Michael Jacobs, MD, PhD

Maastricht, the Netherlands:

� Professor and Chairman department of Surgery,

Maastricht University Medical Center

�Director Cardiovascular Center

Aachen, Germany:

� Professor and Chairman department of Vascular

Surgery, University Hospital Aachen, Germany

TREATY OF MAASTRICHT 1992: start of EU

Maastricht University

• Young (1976)

• 16.000 students, 4400 medical

• International: 51% foreign students

Cardiovascular Research Institute Maastricht (CARIM)

• Annual budget 30 Mio $

• Researchers 196 fte

• Technical staff 77 fte

• Principal Invest 27

• Departments 13

• Scientific papers 557

• PhD thesis (2012) 43

• Patents (2012) 4

715 beds

in numbers

4400 students

450.000 patients

€ 700 mio.turn over50 companies

7700 employees

• Cardiovascular center of excellence: integration CV specialties

• Integration basic research and patient care

• Scientific and clinical leadership in the Netherlands, top 10 in Europe

• Superspecialization in selected cardiovascular niches: number 1 in EU

• European cardiovascular training center

• Strong partnership with technical universities en medical industry

2002-2013: TARGETS

• 2002 Start Cardiovascular Center and integration

of cardiology, cardiac surgery, vascular

surgery vascular neurology, vascular medicine and

phlebology

• 2006 Integration CVC clinic and CARIM

• 2011 Start Lean Six Sigma

• 2012 (October) Opening new, integrated outpatient clinic (2500 sqm)

• 2012 (November) Opening hybrid operating room

• 2013 Launch CVC “Center of Excellence”

• 2013 Start EM-TRAC

• 2015 Opening new EM-TRAC building

• 2016 Opening 3 new hybrid operating rooms

Short History and future steps

CARDIOLOGY

CARDIAC

SURGERY

VASCULAR

SURGERY

VASCULAR

MEDICINE

VASCULAR

NEUROLOGY

INTERVENT

RADIOLOGY

PHLEBOLOGY

Cardiology

Cardiac

Surgery

Vascular

Surgery

Vascular

Medicine

Vascular

Neurology

Phlebology

Maastricht Cardiovascular Center

Next step: Integration CV Clinic and CV Research

�Atrial fibrillation

�Ventricular tachycardia & sudden

cardiac death

�Electrical management of heart failure

�Heart failure preserved ejection

fraction

�Non-ischemic cardiomyopathies

Cardiac Arrhythmias and FailureThrombosis

�Atherothrombosis

�Recurrent venous thromboembolism

and post-thrombotic syndrome (PTS)

�Novel targets and drugs

Vascular Diseases

�Aortic diseases

�Venous disorders

�Vascular cognitive impairment

�Hypertension

CVC Maastricht – Specialties en cross connections

Maastricht Study - Cardiovascular Metabolics

�Metabolic syndrome

�Diabetes

�CV risk management (prevention)

Diagnostics and Techniques

�Cardiovascular genetics

�Cardiovascular imaging, including non invasive and biomolecular imaging

�Cardiovascular systems biology

�Minimal invasive and robot assisted techniques

540 fte

120 mio $ turn over

DIA

GN

OS

IS

DIA

GN

OS

IS

DIA

GN

OS

IS

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

TECHNOLOGY FOUNDATION

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

Klinikum

Aachen

Maastricht

Health

Campus

Medtronic Medtronic

Maastricht

Health

Campus

Klinikum

Aachen

University

Eindhoven

University

Eindhoven

TECHNOLOGY FOUNDATION

DIA

GN

OS

IS

Klinikum

Aachen

Maastricht

Health

Campus

Medtronic Medtronic

Maastricht

Health

Campus

Klinikum

Aachen

University

Eindhoven

University

Eindhoven

70.000 patients

New CV outpatient clinic

• 2500 square meters

• All cardiovascular specialists

• All non-invasive diagnostics

• CVC pathways

• “one-stop-shop”

• 70.000 patients per year

• 100.000 visits per year

Strategic ambitions were not

driven by excellent

operational processes

Objectives of operational excellence to

support our European ambition

QUALITY

• Less incidents

• Better clinical outcomes

• Transparency on outcomes

PATIENT EXPERIENCE

• Less waiting

• Seamless integration of patient appointments

• Better upfront awareness about the individual health journey

EMPLOYEES

• Become an employer of choice

• Employee involvement

COST

• Capacity to cure more patients with same organization

40

Lean Sigmatraining &

deployment

MDT run performance

projects

Hospital run performance

projects

Program Mgmt Office

Operational Excellence program

• Optimization outpatient clinic

• Optimization 5 CVC pathways

• Optimization design new OR complex

• Optimization cathlab & neuroinventory

• 3 Black belts

• 45 green belts

• 1000 yellow belts

• 19 champions

• 25 Lean Executives

41 projects coached by Medtronic

• 3 Length of stay• 2 scrap reduction• 17 process improv.• 8 patient experience• 7 employee

satisfaction• 4 quality & compliance

Investment for MUMC: € 580k

• MDT consulting : € 150k

• MDT LS training : € 80k

• MDT PMO: € 100k

• Internal staff: € 250k

MUMC savings (YTD): € 4,500k

• MDT run projects : € 2,200k

• Hospital run projects : € 2,300k

Intangible benefits **

• Staff engagement & built-in change capability

• Performance improvement culture instilled

• Quality, clinical outcome & patient experience improved**

MUMC business case

** Metrics in development

MUMC Management

Excellency and Transparency in Cardiovascular outcomes

Development of Integrated Cardiovascular Care pathways for the major cardiovascular diseases: optimizing the patient journey,

Enhanced access to highly specialized Cardiovascular Care

Re-investments of the achieved cost savings into Cardiovascular Clinical Research

Re-distributing the Maastricht UMC Cardiovascular Expertise in Europe. Medical Professional Skills-building Training and Education

“Cornerstones” center of excellence

• “Established” research center CARIM

• CVC with international top activities (rhythm, aorta, heart failure)

• Full integration wit CARIM

• Unique multidisciplinary outpatient clinic

• New OR complex with 3 hybrid OR’s

• New European CV training center (2013-2016)

• Partnership medical industry: operational excellence

• European Vascular Course as education platform

• Partnership with city and province

Our motto for MUMC CVC is

EVERY DAY BETTER

THAN YESTERDAY

European Medical Training Center

• New building

• 3000 square meters

• Training center for cardiovascular specialists

and employees medical industries

• 6000-8000 trainees per year

• Lean Transformation program for CVC

Cath-lab operations experts and benchmarking

Cardio vascular care pathways

Industrial planning en scheduling

Status: 1000 Lean Sigma yellow belts trained

70 green and 5 black belts

Status: $6 million savings already achieved

• Risk sharing

No-Cure No-Pay based contract

Fair market value and best pricing for Medtronic

medical devices

• R&D opportunities

Priority access to Medtronic clinical trials

Components of the partnership between CVC and Medtronic

Medtronic provides to CVC:

• Opportunity for Medtronic to create healthcare value

beyond medical devices

Adding new value elements to the current Medtronic

business model

• High quality clinical research and faster access to market

for new Medtronic therapies

• Long term volume commitment: purchase of Medtronic

medical devices

• Cardiovascular skills lab and Medical Training facility

3000 medical professionals per year to be trained in CVC

to the highest standard (cardiovascular)

• Access to the expertise of the best of the best doctors

Components of the partnership between CVC and Medtronic

CVC provides to Medtronic: