How 2018 Will Be The Year You Embrace Continuous Connectivity. NERSI NAZARI, PHD Chief Executive Officer

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1 How 2018 Will Be The Year You Embrace Continuous Connectivity NERSI NAZARI, PHD Chief Executive Officer

2 WE ARE CONTINUOUSLY CONNECTED Socially Friends and community Financially Balances and bills Parenting Location and access 2

3 WE ARE CONTINUOUSLY CONNECTED Safety Alerts, remote control Environment Habit learning Utilities Water usage levels 3

4 WE ARE CONTINUOUSLY CONNECTED Fitness Eating Pet Monitoring 4

5 CONTINUOUSLY CONNECTED NO LONGER NICHE Wearables & Health apps have tripled since

6 CONTINUOUS MEDICAL GRADE DATA? ICU General Ward Post Discharge Monitored 100% Of hospital stay Spot Check Only Unmonitored 97% of stay How do we get physicians to have data at their finger tips outside of the ICU for a reasonable cost? Check-in via telemedicine Unmonitored nearly 100% $$$$$ $$$ $ 6

7 TODAY S STANDARD OF CARE Healthcare size and costs keep growing 5,700 hospitals 4.5 days average length of stay $2,000 per hospital day 7

8 TODAY S STANDARD OF CARE Spending money on expensive care not fixing the cycle 70% of costs is for the management of chronic diseases 65% of ER visits are not emergencies 2 Million patients are readmitted every year $27 billion in Medicare costs of readmissions % of Medicare readmits are preventable 8

9 HOW DO WE CHANGE CARE IN 2018? X X Keep patients OUT of the hospital Keep patients healthy at home Catch deterioration sooner Create more preventative care Reduce clerical burden 9

10 HEALTHCARE IS AT A TIPPING POINT $3.2 Trillion 18% GDP 32% is hospital costs Population is aging.change is needed Continuous monitoring will drive this change 10

11 Why CONTINUOUS monitoring? 440,000 annual preventable adverse events 5 Over 50% of Medicare readmits are preventable Currently patients are identified only 15 min before cardiac arrest 6 Early warning signs are often present, but often only recognized retrospectively. Frequent spot checks leave patients unmonitored 96% of their hospital stay 11

12 WHERE CONTINUOUS COULD BENEFIT US Statistics on Sepsis 12.2% of readmissions - most common reason for readmission Every hour sepsis is diagnosed, 8% increased mortality rate Every 2 mins someone dies from sepsis Sepsis contributes to about ½ of all hospital deaths Subtle/early changes in HR & BR can be detected with continuous monitoring 12

13 If these deteriorations are preventable.. Why haven t things changed? 13

14 Methods we have had up until now are not scalable We weren t ready Developing medical-grade devices is hard 14

15 INTENSIVE CARE UNITS 24/7 MONITORING Expensive, inconvenient, uncomfortable 15

16 GENERAL WARD MONITORING SPOT CHECKS Manual, disruptive, ineffective 16

17 GENERAL WARD MONITORING SPOT CHECKS Limited access to patient data, local only 17

18 Why can we change this NOW? TECHNOLOGY has evolved CULTURE has evolved 18

19 HOW HAS TECHNOLOGY EVOLVED? CLOUD ANALYTICS REAL-TIME CONNECTIVITY WEARABLE BIOSENSORS ARTIFICIAL INTELLIGENCE Ability to aggregate data like never before Real-time data on patients is possible from any environment Biosensors that don t require an ICU environment Data that does not always need a doctor to interpret 19

20 HOW HAS CULTURE EVOLVED? X BUSY LIFESTYLES Patients want convenient options for healthcare services. MOBILE DEVICE USAGE Access to data and services on their own terms. CHANGING CENTER OF CARE Hospital is the last resort. 20

21 CONTINUOUS MONITORING One Patient Story VitalConnect Clinical Study ECG of Sample Episode 1 RR of Sample Episode 2 21

22 CONTINUOUS MONITORING HF Patients physiq Clinical Study with VitalPatch biosensor LINK-HF Multi-Center Study Can rehospitalization be predicted post HF admission using analytics from continuous multivariate patient data streams via a wearable biosensor? 100 subjects, 4 VA Hospitals Continuous monitoring for 90 days Presented at: 22

23 CONTINUOUS MONITORING HF Patients physiq Clinical Study with VitalPatch biosensor Prediction of HF readmissions was ROC AUC of 0.88 compared to AUC 0.58 for equivalent random decision generator (figure) At 85.9% specificity there was 84.2% sensitivity Mean time from alert to readmission was 10.8 days Median time from alert to readmission was 6 days 6-10 days notice! 23

24 Why CONTINUOUS monitoring? Tells the full patient story Short-term patient stage changes are detected Vital signs in context of activity, and other biometric status Ability to apply real-time scoring algorithms Cost effective for small or large scale NOW it is a viable and sustainable solution 24

25 STATE-OF-THE-ART HOSPITALS 25

26 CONVENIENT & COMPLETE CARE CYCLE 26

27 DATA FLOW MUST BE SEAMLESS 27

28 CONTINUOUS CARE SYSTEMS Accurate, Secure & Robust High sensor accuracy compared to standards - FDA cleared - Class II devices Anywhere, anytime access to data Protected patient information Trending & analytics for real-time Data storage for future reference VistaPoint Patch ID: B0:08:BF:00:00:00 Respiration Rate BrPM Life:100% Upload: OFF Bluetooth: ON Nurse s Log Heart Rate BPM Skin Temperature C Pedometer Steps Live ECG Posture Walking 20 mv 0-20 mv 1.0s Disconnect Fall Detection No falls detected About 28

29 PATIENT EXPERIENCE: AFib monitoring Current Standard-of-Care The Future 29

30 PATIENT EXPERIENCE: Sleep analysis Current Standard-of-Care The Future 30

31 BRIGHAM & WOMEN S HOSPITAL Continuous Monitoring for Home Hospital Initiative 1 st randomized study of it s kind, n=20 Wireless biosensor enabled continuous vitals monitoring 52% savings for acute episode 67% savings 30-days post Fewer readmissions (11% vs. 36%) More physical activity (209min vs. 78min) Upright more & more sleep Less use of home-care services (22% vs. 55%) David Levine, MD 31

32 MERCY VIRTUAL Continuous Monitoring in the General Ward & Outpatient Populations 43 hospitals across 5 states World s first Virtual Care Center Vision to streamline care and catch health decline earlier Embracing continuous connectivity to help deliver better care at lower cost 32

33 HOSPITALS AS THE HUB & SPOKE Continuous monitoring via a secure platform enables: - Improved care within hospitals - Quality care outside the hospital walls Care continuum for the patient changes Past 100 years Next 100 years 33

34 TOMORROW S STANDARD OF CARE 5,700 hospitals 4.5 days average length of stay $2,000 per hospital day 34

35 TOMORROW S STANDARD OF CARE 70% of costs is for the management of chronic diseases 65% of ER visits are not emergencies 2 Million patients are readmitted every year $27 billion in Medicare costs of readmissions % of Medicare readmits are preventable - $17 billion classified as potentially preventable 35

36 CONTINUOUS CONNECTIVITY 2018 is the tipping point Save lives Improve the patient experience Get clinicians back to focusing on patients Monitor patients anytime anywhere 36

37 Thank You