Introduction page

1. Introduction page Setting the Stage for Disruptive Innovation in the Health Care Industry

2. What is Strategyn What is Strategyn? Strategyn specializes in the discovery of high-growth emerging markets and the creation of breakthrough product and services. Our patented approach to innovation is featured in the January 2002 issue of the Harvard Business Review … ... and in the March issue recognized as one of the best business ideas of 2002.

3. How did we evolve? How did we evolve? Our approach is the result of 10 years work with companies such as HP, Johnson & Johnson, Medtronic, Agilent, Motorola, UTC and Bosch, all of which have applied Strategyn’s thinking to manage various aspects of innovation.

4. How will this impact your bottom line? What successes have been realized? Cordis became the angioplasty balloon market leader - gaining over 20 points of share. They also created the stent - which became a $1 billion market in one year … the fastest growing medical device in history.

5. 70+ How did they achieve this success? 1) Uncovered the criteria their customers used to judge value. Minimize the force to cross the lesion Minimize restenosis - recurrence Minimize the time to move in winding vessels Minimize damage to other vessels Minimize the time to place the balloon

6. How did they achieve this success? Imp Sat 2) Quantified their importance and the degree to which they were currently satisfied. Minimize the force to cross the lesion Minimize restenosis - recurrence Minimize the time to move in winding vessels Minimize damage to other vessels Minimize the time to place the balloon 7 9 4 8 5 4 3 7 7 2 46% Value delivered

7. How did they achieve this success? Imp Sat Opp 3) Identified the opportunities for improvement - the most important, least satisfied criteria. Minimize restenosis - recurrence Minimize the force to cross the lesion Minimize damage to other vessels Minimize the time to place the balloon Minimize the time to move in winding vessels 9 7 8 5 4 3 4 7 2 7 15 10 9 8 4 46% Value delivered

8. How did they achieve this success? Projected Sat Imp Sat 4) Devised and patented product features that better satisfied the key opportunities for improvement. Minimize restenosis - recurrence Minimize the force to cross the lesion Minimize damage to other vessels Minimize the time to place the balloon Minimize the time to move in winding vessels 9 7 8 5 4 3 4 7 2 7 7 8 8 5 7 70% 46% Value delivered

9. 2y + yz3 x zy3 + yz3 x zy3 - x2y3z6 + 2x2 + 2y + yz3 x zy3 - x2y3z6 + x2y3z6 + 2x2 + 2y + yz3 x zy3 - x2y3z6 + 2y + yz3 x zy3 + yz3 x zy3 - x2y3z6 + 2x2 + 2y + yz3 x zy3 - x2y3z6 + 2y = The Optimal Solution How do we think about the innovation process? Solutions The process is analogous to solving a complex simultaneous equation, where the objective is to find the best solution to satisfy the criteria used to judge value. Optimal Solution Criteria

10. How is the process typically addressed? Organizations often talk with customers to formulate and brainstorm ideas, select those to prototype, evaluate them with customers and use the feedback to make design refinements ... without ever knowing what criteria customers use to judge value. Solution-based

11. What is wrong with this approach? Talk with customers • It is a process of trial and error • Conflicting outcomes between constituents are often unknown • Hundreds of worthless ideas are considered • Breakthrough ideas may go unnoticed • The wrong trade-off’s may be made Document requested solutions Deliver what customers request

12. IBM PCjr 1984 - 1985 How does Strategyn make these improvements? We have devised a system for measuring the value of an idea ... making it possible to formulate and pursue breakthrough ideas, while avoiding investments in efforts that will ultimately fail.

13. What do we do differently? • Capture and prioritize all the criteria customers use to judge value • Systematically focus creativity on key opportunities for improvement • Optimize ideas to create breakthrough solutions Outcome-based

14. How can this be applied to the health care industry? • Understand how value is measured in the eyes of each constituent • Prioritize the opportunities for improvement • Provide critical information needed for strategy formulation

15. What is the goal? The goal is to provide suppliers, insurers, regulators, service providers and others in the industry with the market insight that is needed to direct resources and speed progress toward health care reform and market and product innovation

16. What are the challenges? There are many constituents - suppliers, insurers, regulators, service providers and patients - all of whom have conflicting desired outcomes … … but all of which are increasingly more dependent on the patient as a source of revenue.

17. How can we leverage this fact? We can provide the industry with a customer-centric view of the market … … a view that will set a foundation from which disruptive innovation can flourish.

18. How do we begin? We begin by understanding, from the customer’s perspective, what job they are trying to perform … or what underlying process they are trying to execute. Obtaining Care Managing Health

19. Managing Health 1. Manage basic body functions 2. Maintain physical function 3. Assess physical condition 4. Ensure proper nutrition 5. Reduce the risk of disease 6. Manage medications 7. Manage mental health 8. Manage disease Obtaining Care Managing Health

20. Obtaining Care 1. Accessing care 2. Diagnosing illness 3. Planning treatment 4. Obtaining treatment 5. Managing costs 6. Paying bills Obtaining Care Managing Health

21. What do we do next? Next, we determine what customers are trying to achieve and how they measure success as they execute this job or underlying process. Obtaining Care Managing Health

22. How do we capture these measures of value? • Define the customer(s) • Plan outcome-based interviews • Capture “desired outcomes” • Net out duplicate outcomes

23. How was this accomplished? In May 2002, we conducted interviews with 70 males and females of all ages and income levels to capture their desired outcomes on managing their health and obtaining health care. The interviews were conducted in Miami, FL and Minneapolis, MN.

24. 10 What criteria are used to judge value? • When managing basic body functions, people are trying to: • Get the proper amount of sleep • Achieve the desired level of energy – prevent fatigue • Maintain regularity – regular bowel movements • Remain free from pain, move without pain • Prevent dehydration

25. 7 What criteria are used to judge value? • When maintaining physical function, people are trying to: • Maintain body weight within a desired range • Maintain the desired level of muscle tone • Maintain the desired level of strength • Maintain the desired level of flexibility • Maintain the desired level of physical performance

26. 10 What criteria are used to judge value? • When assessing physical conditions, people are trying to: • Determine if any genetic defects are present • Determine if any toxins are present in the body • Determine if any hormonal imbalances are present • Determine if any internal body parts are being overburdened • Know with certainty that the body is free from disease

27. 8 What criteria are used to judge value? • When ensuring proper nutrition, people are trying to: • Determine how the body is reacting to what is eaten • Determine if certain foods are not being digested properly • Determine which foods may have potentially harmful effect • Determine if the body is properly absorbing nutrients • Determine what dosage of supplements should be taken

28. 11 What criteria are used to judge value? • When reducing risk of disease, people are trying to: • Prevent the likely onset of a genetically disposed disease • Minimize the frequency of illness – e.g., common cold • Minimize the frequency of allergic reactions • Reduce the risk of contracting a curable disease or infection • Prevent the build-up of harmful toxins, pollutants in the body

29. 5 What criteria are used to judge value? • When managing medications, people are • trying to: • Minimize the number of medications that must be taken • Determine what dosage produces the desired results • Determine if a medication is having the desired effect • Avoid unwanted drug interactions and side effects • Ensure needed medications are taken when required

30. 12 What criteria are used to judge value? • When managing mental health, people are • trying to: • Maintain a positive attitude • Stay mentally alert • Maintain concentration and focus • Determine why you do things that are not good for you • Manage anxiety

31. 6 What criteria are used to judge value? • When managing disease, people are • trying to: • Slow the progression of an incurable disease • Prevent the aggravation of an existing medical condition • Prevent a cold/illness from getting worse • Learn how to control, manage a disease/problem • Prevent the reoccurrence of a disease

32. What is unique about these desired outcomes? • They are stable over time • They are finite in number • They represent all the customer’s measures of value

33. The Objective of Innovation 100% Outcomes Outcomes Outcomes EVOLVED 1 2 3 4 1 2 3 4 1 2 3 4 n n n Solution “N” Solution A Solution B 0%

34. How do we prioritize the outcomes? • Prepare a survey • Administer it to a larger population • Determine the importance of each outcome • Determine the degree to which they are satisfied

35. How was this accomplished? Between August and October 2002, we surveyed 270 individuals that represented an accurate sample of the US population across age and gender.

36. Outcomes What new insights does this present to the industry? 1 2 3 4 • Prioritize areas of opportunity • Identify segments of opportunity … and with this knowledge we can … • Apply disruptive technology concepts • Create outcome-based “purpose” brands n

37. Outcomes Prioritize areas of opportunity 1 2 3 4 Imp Sat Opp Determine if genetic defects are present Determine if any toxins are present in the body Maintain body weight within a desired range Maintain the desired level of muscle tone Maintain concentration and focus 9 7 8 5 4 3 4 7 2 7 15 10 9 8 4 n Opportunity = Importance + f(Importance - Satisfaction)

38. Outcomes Identify segments of opportunity 1 2 3 4 Segments of opportunity n 4 segment solution

39. Outcomes Apply disruptive technology concepts 1 2 3 4 Skill Level Cost Level Target Determine if genetic defects are present Determine if any toxins are present in the body Maintain body weight within a desired range Maintain the desired level of muscle tone Maintain concentration and focus 10 8 7 5 7 10 7 6 8 7 1-1 1-1 1-1 1-1 1-1 n

40. Create outcome-based “purpose” brands Purpose Brand Not extendable but most valuable Infinitely extendable Descriptor Brand

41. What were the key findings? • Uncovered opportunities across the broad market • Discovered 4 market segments and unique opportunities within each • Prioritized opportunities to pursue with disruptive technologies • Identified potential “purpose” brands

42. What were the key findings? • Uncovered opportunities across the broad market • Discovered 4 market segments and unique opportunities within each • Prioritized opportunities to pursue with disruptive technologies • Identified potential “purpose” brands

43. Broad Market Opportunities - Managing Health (Greatest Opportunities for Improvement Across All Segments)

44. Broad Market Opportunities - Managing Health (Opportunities for Improvement Across All Segments)

45. Broad Market Opportunities - Managing Health (Opportunities for Improvement Across All Segments)

46. Broad Market Opportunities - Managing Health (Opportunities for Improvement Across All Segments)

47. Broad Market Opportunities - Managing Health (Opportunities for Improvement Across All Segments)

48. Broad Market Opportunities - Managing Health (Least Opportunities for Improvement Across All Segments)

49. Broad Market Opportunities - Obtaining Care (Greatest Opportunities for Improvement Across All Segments)

50. Broad Market Opportunities - Obtaining Care (Opportunities for Improvement Across All Segments)