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May 2009 ConfidentialBLAH BLAH BLAH 1 May 2009 Confidential Concept Overview

What did the Doctor Say? Concept Overview

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May 2009 ConfidentialBLAH BLAHBLAH

1May 2009 Confidential

Concept Overview

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Concept Overview

What we do

What did the Doctor Say?™ does two basic things:

First we provide a service that records messages from a patient’s doctor to thatpatient’s family members regarding the diagnosis and treatment plan for their lovedone. We also record messages from other caregivers; physical therapists, homenurses, even neighbors--anyone the family wants to hear from.

Then we store these messages in a family medical hub we host on the web. Hereeach authorized family member can access an accurate record of “what the doctorsaid” about their loved one and discuss it in a blog-type format. They can shareinformation, make decisions, assign tasks and monitor progress. Family memberscan also connect to care giver resources to help them sustain their support overtime.

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Concept Overview

The ProblemThe Problem

Family support is critical to the health care of aging patients…but the health care system only talks to the patient.

Every patient is supported by two systems: the health care system and their family system. The point ofinterface between these two systems is often a simple question asked of every patient after every doctor visit:“What did the doctor say?” It is at this point where the medical establishment connects to the web of humanrelationships behind each patient.

Currently this connection point between the two systems of support doesn’t work very well. Families ofpatients lack a systematic way to connect to the medical system to gain the information they need. Theburden is usually on the patient to translate an often technical medical diagnosis to their loved ones, who areoften at a loss as to how they can best work together to support the patient. As a result, costs are higher andquality of care suffers. This is particularly the case in care for the elderly when the family is geographicallydispersed.

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It wasnIt wasn’’t always this wayt always this way……

Concept Overview

For most of human history, medicine was rooted in the social context of the family as most care wasdelivered in the home. The doctor, family and patient were naturally aligned by the simple fact of wherecare took place.

The rise of institutional medicine disrupted this natural alliance by shifting the context of care away fromthe home. Families were now cut off from a natural proximity to the doctor and often removed from thedelivery of care altogether. Medicine has become a lot more scientific and technological, with myriadassociated benefits. But it has also become a lot less personal.

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The OpportunityThe Opportunity

Concept Overview

Reconnect the family to the health care process.

We see an opportunity to make medicine personal--again--by reconnecting the family to the health careprocess. Direct and efficient communication between the doctor and the patient’s family will help activate awider system of support to better meet patient needs while saving time and money.

Our mission is to help families get the patient information they need, make meaning out of itand act on it in a coordinated fashion.

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Concept Overview

Patient visits doctor;Patient visits doctor;receives diagnosisreceives diagnosisand treatment plan.and treatment plan.

Patient repeats theirPatient repeats theirversion of what theversion of what thedoctor said to familydoctor said to family members. members.

Family members talkFamily members talkto patient, talk to eachto patient, talk to eachother, get confused,other, get confused,call doctorcall doctor’’s office.s office.Repeat cycle.Repeat cycle.

Son in DenverSon in Denver

Sister in ChicagoSister in Chicago

Son in NYCSon in NYC

Son in MiamiSon in Miami

Daughter in LADaughter in LAThe Current SystemThe Current System

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They tend to live in a separate city from their parents and have several siblings in other cities as well.

They have a family of their own and struggle to balance their sense of responsibility to their own familyand to their family of origin.

While they tend to lead networked lives themselves, they lack a systematic way to deal with familyhealth issues. They struggle with how to communicate with their parents about their health, how tocommunicate with siblings about what should be done and who should do it, and how to connect withthe medical establishment to get clear information on their parent’s condition.

The resulting time drain gives them an abiding sense they are neglecting their own family or their work.They often feel overwhelmed, guilty and ineffective.

There are a lot of them: According to the Pew Research Center, between 7 to 10 million adults are caringfor their aging parents from long distance. US Census Bureau statistics indicate that the number of olderAmericans aged 65 or older will double by the year 2030, to over 70 million.

Who feels this problem most?Who feels this problem most?

Concept Overview

Baby Boomerswith aging parents

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Concept Overview

Direct input from doctor on how their loved one is doing.

What do families need?What do families need?

A place to share this information, discuss options, coordinate tasks and connect to a wider community of support.

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Concept Overview

Our approach: Technology + Personal connectionOur approach: Technology + Personal connection

Offer a simple, easy to use, HIPAA compliant service thatprovides caregiver reports in a confidential setting.

Provide digital/social-networking tools so that the family cancreate value for each other with this information; an activefamily medical hub ensues from this.

Build follow on offerings to continue adding value to the huband create additional revenue streams.

Combine personalized patient information with socialnetworking tools

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Concept Overview

Patient visits doctor;Patient visits doctor;receives diagnosisreceives diagnosisand treatment plan.and treatment plan.

Patient repeats theirPatient repeats theirversion of what theversion of what thedoctor said to familydoctor said to family members. members.

Family members talkFamily members talkto patient, talk to eachto patient, talk to eachother, get confused,other, get confused,call doctorcall doctor’’s office.s office.Repeat cycle.Repeat cycle.

Son in DenverSon in Denver

Sister in ChicagoSister in Chicago

Son in NYCSon in NYC

Son in MiamiSon in Miami

Daughter in LADaughter in LAThe Old WayThe Old Way

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Concept Overview

Patient visitsPatient visitsdoctor per usual.doctor per usual.

Doctor's officeDoctor's office phones or emails phones or emails summary of visit to summary of visit to the family hub. the family hub. WDTDS WDTDS ““familyfamily advocate advocate”” ensures ensures report is delivered. report is delivered.

Authorized familyAuthorized family members are alerted members are alerted a new doctor message a new doctor message isis in the hub. They login the hub. They log on to see report,on to see report, discuss options,discuss options, develop action plansdevelop action plans and and access services.access services.

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Our initial launch strategy will focus on connecting first to the family and then from the family to their careproviders through our Family Advocate. The Advocate is the connector between the family and careproviders, easing the path for families to hear directly from those providing care to their loved ones.Empowered by the patient’s authorization, the Family Advocate will contact care providers on the family’sbehalf and help them contribute to the family hub. The Advocate will then submit questions from the familyto the provider in advance of the next patient visit.

The Family Advocate can provide additional services to the family such as working with providers to establisha Personal Health Record for the patient and helping the family devise a care plan for the situation they arefacing.

This approach recognizes two fundamental truths of the heath care system today: Providers are highlyfragmented and they are mostly analog.

• 75% of doctors work in small practices of 10 doctors or less.• Only 17% of doctors use an electronic medical records system.*

To best serve our families, we have to be prepared to go “fetch” the data in whatever form it exists. This isthe role of the Family Advocate. Over time, as EMR usage expands we hope to enroll most practices in ourcommunity, so that families will be able to link directly to their patient’s providers. But for now we willaddress the world as it exists.

*“How to Make Electronic Medical Records a Reality”,The New York Times, February 28, 2009.

Concept Overview

The Family AdvocateThe Family Advocate

The human connector between families and health care providers

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Concept Overview

The Family Medical HubThe Family Medical Hub

View reports, discuss options, share links, make decisions and assign tasks.

Healthcare provider reports on patient

Connected Family actions in support of the patient.

Family Members

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Concept Overview

Sample family discussionSample family discussion

Physician Name, Robert M. Barry, MD (Internal Medicine)Date of Visit, 1/9/09Physician Comments““Jane complains of fatigue, shortness of breath and ankle swelling. She also has high blood pressure atJane complains of fatigue, shortness of breath and ankle swelling. She also has high blood pressure at160/95160/95. Her ECG results, along with these other symptoms, suggests she may be experiencing the early. Her ECG results, along with these other symptoms, suggests she may be experiencing the earlystages of stages of chronic heart failurechronic heart failure. As a result, I will be prescribing Jane a . As a result, I will be prescribing Jane a calcium channel blocker calcium channel blocker and aand adiureticdiuretic. If her symptoms do not improve over the next two weeks, I will refer her to a cardiologist, Dr. Ken. If her symptoms do not improve over the next two weeks, I will refer her to a cardiologist, Dr. KenJones, for additional workup including an Jones, for additional workup including an echocardiogramechocardiogram and and BNPBNP test to refine her therapeutic treatment. test to refine her therapeutic treatment.””

1/15/09, Tom1/15/09, TomFine Ben, you go ahead and do your research on natural remedies and IFine Ben, you go ahead and do your research on natural remedies and I’’ll make sure to ask the Doctor nextll make sure to ask the Doctor nexttime. Itime. I’’m scheduled to arrive on the 23m scheduled to arrive on the 23rdrd of January. I will plan to go with her to the doctor for her next visit. of January. I will plan to go with her to the doctor for her next visit.Also, please donAlso, please don’’t forget to post any questions that you may have for the doctor prior to her visit.t forget to post any questions that you may have for the doctor prior to her visit.

1/09/09, Ben1/09/09, BenII’’ve heard that Calcium Channel Blockers can have some pretty bad side effects. Maybe we should ask theve heard that Calcium Channel Blockers can have some pretty bad side effects. Maybe we should ask thedoctor about pursuing some natural remedies.doctor about pursuing some natural remedies.

1/09/09, Liz1/09/09, LizI talked to Mom and she down played it, as usual. She is resting fine. The drugs seem to be making her feelI talked to Mom and she down played it, as usual. She is resting fine. The drugs seem to be making her feelbetter and her ankle swelling has gone down. Ibetter and her ankle swelling has gone down. I’’ll be staying with her for the next couple of days to make surell be staying with her for the next couple of days to make sureshe is stable.she is stable.

Who is coming out next to see her??Who is coming out next to see her??

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Concept Overview

View of Family HubView of Family Hub

The Hub- Doctor Update on Wednesday- Doctor Update on Wednesday-- Family phone conference Thursday 6PM MST Family phone conference Thursday 6PM MST

Patient, Mom in BoulderPatient, Mom in Boulder•• Event: Hip Replacement Event: Hip Replacement

Son, Paul, in MiamiSon, Paul, in Miami•• Tasks: Tasks:-- Call on Sunday Call on Sunday-- Research walking shoes Research walking shoes-- Look into Look into Family Cruise Family Cruise in January in January

Daughter, Janice in L.A.Daughter, Janice in L.A.•• Tasks: Tasks:-- Call on Friday Call on Friday-- Follow up on Follow up on Medicare Claims Medicare Claims-- Research Acupuncture Research Acupuncture

Son, Dan, in NYCSon, Dan, in NYC•• Tasks: Tasks:-- Call Thursday Call Thursday-- Find articles on Hip Find articles on Hip Replacement Recovery Replacement Recovery-- Order Cane Order Cane

Sister, Liz, in ChicagoSister, Liz, in Chicago•• Tasks: Tasks:-- Call on Wednesday Call on Wednesday-- Send flowers from family Send flowers from family

““Key ContactKey Contact”” Son, Tom, in Denver Son, Tom, in Denver•• Tasks: Tasks:- Arrange Rehab facility- Arrange Rehab facility-- Follow up on In-home nurse/caregiver visits Follow up on In-home nurse/caregiver visits-- Arrange meal delivery service Arrange meal delivery service

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Concept Overview

Family Medical Hub: Initial Feature SetFamily Medical Hub: Initial Feature Set

- Immediate text and e-mail updates to all family hub members when new information arrives- Phone-in chat rooms for families at a distance to discuss health emergencies- Links to Wiki content to provide further information on a diagnosis and medication- Social networking tools to help families connect to others who have dealt with their situation- Voice recognition tool that can transcribe the doctor’s/nurse’s voice message to text- Physician visit preparation, notes and questions- iPhone App to allow patient to record and send doctor visits to their family hub- Care Planner engine (premium feature) helps family members determine the tasks required to provide proper care of the patient, including medical, financial, insurance and advocacy group connection-“Ask an Expert” (premium feature) provides family members an opportunity to chat with an expert on family support for their specific patient condition- Links to insurance companies for claims information and questions on Medicare- Links to extended care options and local services- Links to financial planning resources for wills and estates

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What did the Doctor Say?What did the Doctor Say?™™ VALUE VALUE

Concept Overview

Family VALUE•Improved sense of order and control•Sense of teamwork and connection•Ability to sustain support over time• Reduced worry• Reduced costs

Patient VALUE•Release from being the primary source of info•Release from always having to ask for help•Confidence family stands behind them•Ability to maintain independence•Improved quality of care/life

Healthcare Providers VALUE• One-stop connection to family eliminates phone tag; saves time• Reduced risk of patient misunderstanding diagnosis• Better care coordination between patient visits• Efficient way to deliver better customer service

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Concept Overview

The original social networkThe original social network

A powerful newspaper publisher once beseeched Mark Zuckerberg, the founder of Facebook for advice onhow he could build his own on-line community. The famously laconic Zuckerberg replied, "You can't."

Zuckerberg went on to explain that communities already exist--you can't artificially create them. The taskis to provide them with "elegant organization" to do better what they already want to do.

Families are our first social network; it is deep in our nature to support a family member in need.We help families perform this vital function by giving them the tools, information and “elegantorganization” to do better what they already want to do.

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Concept Overview

I. Launch What did the Doctor Say?™ service and family hub- Beta test live in August 2009- Full version site launched in first quarter 2010- Economic model centered around caregiver reports

II. Add monitoring applications to help the family stay connected to the patient and each other

- Interactive medication management- Monitoring (location/movement and vital signs)- Fall monitoring and prevention- Chronic disease management

III. Expand role of Family Advocate- Premium services to help the family develop and implement patient care plans

Strategic Plan

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Concept Overview

Where we are nowWhere we are now

I. Beta site live in August 2009 - Private family hub

- Doctor/HCP/Family posting log - Simple calendar and task lists - Basic account functionality

II. Begin private beta test in August - twenty families - learn how families decide to join, how they use the hub and what services they need - get insight on pricing plans and the viral potential of the business - understand how to best work with care providers to get patient information

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Why Now? Converging TrendsWhy Now? Converging Trends

Concept Overview

Med ITAdvances in: -- monitoring devices -- remote sensing -- social networks -- smart phone -- shared data (PHR)

Healthcare environment-- cost containment pressure-- quality concerns-- consumerism; Health 2.0-- less third-party reimbursement-- increasing patient involvement

Our “Sweet Spot”

Population Demographics-- aging population-- digitally aware and empowered-- chronic conditions-- “family caregivers”

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The convergence of the empowered patient with the free flow of accurate, timely and relevant medicaldata is inevitable. What interests us about this brave new world is how this free flow of information andconnectivity can be used to improve the caring side of health care: The patient’s sense that they aresupported by a unified web of people—both professionals and family members-- acting toward their wellbeing. We believe this type of coordinated, active family involvement is the best way to meet thechallenge of improving quality of care while lowering costs.

That’s a future we want to create. To get there we will focus on strengthening the connective tissuebetween doctors, patients and families-- the three legs of the health care stool. We’ll help families andpatients make meaning out of all the information they’re getting, and we’ll facilitate the conversationsthat need to happen so that real human care can occur. By doing these things we will create a thrivingbusiness and a way for families to thrive while coping with the health and aging challenges we all mustface.

Concept Overview

Toward the futureToward the future

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Who we areWho we are

Concept Overview

What did the Doctor Say?™ is a project of Patients + Families LLC, based in Boulder, Colorado. We are aveteran team that combines deep knowledge of health care with entrepreneurship and branding. Moreimportantly, we have each been through the experience of supporting a parent in decline from afar.We are the consumer we wish to serve.

Brian Lanahan is an expert at connecting brands to people, having worked on more than sixty consumerproducts in his twenty-year career.Brian began his marketing career at the Coca-Cola Company, where hespent eight years in brand management, strategic planning and new product development. He thenserved as Managing Director and co-founder of Character LLC, a Portland Oregon based consultancy thatdevelops story frameworks for brands in consumer products, media and retail. Brian has a BA in Historyfrom Duke University and an MBA in Marketing and Human Resources from Northwestern’s KelloggGraduate School of Management.

Phil Siegert is an accomplished interactive strategist. He’s worked at larger advertising agencies such asLeo Burnett, was a founding partner of The Royal Order of Experience Design, a cross media boutique,and is a partner in Twiss, a consultancy focused on shaping how brands transact directly with consumersacross multiple channels.Phil’s talent is understanding customer expectations, envisioning the ideal userexperience and applying his knowledge of the growing variety of media and technologies to bring complextransactional concepts to life. He has developed solutions ranging from multiplayer online games toecommerce platforms for numerous well-known brands such as Patagonia, Kohler, Naturopathica,Seventh Generation, Burton Snowboards, Revolution Living, and Kiehl’s since 1891. He possesses an MFA(Painting) and BFA from the School of the Art Institute of Chicago in addition to a BA in Art andArchitectural History from the University of Illinois at Chicago.

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Who we are, continuedWho we are, continued

Concept Overview

Marc Silverman is a seasoned corporate executive with over twenty-five years experience in thehealthcare industry. He has conceived, developed and successfully brought to market a variety of medicaldevices and medical information technologies. His business experience includes large and smallcompanies and startup endeavors, including Bayer/Cutter Laboratories, Hexcel, Technicon, Baron MedicalSystems, Performance Factors, and Performance Health. He is a successful entrepreneur (two exits, incl.IPO), angel investor, and advisor. He currently serves on the boards of the Deming Center forEntrepreneurship at the University of Colorado at Boulder, and the advisory board of the MetropolitanState College of Denver Center for Innovation. Mr. Silverman is an engineering graduate of the Universityof California, Los Angeles, The San Francisco Art Institute, and the Stanford University Executive Program.

Gina Simmering is a highly motivated health and wellness professional with over twenty four years ofexperience in the fields of nursing, fitness, nutrition and self and family care. She has founded andpublished a successful wellness magazine and advised numerous organizations on health advocacy,including Stanford University Hospital and Hospice of Boulder and Broomfield Counties. Gina holds aBachelors of Science from West Chester University in Corporate Wellness as well of a Bachelors of Sciencefrom the University of San Francisco in Nursing.

Gordon Van Dusen has over twenty years of experience in business development, marketing, productmanagement and strategic planning in the healthcare industry. His business experiences encompass largeand small, earlier staged healthcare companies including Baxter Healthcare, Myogen, Somatogen,Hiberna and RxKinetics. Gordon has been on the founding management team of four healthcare startups,most recently as a founder and CEO of Hiberna Corporation and Vice President of Business Developmentfor Myogen, Inc. He currently serves on the advisory board for Fitzsimon’s BioBusiness Partners, Inc andhas been an angel investor, advisor and consultant to several startup businesses. Mr. Van Dusen holds aB.S.E. in Biomedical Engineering from Duke University, an M.S. in Bioengineering from the University ofMichigan and an MBA in Finance and Marketing from the Kellogg Graduate School of Management.