<Insert Picture Here>

The Data Driven Healthcare EnterpriseThe Transformation to Value Based, Personalized Healthcare

Brett J. DavisSenior Director, Personalized HealthcareOracle Health Sciences Global Business Unit

© 2010 Oracle and/or its affiliates. All rights reserved. 2

The following is intended to outline our general product direction. It is intended for information purposes only, and may be incorporated into any contract. It is not a commitment to deliver any material code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle's products remains at the sole discretion of Oracle.

Roadmaps previously communicated by Phase Forward are subject to Oracle review and amendment.

© 2010 Oracle and/or its affiliates. All rights reserved. 3

“To wrest from nature the secrets which have perplexed philosophers in all ages,

to track to their sources the causes of disease, to correlate the vast stores of

knowledge, that they are quickly available for the prevention and cure of

disease – these are our ambitions.”

- Sir William Osler, 1906

Personalized Healthcare:Bringing a century old vision to reality…

© 2010 Oracle and/or its affiliates. All rights reserved. 4

“Supposing is good, but finding out is better.”

- Mark Twain

…Put More Simply

© 2010 Oracle and/or its affiliates. All rights reserved. 5

A Changing Healthcare Landscape

5© 2010 Oracle and/or its affiliates. All rights reserved. Oracle confidential

© 2010 Oracle and/or its affiliates. All rights reserved. 6

Life Sciences and Healthcare are convergingPredictive, Preventive, Personalized and Participatory Healthcare

HEALTHCAREHEALTHCARELIFE SCIENCESLIFE SCIENCES

“Trial and Error”Healthcare

“Trial and Error”Healthcare

“Evidence Based” Healthcare

“Evidence Based” Healthcare

“Precision”Healthcare“Precision”Healthcare

Blockbusters andmass-production of novel drugs

Blockbusters andmass-production of novel drugs

TargetedTherapiesTargetedTherapies

Increased regulation and

efficacy standards

Increased regulation and

efficacy standards

Analytics

LIFE SCIENCES HEALTHCARE

DNA chemistry and advanced

technology

DNA chemistry and advanced

technology

“Managed” Healthcare“Managed” Healthcare

Paper based Records

Electronic Data Capture

Pharmacovigilanceand Risk Mgmt

Safety atPoint of Care

Electronic Medical Records

Paper basedSystems

Personalized Healthcare

Patient Care and Disease Mgmt

Translational Med

© 2010 Oracle and/or its affiliates. All rights reserved. 7

The Future of the Healthcare Industry Lean. Global. Networked.

A transformation is only possible through the synergy of healthcare information technology (HIT) with scientific breakthroughs in the molecular understanding of disease, novel therapeutics and diagnostics, as well as a redesign of our healthcare delivery models. Leveraging data from multiple sources and diverse populations from across the healthcare system will be essential. 

Not only is this approach necessary for providing the “best care for the right patient,” but it has major business model implications for many constituents in the healthcare ecosystem including pharma/biotech, health providers, PBMs and payers, and as a result, their IT strategies.

—Bill Dalton, PhD, MD, President/CEO, Moffitt Cancer Center

© 2010 Oracle and/or its affiliates. All rights reserved. 8

The Future of the Life Sciences IndustryLean. Global. Networked.

Our scientists are working in new ways. By using highly-specialized techniques, we're aiming to design treatments personalized for the unique needs of individual people. Science is making this type of personalized medicine possible for the first time in history… This personalized medicine approach means new opportunities for people who are sick, for physicians and for our shareholders.

…finding new treatments depends on collaboration. No company, hospital, lab, or scientist can do it alone. That's why we've formed partnerships with governments, independent medical and scientific groups, companies and advocates….

—Jeff Kindler, CEO

Pfizer Corporation

© 2010 Oracle and/or its affiliates. All rights reserved. 9

Systemic Collaboration to Improve Health

These systems supported individual silos across the health science ecosystem, but must now provide data for an integrated view

Investment is shifting towards R&D and clinical collaboration, personalized / translational medicine and care management

Increasing demand and capabilities for personalized medicine will drive new business models, including more value-based healthcare

Initial customer investment focused on transactional capabilities (EMR, Claims, EDC, Trial Management, etc.)

The new healthcare delivery paradigm requires collaboration

Patient

Researcher Citizen / Member

Individual / Family

Care Managemen

t

Personalized / Translational

Medicine

Value-BasedHealthcare

© 2010 Oracle and/or its affiliates. All rights reserved.

© 2010 Oracle and/or its affiliates. All rights reserved. 10

The new drug development paradigmA networked healthcare and life science model

Basic Research Discovery & Development

Point of Care

CROCRO

Source: adapted from DataMonitor

Academia, CRO &

SponsorSponsor Healthcare

© 2010 Oracle and/or its affiliates. All rights reserved. 11

Aerospace transformation… Boeing has rapidly shifted the company to embrace a “network” of partners

Aerospace transformation… Boeing has rapidly shifted the company to embrace a “network” of partners

Partners Across the Globe Are Bringing the Boeing 787 Together

Clinical development transformation… Merck is shifting drug development toward embracing a “network” of partners

Clinical development transformation… Merck is shifting drug development toward embracing a “network” of partners

Merck External Basic Research (EBR) team expects to deliver 25% of early pipeline from external partners by 2013 (Source: Pharma Focus Asia)

The new drug development paradigm

Piramal

PoC Oncology Drug Discovery

Patheon

• Commercial Manufacturing

• Pharmaceutical Dev. Services

PPD

• Vaccine Testing

• Central Lab and Sample Storage

Moffitt Cancer Center

Total Cancer Care

Advinus

Candidate Drugs for Metabolic Disorders

Orchid Chemicals

Bacterial and Fungal Infection Dev

WuXi AppTec

Discovery Chemistry

Ranbaxy

Antifungal and Antibiotic Target Programs

© 2010 Oracle and/or its affiliates. All rights reserved. 12

Patient-centered, collaborative care

Reid, Compton, Grossman, and Fanjiang, Editors, Committee on Engineering and the Health Care System, National Academy of Engineering and the Institute of Medicine, National Academies Press, 2005, pg. 20. Adapted from Ferlie and Shortell, 2001, Improving the quality of health care in the United Kingdom and the United States: A framework for change, Milbank Quarterly 79(2): 281-315

“Care that is safe, effective, patient-centered, timely, efficient, and equitable.”

-- Institute of Medicine, 2001

© 2010 Oracle and/or its affiliates. All rights reserved. 13

What is the data driven healthcare enterprise?

13© 2010 Oracle and/or its affiliates. All rights reserved. Oracle confidential

14Page 14

The Learning Healthcare

Organization

Accountable Care Organizations

Enterprise Quality

Standards

Clinical Effectiveness

Comparative Effectiveness

Automating “Today’s”Healthcare Enterprise

Need for Secure, Interoperable Healthcare Data and Analytics

Impact on HC Transformation /

Value to Healthcare

System

Today

Performance Management

Implications for healthcare providersThis evolution has both clinical and operational implications

Core Transactional Systems

Clinical & Enterprise Integration

Enterprise Data Warehouse

Context Specific Analytics and Applications

Core Systems Requirements:

Today’s “Transactional” Systems Were

Not Designed to Enable this

Transformation

Evidence Based Medicine

Evidence Based Medicine

Value-based, Personalized Healthcare

Value-based, Personalized Healthcare

Trial and Error Medicine

Trial and Error Medicine

15

-Basic / Translational Research

-Clinical Research/Trials

-CER

-Deep Analytics / Informatics

Framework for PHC Enabled by HITAchieving this will create a “learning healthcare” paradigm

“Learning Healthcare” Paradigm Supported by Robust, Interoperable Informatics

-Trustworthy data from EHRs

-Longitudinal Biobank data

-Imaging

Translate guidelines and empirical results into specific process steps

Leverage workflow driven informatics processes to drive to point of care with decision support analytics

Trustworthy data to measure protocol with analytics to track outcomes or deviations

Employ analytics to measure results and teach people, activate patients and transform care

16

-Basic / Translational Research

-Adaptive Clinical Research/Trials

-CER

-Deep Analytics / Informatics

“Learning Healthcare” Paradigm Supported by Robust, Interoperable Informatics

-Trustworthy data from EHRs

-Longitudinal Biobank data

-Imaging

Translate guidelines and empirical results into specific process steps

Leverage workflow driven informatics processes to drive to point of care with decision support analytics

Trustworthy data to measure protocol with analytics to track outcomes or deviations

Employ analytics to measure results and teach people, activate patients and transform care

Health Management PlatformEnterprise Health

Analytics Context Specific Analytics

Existing Clinical

Systems

Novel Research Methods for Enabling Rapid Learning

Networks (e.g. adaptive trial design, signal detection)

Real-time FeedbackReal-time Feedback

Framework for PHC Enabled by HITAchieving this will create a “learning healthcare” paradigm

17

Personalized Healthcare Requires Deep Analytics

Departmental “Dashboards”are Insufficient

DASHBOARDS

• “Visible”

PLUMBING

•Mappings to applications and data transformations take expertise & time

• The technology infrastructure has its own complexities

18

Personalized Healthcare Requires An Integrated View Insights From Combining Clinical, Biomedical, Operational and Financial Data

“How is our nurse overtime policy affecting our ICU quality measures? Patient satisfaction?”

FINANCIAL

HR

SUPPLY CHAIN

CLINICAL

“Do our cardiac care reimbursements reflect our improved quality measures?”

“How many patients with a particular molecular profile and clinical attributes are in our system?”

“INTEGRATED VIEW

ANALYTICS”

“GENOTYPE”“SILO ANALYTICS”

“What’s our overall performance? Our quality performance and cost to deliver that quality?”

19

What does this ultimately mean for a health system?Data and applications must be decoupled for robust use of the data and for applications to draw upon multiple data sources

Fulfill Health Information Request

Health Information Services Agreement For Secondary Use

Health Information RequestAuthenticate

Requester

Transform and Normalize Health Information

Patient Health Information Aggregated for Normalization

Transformed into Information Service Format

Patient Health Information Gathered

Clinical Innovations

Clinical & Operational

Benefit

Copyright © 2010, Oracle. All rights reserved.

Oracle & [customer] Confidential 20

Analytics coupled with the right health management platform can support longitudinal careFocus for Today: Citizen/Patient Care Cycle

• Identifying, stratifying and targeting patients• Attracting patients• Improving administrative processes to

– Improve utilisation of resources– Help Patients get treatment– Improve patient experience

Unaware Patient AwarePatient

PatientVisits HC

Professional

GetTreatment

Patient Discharged

Patient is Compliant

Patient is Stable

• Support after discharge• Adherence• Patient monitoring• Supporting patient behavior modification

Health Consumer Gateway

Pre-Acute AcuteIntervention

Post-Acute/DiseaseManagement

Copyright © 2010, Oracle. All rights reserved.

Oracle & [customer] Confidential 21

Effective Care Cycle Management Has a Positive Impact on Both Cost and Quality

Source: Intel Corp 2006

Cost of Care/Day

0%10

0%

$1 $10 $100 $1,000 $10,000

Acute CareResidential Care

Home Care

ICU

CommunityHospital

SpecialtyClinic

Assisted Living

Skilled Nursing Facility

Doctor’sOffice

CommunityClinic

Chronic Disease Management

Healthy Independent Living

Qua

lity

of L

ife

© 2010 Oracle Corporation Confidential

These platforms also create opportunities for biopharma industry innovation and novel collaborationReal-time Clinical Information Exchange Across the System

Patient RecruitmentClinical Data

PROVIDERSHospital

Clinics

Bio-banksCRO

Pharma/Biotech

Life Sciences

Clinical Trials

Safety & Pharmacovigilance

Learn

Confirm

Learn

Confirm

HEALTHCAREHEALTHCARELIFE SCIENCESLIFE SCIENCES

For Oracle employees and authorized partners only. Do not distribute to third parties.© 2010 Oracle Corporation – Proprietary and Confidential

© 2010 Oracle and/or its affiliates. All rights reserved. 24

Join in on the Conversation with Oracle Health Sciences

Del.icio.us/rss/OracleHealthSci

Facebook.com/OracleHealthSciences

Twitter.com/OracleHealthSci

© 2010 Oracle and/or its affiliates. All rights reserved. 25

Oracle Health Sciences InstituteIn Partnership With Sun Labs

• Focused on research that will accelerate IT innovation to advance personalized medicine andthe delivery of safe and effective treatments and health care services to patients around the globe

• Works in collaboration with academic research centers. Current collaborations include:• Dana Farber Cancer Center (translational research)• The Cleveland Clinic (cardiac decision support)• St. Francis Xavier University (parallelizing ontological reasoning)

• Focuses on areas fundamental to the challenges facing health sciences organizations. Research priorities include: • Artificial intelligence and semantic technology• Genomic, genetic and phenotypic data analysis• Data mining to support optimization of clinical trials• Predictive algorithms to enable earlier detection of adverse events• Advanced decision support at the point of care