Trieste: from Research Projects to Innovation

1. Trieste: from ResearchProjects to Innovation Alberto Steindler – COO eHealth & eGovernmentintegratedsolutions

2. Friuli Venezia Giulia a Region of Excellence 3 Universities (UniTS - UniUD - SISSA) 4 Science & Technology parks Area Science Park the main Italian Scientific campus Friuli Innovazione Polo Tecnologico Pordenone Agemont 30+ Research Centresand International Institutions The FVG Region scores 8.8 researchers out of 1,000 workers ITALY 3.3 EU 5.4 OECD average 6.9 USA 9.6 Japan 10.4

3. TRIESTE City of Science Trieste 38.5 researchers per 1,000 workers University of Trieste SISSA International School for Advanced Studies INAF Astronomical Observatory of Trieste LBM Marine Biological Laboratory ICTP International Centre for Theoretical Physics TWASAcademy of Sciences for the developing world CIB Interuniversity Consortium for BiotechnologiesICGEB International Centre for Genetic Engineering and Biotechnology INFN National Institute for Nuclear Physics ICS UNIDO International Centre for Science and High Technology ELETTRASynchtrotron and Free-electron laser light TASC National Laboratory for Advanced Technology and Nanoscience CNR Institute for the Structure of Matter OGS National Institute for Oceanography and Geophysics This fertile background gave birth to bright examples of excellence in local industry, such as TBS Group

4. TBSGroup • Born from the research project ACMAGEST, was established in the ‘80s as an advanced clinical engineering service provider • From2000 itbegan investing in its growth abroad (esp. EU) widening its range of activities • Leader in the services for MedicalEquipment & DevicesReference player for e-Health & e-Government systems and solutions • HQ - AREA Science Park (Trieste) • Operates in 13 countries through over 20 subsidiaries(Austria, Belgium, China, France, Germany, India, UK, Italy, The Netherlands, Portugal, Saudi Arabia, Serbia and Spain) • 2200+ highlyqualified staff and 197,5M revenues(2011) • 330 workshops, 45 Regional operational centres, 25 competence centres • 300 laboratorieson site, connected to more than1.000 European and Extra-european Hospitals • Listed on the Stock Exchange AIM Italy since 2009

5. TBS Group: from Trieste to Europe… and Beyond PCS GmbH www . pcs . at TBS BE Telematic & Biomedical Services Bvba www . tbsbe . com TBS FR Telematic & Biomedical Services Sarl www . tbsfr . com Subitec GmbH www . subitec . de MSI MedServ International Deutschland GmbH www . medservinternational . com TBS Group S . p . A . TBS Group, Area Science Park, Trieste www . tbsgroup . com EBM Srl www . ebm . it Insiel Mercato S.p.A www.insielmercato.it TeSAN S . p . A . www . tesan . it TesanTelevita srlwww.tesantelevita.it CRIMO Italia Srl www . crimo . it Caribel srl www . caribel . it SLT srl www.slt.eu.com Surgical Technologies BV www . surgical . nl TBS PT (STB Serviços Telemáticos e Biomédicos Unipessoal LDA) www . tbspt . com TBS ES (Telematic & Biomedical Services SL) TBS G . B . Telematic & Biomedical Services Ltd www . tbses . com www . tbsgb . com MNE Technologies Private Ltd. Sinopharm TBS (China) Arab Health TBS Saudi www.mneindia.com

6. WhyInnovate? …to create VALUE The WHY of innovation is simple: change is accelerating and we don’t know what’s coming in the future: we must innovate to both prepare for change …and …to make change. CHALLENGES Nanotech Biotech CARE (Social and Healthcare Systems) Aging Society Medical– Bio - informatics Chronicdiseases TOOLS €$£

7. R&D – OverallAims • New products/services • New “state of the art” technologies • New business models & sales partnerships • Intensified cooperation withother businesses and PROs (Public Research Organizations) • Enhance culture within the company and outwards: • integrated care • genomics, proteomics, nutrigenomics(and other –omics) and personalized medicine INNOVATION

8. R&D and INNOVATION in TBS • Process innovation to optimize the way in which products and services are created • DevelopnewTelemedicine product & services • Developnewmedical & bio– informaticssolutionsfor the personalization of medicine (integration of clinical and genetic data) • Innovation of processesto betterfulfill or evenanticipatethe requirements of ourcustomer GOAL strengthen our position as a reference player in the markets and as a crucial actor for the new scopes of healthcare - such as the Proactive Medicine - increasing the quality of social and healthcare services provided to the population

9. CASE EXAMPLES Our latest and most significant R&D projects

10. Telemedicine … we are notDreamingonly! I-DON’T-FALL: ICT Platform for the prevention and management of falls with personalized solutions for vulnerable patients. HEALTH AT HOME: designand development of a home monitoring system for Chronic Heart Failure patients. IN PISTA: consolidation and extension of support standards to interoperability and integration of social and health information systems. CHRONIUS: management of chronic patients (COPD and Kidney disease) at their home. Several tools such as wearable sensors, and others for lifestyle monitoring, smart clinical decision support system. FEARLESS:detecting potential situation of risk in domestic environment with automatic alarms. Fall alarms, imaging analysis alarms; flood, gas, smoke alarms.

11. Medical & Bio- Informatics Pharma PHI: integratedmolecular data EPR for more personalizedand thusefficientdrugs. SYMPAR: EPR for the management of neurodegenerative diseaseprotocols(Parkinson). D.NAMICA: IT integratedplatformfor the personalizedmedicine (genothypic and phenotypic data). Nutraceutics& Nutrigenomics a path to personalizeddiet: functional foods and services that improve the health of individuals and reduce the occurrence of disease.

12. Furthereffects of R&D Telemedicine in the VCO Verbania Cusio OssolaMulti-pathologyunifiedplatform The first real-time Telemedicine experience in the Piedmont Regionfor 300 home patients affected by cancer- diabetes - COPD – Heart Failure. phi-Technology: open source platform for the design-generation-implementation of healthcare web applications (process/model driven& seviceorientedarchitecture) 25+ runningcontracts Genotype and PhenotypeintegratedEPR NHS’ Whole System Demonstrator Programme(partecipation in KENT) the largest randomized control trial of telehealth and telecare in the world, involving 6191 patients (diabetes, Heart Failure and COPD) and 238 GP. Telemedicine in the Veneto Regiontelemonitoring of people who live situations of social and/or health care risk (2,400 users), electronic detection falls (1,200 users), remote monitoring vital signs (1,200 users) now 246 active users.

13. What’scomingnext? CLINICAL PATHWAYS: to standardize care processes and improvequality in healthcare. INTEGRATED CARE: to overcome the fragmented delivery of health and social services - more coordinated and integrated forms of care provision (diagnosis, treatment, care, rehabilitation and health promotion). PROACTIVE MEDICINE: shift from reactive medicine (waits for the disease and then provides treatment) Proactive medicine provides a platform for maximizingprevention and aims at treating the root causes of the disease process improving the care of chronic disease and boosting the self care model

14. So… why is R&D so crucial? Our experience… R&D plays an important role leveraging the INNOVATION process which is increasingly vital to current and future profits. Innovation brings new or improved products and services to the market place (more customers, more satisfied customers). Innovation allows to participate in new markets. It results in high quality jobs, elevating knowledge among employees. R&D provides a better position to achieve and maintain competitive advantage in the increasingly challenging global market place. R&D IS OUR EYE ON THE FUTURE

15. “The greatestdiscovery of my generation isthat human beings can alter theirlives by alteringtheirattitudes of mind.” William James 1842 - 1910 Free reconstruction from “Metamorphose” by M.C. Escher