within which the patient can move. When the patient crosses the safe zone, the alarm signal is sent to the nurse or caretaker (for patients suffering from Alzheimer’s disease) • fall down sensor – the device can send a notification with GPS position the the Monitoring Centre (only for the devices with built-in GPS module) • automatic record of ECG examination triggered by the measurements from the external sensors, e.g. pulse oximeter – the device continuously monitors the level of saturation and pulse, and after exceeding the levels set up by the doctor automatically performs ECG examination (with reverse buffer), which allows to determine the background of saturation disorder (sleep apnea)

22. EHO12 12-lead cardiomonitor Enables the measurement of resting, 12-lead ECG, performed after connecting the device to the computer.

23. EHO12 View of the ECG examination sent from the device to Telemedical Platform:

24. EHO12 12-lead resting ECG recording • 12-lead, resting ECG, performed after connecting the device to the computer. • 12 synchronic leads: – limb leads: I, II, III, aVR, aVL, aVF –pre-cordial leads: V1-V6 • Detachable electrode patient’s cable (12 electrodes) • Working time: power supply from the computer

25. EHO12 12-lead resting ECG recording • Sample rate: 250/samples/second • Resolution: 10 bit/sample for each channel • Direct, digital transmission via USB cable • Transmission speed: directly: USB 2.0, 115200 b/s • Frequency range: 0,05-100 Hz • CMRR >70 dB • Input range: 30µVac do 15mVac • Size: 115mm x 70mm x 25 mm • Weight: 100g

26. ADDITIONAL MODULES It is possible to widen the functionality of the devices by the measurement of any parameter, e.g.: • body mass • blood pressure • blood saturation • glucose

27. TELEMEDICAL PLATFORM

28. TELEMEDICAL PLATFORM Pro-PLUSTelemedical Platform is a software available for users from anywhere in the world, through a web browser. Telemedical Platform enables: • Integration of a patient and a doctor • Collection of medical data • Usage of modern telemedical devices for remote patient care • Monitoring of selected medical parameters • Easy access for all users (doctors, nurses, patients and their family members, Monitoring Centre) from anywhere in the world

29. TELEMEDICAL PLATFORM The main functionalities of TelemedicalPlatform: • Collecting and viewing of medical data • Management of: users, their priviledges and devices • Clear presentation of ECG examination records in a modern web browser • Automatic ECG algorithms supporting a doctor • ECG description service for health care centers which don’t hire a cardiologist • Consultations between specialists • Possibility of manual entering of medical data from devices not integrated with Telemedical Platform • Remote management and care for the patient • Geolocation of devices and geo-tagging studies • SMS module – event notification

30. TELEMEDICAL PLATFORM Collecting and viewing of medical data

31. TELEMEDICAL PLATFORM Management of Platform users, their rights and devices

32. TELEMEDICAL PLATFORM Clear presentation of ECG records in a modern web browser

33. TELEMEDICAL PLATFORM Automatic ECG algorithms supporting a doctor

34. TELEMEDICAL PLATFORM Consultations between specialists

35. TELEMEDICAL PLATFORM Possibility of manually entering medical data from devices unitegrated with Telemedical Platform

36. TELEMEDICAL PLATFORM Remote management and care for a patient

37. TELEMEDICAL PLATFORM Geolocation of devices and geo-tagging studies

38. TELEMEDICAL PLATFORM SMS module – event notification

39. Pro-PLUS FUTURE • New medical areas: • CTG • Wearable devices • HCMS (Home Care Monitoring Station) • Intensive product development: • new design of devices • integration withmobile devices like smartphones • Entering US market (FDA Certification) • Private health care center

40. Pro-PLUS BUSINESS MODELS Pro-PLUS offers various telemedical solutions suited to individual needs of all users – doctors, health care centers, environmental nurses and patients. They are used for effective diagnosis of cardiac disorders and monitoring of patients’ health condition. Examples of Pro-PLUS business models: Model 1 Long-term monitoring Model 2Cardiac event-type diagnostics Model 3ECG preselection Model 4Environmental nurse

41. MODEL 1: LONG-TERM MONITORING Model directed to patients under permanent care of a cardiologist. The doctor offers remote service like long-term cardiac monitoring in addition to traditional medical care. A patient regularly but rarely, at the time and frequency consulted previously with the doctor, performs a number of tests – usually several times a month. Records go directly to the Telemedical Platform, where they are available to the specialist. A cardiologist can get SMS notifications about the latest examinations and watch them in chosen time. Doctor responds only if the ECG is abnormal for the patient. It provides better control of the patient between visits and makes an opportunity to automatically respond to incoming signals and to intervene quickly in situation of disease progression, eg. modifying the dose of medicaments. It also reduces the amount of unnecessary medical visits, which translates to greater availability of the doctor to another patients.

42. MODEL 2: CARDIAC EVENT-TYPE DIAGNOSTICS In cases of patients suffering from rare and irregularly occurring cardiac disorders, in which the classical diagnostic Holter-type methods failed, EHO-MINI event-holter device is recommended. It can be used for a very long period of time, up to effective registration of ECG abnormalities/ incidents. A doctor lends a patient a small, mobile device that patient wears all the time. At the time of feeling unwell, e.g. pain, palpitations or arrythmia, the patient presses a button on the device. Examination goes on-line to the Telemedical Platform, where it is available to the cardiologist or directed to the Monitoring Centre for description. This enables highly efficient detection of very rare and sporadic cardiac disorders. After detection of irregularity the doctor and the patient receive reliable material, which is the basis for application of an effective treatment method. Such model has been running successfully at the Cardinal Stefan Cardinal Wyszyński Institute of Cardiology in Anin. This model would also work for a GP, who rents a device to a patient with suspected cardiac disorders. Examination from the device goes through Telemedical Platform to the cardiologist, who makes description and sends it to the GP, so that it is possible to make a preliminary diagnosis. It has a significant impact on shortening queues and greater availability of medical specialists for those who are truly sick.

43. MODEL 3: ECG PRESELECTION Model addressed to cardiologists for rapid diagnosis of rare and irregular cardiac disorders. A doctor lends a patient an EHO-MINI event-holter device for 7, 14 or 30 days. The device performs ECG examination every three minutes, without the participation of the patient. Records are automatically sent to the Telemedical Platform. Then they are viewed and selected live by cardiologists at the Pro-PLUS Monitoring Centre. Cases in which irregularities were found are identified and after the preselection – submitted in a report to the doctor or the patient. This provides more than 80% relative detection of existing disorders due to the large amount of research. At the same time, thanks to the preselection service performed by specialists from the Monitoring Centre, there is no need for the cardiologist to view and analyze a large amount of records. The doctor gets only significant studies and settles effective treatment. It crucially enhances specialists’ work.

44. MODEL 4: ENVIRONMENTAL NURSE 12-lead ECG at patient’s home Through EHO12 connected to a computer with the Internet a nurse can perform professional 12-lead ECG examination at patient’s home. Examination is sent automatically to the Monitoring Centre, where a cardiologist describes it. After ten minutes results are sent back to the nurse. This way, the nurse has reliable information about patient’s state of health during the same visit. It is possible to react properly to a communicate about dyspnea or pain in the chest. It eliminates unnecessary calling for an ambulance and transporting the patient to a hospital. The examination can be performed periodically and prophylactically to the elder cardiac patients. The examination may be sent to the cardiologist that takes care of the person. It helps to avoid unnecessary visit to the cardiologist, better treatment and react to the progress of disease, e.g. by modifying dose of the medicines.

45. MODEL 4: ENVIRONMENTAL NURSE EHO-MINI event-holter Through using EHO-MINI event-holter and Telemedical Platform an environmental nurse and a doctor can remotely monitor cardiac disorders and another medical parameters like: blood pressure, weigh and saturation. The nurse consults with the patient the frequency and kind of examinations. The device is easy to use. Examinations are sent automatically to the Telemedical Platform, where they are available to the nurse. It enables monitoring of any number of patients. Remote access to the data enables the observation of the results more often, react to signals faster and sending examination results to the doctor for consultation in case of an emergency. The patient can enter their examination manually at Telemedical Platform and add comments. It enables the nurse to: • fully control their patients’ health condition • offer professional care to larger numer of patients • perform more medical services and tele-care

46. ADVANTAGES OF TELEMEDICINE IMPLEMENTATION • Better detection of cardiac disorders during diagnostic process • More effective monitoring of treatment progress • Less amount of traditional medical visits • More clients, especially wealthy people • Increasing health care centers incomes • Enrichment of services package • Optimal time management of specialists • Possibility to perform services to health care centers that don’t employ any cardiologist • Competitiveness in performing services in comparison to other units on the market

47. CONTACT: Mobile: (+48)725 724 919 (+48)785 436 707 e-mail: info@pro-plus.pl www.pro-plus.pl