Wireless Ambulatory Monitoring Anytime-Anywhere” · Ambulatory EHR Solution o Electronic Medical...

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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

3333

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

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