Medical Needs for the Electronics Industry; Market Analysis and Electronic Roadmap Needs.

1. Medical Needs for the Electronics Industry;Market Analysis and Electronic Roadmap Needs. Terrance J. Dishongh, Ph.D. Support from: Intel (Brad Needham, Eric Dishman, Jay Lundell, Margie Morris), Plexsus (Bill Bartel), 3M, ITF,

2. Elder care is returning home again Poor Houses / Almshouses “pauper” Home “grandma” Insane Asylum “inmate” Only way to save costs but increase quality is home care. Home care is fastest growing segment of health industry. Hospital “patient” Home “grandma” Nursing Home “senior citizen” Assisted Living “resident”

3. To care for an aging planet 2002 2050 Percentage of Population over 60 years old Global Average = 10% Percentage of Population over 60 years old Global Average = 21% SOURCE: United Nations ▪ “Population Aging ▪ 2002”

4. Worldwide age wave is coming Today… 34 million elders in U.S. 550 million worldwide 5 U.S. workers to 1 retiree 3 Japan workers to 1 retiree By 2025… 74 million elders in U.S. 1.2 billion worldwide 3 U.S. workers to 1 retiree 2 Japan workers to 1 retiree Other facts… 80+ years old is fastest growing “old old” are 2 women : 1 man

5. Nurses/caregivers in short supply “The 10 fastest-growing occupations include medical assistants, jobs for whom are expected to grow by 59 percent, or 215,000 new jobs; network systems and data communications analysts, positions for whom the BLS expects to jump by 57 percent, or 106,000 new jobs; and physician assistants, for whom the BLS projects a 49 percent rise, or 31,000 new jobs.” Source: Bureau of Labor Statistics, pub in CNN/Money.com, “Where the jobs will be Greatest employment growth is likely to be in service industries, according to new labor study.” By Jeanne Sahadi, Feb 13, 2004.

6. Boomers spending big on health • “The biggest growth in health-care spending these days isn't coming from today's elderly. It's coming from tomorrow's elderly -- the baby boomers and their younger siblings.” • “Per capita spending among Americans aged 30 to 50 rose more than 75% between 1987 and 2000.” Source: WSJ: “Tomorrow's Elderly Fuel Health-Care Spending And Strain the System” 1-25-04

7. The global challenge simply put • Increase the quality of care & of life… • for twice the number of seniors… • while reducing healthcare costs. • Current healthcare system is optimized for treating disease; innovation is clinic-and-pharma centric • Have to invent system optimized for wellness (prevention, early detection, compliance, caregiver support) • Must put technologies into everyday lives of people; must put the home, consumer, & informal caregivers “in the loop” and offload formal institutions when appropriate • It will take decades to achieve, but must start R&D (research & debate) now if we ever hope to get there

8. Worldwide healthcare crisis is here • Every major world economy has health as biggest percentage • Nursing shortage in many parts of the world • South Korea and Japan technology infrastructure

9. Result: Home care inflection point “Healthcare’s costs, coverage problems and demographic pressures mean system overload; it’s formal institutions can’t cope with the future. What will ease the pain? A major shift, enabled by technology, to self-care, mobile care, home care. - Forrester Report, Dec 2002

10. Market Analysis • Prismark estimates that medical electronics equipment production will be $39.5Bn in 2004, accounting for about 4% of the global electronics industry. • This market is expected to continue to increase at an average rate of 4.4% per year through 2008. • Growth is primarily driven by the worldwide demographical shift to an older population, which indicates a continuing increase in medical care spending. • Medical care is already the single largest component of the US GDP.

11. Market AnalysisOutsourcing and R&D • Prismark estimates that 62% of medical electronics equipment will be assembled in the Americas in 2004. • This region is followed by Europe 21%, Japan 10%, and the Rest of Asia 7%, • Most medical electronics systems (by value) are produced in the region where the products are consumed. • However, several major medical electronics companies, such as Siemens and GE, are increasing design and assembly activities in lower-cost regions, such as China. • As the percentage of medical electronics consumed in developing economies increases, a greater percentage of medical electronics systems will be produced there.

12. Market Analysis

13. Market Analysis

14. NEMI Roadmap Issue • Situation Analysis • NEMI is addressing the rise in the electronic healthcare sector. • Convergence of Market Demands and Regulatory Issues are Driving Action in two different directions. • Critical (Infrastructure) Issues – • American Retirees should double by 2025 putting excessive demand on the healthcare system. • Demand for Healthcare is outpacing the supply. Especially as ‘boomers’ age. • No-lead issues with chlorine bleach.

15. Convergence = new home health platform • Digital home entertainment infra can be used for health • Everyday health through everyday devices • Personalized, proactive health info/reminders/agents

16. NEMI Roadmap Issue Needs in the Industry • Greater IT infrastructure to drive diagnostics and patient records. (Bush has $100M into Patient Electronic Records Research) • There is not a complete architecture between POC, monitoring, compliance, diagonistics and records. (New Technology is not needed as much as integration). • Growing number of PAN based companies show constant monitoring and sensor networks are close at hand.

17. Issues and Future Trends • MEM’s and Implantable Devices are a growing market segment. • New Research near to market • Ion Sensitive Field Effect Transistors • Inductive recharging • Impact to national economy on healthcare will force the need for less expensive systems. • 74 million elders in 2025 • Impact is a national trend toward home health technologies in the long term • “Integration and Interface Design are strongly needed.” Eric Dishman Testimony to House Subcommittee on Aging.

18. Why is Intel here? • Grow our markets: supply computing and communications technologies to a broadly defined home health & wellness market which is poised for massive growth worldwide • Healthy workforce: insure our own 80,000 employees worldwide have tools, technologies, and training to care for their own aging parents • Healthy economy for business: catalyze new paradigms of health care to head off looming worldwide economic crisis from high-cost, clinic-centric care that cannot scale to meet the needs of the age wave We will never be a healthcare company. We supply technology ingredients. But we continue to lead R&D in new areas. And some new players will shape next generation technologies for the next generation of seniors.

19. Intel’s Proactive Health Lab Evidence-Based Technology Research Evidenced-Based Technology Research http://www.intel.com/research/prohealth/

20. Intel’s Proactive Health Lab http://www.intel.com/research/prohealth/

21. Intel’s Proactive Health Lab http://www.intel.com/research/prohealth/

22. Purushothaman and Toumazou IEEE PROC 2001 Ion Sensitive Field Effect Transistor (ISFET) DNA Polymerase Marker for ACGT Nucleotides by pH changes

23. Intel’s Precision Biology Lab

24. Intel’s Research Council grants http://www.intel.com/research/university

25. CAST partnership with AAHSA http://www.agingtech.org

26. CAST partnership with AAHSA http://www.agingtech.org

27. ETAC consortium with Alz Assoc http://www.alz.org

28. “Health care is the mother of all big businesses …. this is life and death—some people will get access to this ‘health-care mainframe,’ and everybody else dies.” - Andy Grove Source: “Intel's Andy Grove: The Next Battles in Tech: The IT visionary says tech needs to learn to think bigger,” by Brent Schlender, FORTUNE, Monday, April 28, 2003