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TRANSCRIPT
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Wireless Ambulatory Monitoring "Anytime-Anywhere”
Unique Perspectives On Remote Monitoring To Engage Consumers and Providers
John M. Mize Director of Federal Business Development
LifeWatch Corp.
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Content
Market Overview
Telecare A.C.T.
Wireless Solutions
Electronic Record Integration
Opportunities
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Medical Automation and Change
o Medical Automation Requires Significant change o Change in Healthcare Delivery o Change in Data Management o Change in how providers manage patients and
diseases o Change in our understanding of guidelines, protocols,
and best practices
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Healthcare Reform
o Managed Care Reformo Tax incentives for individual health plans o Anti-competition laws revoked o Shift in incentives away from procedures and toward outcomes
o Malpractice Reformo Over reliance on defensive medicine o Cause for lack of data collection for medical errors
o Culture of Dependency o We’ve come to expect free healthcare, “someone else will pay
for it” mentality which increases over use…The ER epidemic o Personal Responsibility and ownership
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Healthcare Reform
o Information and Data Reformo Need for quality data on outcomes and errors o Need for data transferability o Need for Electronic integration of security encrypted data across
provider specific organizations… “if banking can do it so can Healthcare”
o Need to collect data to maximize guidelines
o Shift toward Preventative Medicineo Patient Education o Disease state management
o Efficient and early diagnostic measures
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“Any Time – Any Where”
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Projected Health Expenditures
o National health expenditures are projected to reach $2.6 trillion by 2010
3,000 -
500 -
2,500 -
2,000 -
1,500 -
1,000 -
0-
Billions of Dollars
19601980
19931997
19992001
20032005
20072009
Private
Public
Source: U.S. Department of Health and Human Services, Health Care Financing Administration, March 2001.Source: U.S. Department of Health and Human Services, Health Care Financing Administration, March 2001.
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Concentrated Medical Costs
o 25% of medical costs come from ½ of 1% of the population
o 50% of medical costs come from 2% of the population
0%10%20%30%40%50%60%70%80%
0.05% 2.00% 10.00% 20.00%
Pecent of Total Population
Per
cen
t o
f T
ota
l Med
ical
Co
sts
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Factors Driving This Trend
o Over reliance on historical “claims data”
o Focus on sickness rather than preventiono Medical Redundancy, “Silo Care”
o View “providers” as part of the problem ….Not the Solution
o Compliance limitations
o Void of predictive risk analysis & interventiono Manage the rule, not the exceptionally sick
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Healthcare’s Reactive Model
o 72% of the $1.7 trillion* is spent on healthcare services in the U.S.
o Spending goes to treatment of disease and illness that often results from unhealthy lifestyles
o Focus on prevention of disease and better coordination of beneficiaries who already have multiple chronic conditions
2004, Centers for Medicare & Medicaid Services.2004, Centers for Medicare & Medicaid Services.
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Healthcare’s Reactive Model
o ….yet, less than 5% of this expense goes to education, early detection and the prevention of disease and illness.
2004, Centers for Medicare & Medicaid Services.2004, Centers for Medicare & Medicaid Services.
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The High-risk Patient� Early detection of trends and deviations in order for preventive actions� Safety in everyday life in spite of the challenges� Emergency program
The Worried-well� Health condition monitoring e.g. pregnancy, sleep-disorders, etc� Program for weight reduction and weight management
Seniors� Assisted living at home and on travel� Safety when risks are rising� The needs of the patient's family, which is very often very worried about
the health condition of their � Delegation of supervision functions, reduction of responsibility for
the senior
The Sports Athlete� Performance monitoring
The Doctor� More free-time� More doubtlessness when away from his patients
Addressing Patient Needs
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The Challenges
o The Aging Population
o Increasing Life Expectancy o Costs of Chronic Disease
o Compliance limitationso Shortage of Health Care Professionals
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The Desired Outcomes
o Empower patient
o Keep patients at homeo Improve Disease Management
o Reduce healthcare costso Alleviate doctor and nursing shortage
o Maximize diagnostic efficiency and outcomes
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ACT TeleCare
ACT TeleCare is a system of Technology and Services used to:
Assessment of a persons conditionCommunication and analysis of persons
condition and care planTreatment of person with therapy
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A.C.T. TeleCare Solution
• Render support services for doctors, clinics, caregivers and patients
The A.C.T. Service Platform365 days 24 hours
Telemedical devices transmit vital signs for the monitoring
In case of deviations or passing of limit values in vital signs, physicians/ caregivers are notified instantly and automatically
The doctor and the caregivers can access the patient's data all the time, everywhere,and therefor can react in-time and can adapt the treatment
In case of emergency A.C.T.will organize the SOS service
Doctors, Caregiving organisations,Clinics
Seniors,High-risk patients,Athlete, etc.
• Apply modern communication technology likeInternet, GSM, GPS, body sensors and devices• Deliver to all actors the vital signs and data as base for early detection and
preventive action
The A.C.T. Service Platform
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Conditions & Target Markets
OTHERWellness CareElderly CarePost StrokeAlzheimer
Obesity CareDiabetic CareWound Care
Cardiac CareCHF
Trauma &Neuromuscular
Care
Infant CareApnea, Bilirubin
High Risk Pregnancy(Mother & Fetus)
Chronic Obstructive Lung
Disease
Sleep ApneaCare
Asthma &Allergies Care
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Wireless Vital Signs Network
o Generate and manage electronic health files for each patient
o Access from any handheld or PC browser
o Provide patient personal web page to send, view and store health measurements
o HIPAA complianto Allow patient-physicians
interaction “Anywhere –Anytime”
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The A.C.T. Offer
WorriedWorried--wellswells HighHigh--risk Patientsrisk Patients SeniorsSeniors Doctors + CaregiversDoctors + Caregivers
To Target GroupsTo Target Groups
• Health conscious persons• (Pregnant women, persons
with sleep disorders, etc.)• Sportsmen (Performance monitoring)• Weight reduction and management
• etc.
• Patients with cronical diseases• (Heart, Lungs, Asthma, etc.)
• Patients who need to monitor risks for preventive health maintenence
• Emergency program• etc.
• Health maintenance• Special programs
• Preventive monitoring • Emergency assistance
• etc.
• Services for doctors, health and
caregiving organisations• Dispatching
• Emergency services• etc.
To Target PersonsTo Target Persons
Health topics, health maintenance advice, disease containment support
An asthma patient e.g. is focused on his disease, other challenges he is not (not yet!) confronted with he does not notice.
Services therefore will always have to offer complete solutions for specific problems (diseases, chronic challenges) and healthcare needs.
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Target Populations
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The Solutions
Health ConditionHealth ConditionMonitoringMonitoring
Supervision of Supervision of HighHigh--risk Patientsrisk Patients
Assisted Living Assisted Living to Seniorsto Seniors
Telephone Service for Telephone Service for Doctors/Clinics/CareDoctors/Clinics/Care
Body movement analysis
Solutionsfor
Solutionsfor
Solutionsfor
Solutionsfor
Devices
Services
Blood PressureMonitors
Hypertension Management Emergency/Fall-detection Telephone service
Weight reduction
Pregnancy
Performance monitoring
Sleep monitoring
etc.
Lung function monitoring
CHF, Cardiology
Asthma, COPD
Post-infarct surveillance
etc.
TeleContact
Vital signs
Temperature
Activity
etc. etc.
Emergency dispositions
Medication compliance
Fall-detecting Sensors
Spirometers
Body MovementRecorders
Sleep dataRecorders
ECGMonitors
Respiration rate Sensors
PersonalScales
Capnographs
PersonalCalorimeters
CoagulationCheck
MultifunctionalVital Signs Devices
Blood-GlucoseMeters
HSO-LinkSmart Vest
Platform for Monitoring Devices
EmergencyAlarms
365 days 24 hoursService
ActiveAssistance
TelephoneEnquiries
MedicationCompliance
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Outcome monitoring
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ACT System for Target Markets
ACT SYSTEM OVERVIEW
AssessmentDevices &Personal
Input
CommunicationWeb Health PlatformClinical Coordination
Care Planning
TreatmentPersonal Care Plan Therapy Devices
Compliance Monitoring
ACTAssess
CommunicateTreat
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TeleCare
ACT: Assess – Communicate - Treat
Assess Communicate Treat
Assessment Devices Personal Input
CommunicationWeb Health PlatformClinical Coordination
Care Planning
Treatment Personal Care Plan
Therapy DevicesCompliance Monitoring
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Wireless Vital Signs Monitoring
o Wireless web-enabled technologies o Measure physiological data
and transmit results to handheld device and online monitoring network
o Fits many applications:o Disease Managemento Homecareo Wellnesso Fitnesso Clinical Researcho Employee Health
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ACT System
ACT SYSTEM
AssessmentPulse Oximetry
SpirometryPersonal Input
CommunicationTransmitter
Health PlatformCare Server
TreatmentOxygen Smart SystemAerosol Meds/delivery
Vent Support
COPDChronic Obstructive Pulmonary Disease
COPD Disease Management
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ACT System
ACT SYSTEM
AssessmentSpirometry/Peak Flow
02 consumption
CommunicationTransmitter
Care Platform
TreatmentDiet/Exercise Planner
Smart 02Aerosol Meds/Compressor
Asthma/AllergyACT SYSTEM
Asthma & Allergy
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ACT System
ACT System
AssessmentECG,HR,BP,WT,RR,02
CardioScan w/programableSensing
CommunicationTransmitter
Care Platform
TreatmentSmart 02 System
Diet/Exercise Planner
Cardiac CareACT System
Cardiac Care
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ACT System
ACT System
AssessmentGlucoSmartScan
Personal Health Monitor
CommunicationTransmitter
Care Platform
Diet Exercise SystemInsulin/Meds System
Diabetic CareACT System
Diabetic Care
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Advantages of Wireless Monitoring Platforms
o Clinical Benefits o More rapid diagnosiso More reliable diagnosiso Increased Compliance by auto detection and transfer of data
o Benefits for the patiento Increased ease of use o Potential improvement in morbidity and mortalityo Emergency capabilities
o Benefits for the payer o Increased outcomes and decrease in cost of reactive careo Guideline opportunities for post clinician contact o Decreased hospitalization
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ACT System
ACT System
AssessmentOSA Screener
Home OSA ScreenerSleep Monitor
CommunicationPhone/Web AccessCentral Supervision
Diagnostic/Care Knowledge
TreatmentCPAP
02 SupplementDiet/Exercise Planner
Sleep Apnea (OSA)ACT System
OSA (Obstructive Sleep Apnea)
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ACT System
ACT SYSTEM
AssessmentNeuro,Cardio-Resp Monitor
Emotional MonitorBody Position Sensor
CommunicationTransmitter
Care Platform
TreatmentVentilation
Smart 02 SystemDiet/Exercise System
Trauma & NeuromuscularACT System
Trauma & Neuromuscular
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ACT System
ACT SYSTEM
AssessmentApnea/Cardio-Oxy Monitor
Bilirubin MonitorPregnancy Monitor
CommunicatonTransmitter
Care Platform
TreatmentVentilation System
Bili TherapySmart Oxygen
Infant CareACT System
Infant Care
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TeleMonitoring
o Coronary heart disease # 1 killer; stroke # 3 killer
o AF cause of 15-20% of all strokes
o Approximately 2.5 MN Americans monitored annually
o Growing market for cardiac monitoring services
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Cardiac A.C.T.
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ACT Systems
ACT System
AssessmentPersonal Health Monitor
(hr,rr,BP, Etc)Programmable
CommunicationTransmitter
Care Platform
Diet/Exercise SystemCardio-Pulm Care
Smart 02
Wellness,Elderly,Post Stroke, AlzheimerACT Systems
Wellness & Other
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Payor’s Demand Outcomes
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Ambulatory EHR Solution
o Electronic Medical Records (EMR)
o Laboratory Information System (LIS)
o Practice Management System (PMS)
Key Features: o Vital Signs Monitoringo Injection Management o Writing Prescriptions o Preventative Maintenance o Evaluation and
Management o Medical Necessity
Management and Coding o Messaging
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Integrated Vital Signs Monitoring
o EMR Platformo Capture vital signs data via handheld device in any
web location o Immediate viewing and storing of resultso Seamless data integration into EHR o Generate trending and chartso Provide patient “Dashboard” to monitor health
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Integration means active real-time participation in every part of the software process.
• The Reception Module• The Nurse/Triage Module
• The Physician Module• The Prescription Writing Program
• The Lab Module• The Dictation Module
• The Billing Module
• The Insurance Module
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Clinical Trials Market
o Design for CRO pre-clinical, clinical trial, regulatory and lab services
o Approx. 2-3 million patients enter clinical trials yearlyo Approx. 3,700 clinical trials conducted annually
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TeleCare Services
Telephone Services / Emergency ServicesTelephone Services / Emergency Services
Benefits� Discharge from service tasks� 365 days, 24 hours presence and reachability� Control of therapies and monitoring of outcome
Target Groups� Physicians, clinics, caregiving organizations
Problem� Doctors and caregivers are limited in their resources providing
personal 24 hours presence
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Market Opportunities
Physician Research Consumer
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Roadmap
� Definition of Offer for Start-up Phase� Tests with patients� Preparation of Sales documentation� Device implementations� Software translations and adaptations� Device procurement� Pricing policies
� Personnel recruitment� Sales documentation� Hardware procurement� Internet, communication implementation� Sales force� Start sales (limited offer)
Inputs
Start-up Phase 6 months
� Expand offer and services� PR / promotion� Expand sales
Start Year One
Start
Start-up / Market Introduction
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References
o American Heart Associationo #A089-52 © 2001 Frost & Sullivano F070-56 © 2005 Frost & Sullivano Centers for Medicare & Medicaid Services, 2004o U.S. Department of Health and Human Services, Health
Care Financing Administration, March 2001.o www.phrma.org/newmedicineso Paraxels Pharmaceutical R&D Statistical Sourcebook
2004/2005