A Special Presentation For: October 29, 2007 Leesburg, Virginia

The Future of Healthcare Delivery 5 Trends That Will Shake the World Bill Crounse, MD Worldwide Health Director Microsoft Corporation

Significant Healthcare Industry Challenges Increasing Regulation s Healthcare industry faces myriad of regulations Healthcare Industry Aging Population Increased utilization of healthcare services Reduced Reimbursements Labor Shortages There is a shortage of trained nurses and pharmacists Expensive Technology Rising expense of technology is impacting cost

EMR Adoption Just 25% among practices with 10 or more physicians Just 15% among practices with 5 or fewer physicians

The high-tech plumber

The Perfect Storm Is Brewing 5 Trends

Trend #1 Increasing personal responsibility for healthcare costs Government spending constraints Health Savings Accounts Consumer Directed Plans High deductibles & co-pays Market-driven

Comparison of Spending on Health

USA Today 9-159 15-2005 Employee Health Plan Costs $14,000 / year per family Starbucks Will spend more on health insurance for their employees than on coffee beans. This isn t t sustainable!

Concern About Health Costs Percent of American adults who cite rising cost of healthcare as 1 of top 3 personal concerns: 2006 Roper Report

Healthcare is becoming consumer-centric centric

Trend #2 Commoditization of Medical Services Further expansion of OTC market Retail medicine: The $40 office visit Patient self-service service Continued growth in alternative care On-line consultations, e-health e services

Retail Clinic Price Transparency

Organized Medicine Responds AAP ISSUES POLICY OPPOSED TO RETAIL-BASED CLINICS The American Academy of Pediatrics (AAP) has issued a new policy statement opposing the use of Retail-Based Clinics (RBCs) as a source of medical care for infants, children and adolescents. These clinics offer limited, lower-cost services at walk-in facilities that are often located in supermarkets, pharmacies and large retail stores.

Trend #3 Commoditizing Providers More para-professionals professionals Physician shortages Concierge services Machine-aided aided diagnosis

The Next Crisis in Care

Machine-Aided Diagnosis

Trend #4 Information Everywhere Consumer empowerment Cost & quality transparency Intelligent systems & tools Personalized medicine

Trends in e-healthcare Services On-line appointment scheduling Web messaging with physician and support staff Access to lab and radiology reports Prescription refills Reminders and information therapy Access to personal medical record Outcomes & disease management tools Ability to manage benefits on-line

Patient Self-Service Service Check-In Co-Pay Consent Forms Way Finding Physician Referral Tracking

GlucoPhone HealthPia / Verizon Cell Phone / Glucometer

HealthGear Sleep Apnea Monitor HealthGear is a real-time wearable system for monitoring, visualizing and analyzing physiological signals. HealthGear consists of a set of non-invasive physiological sensors wirelessly connected via Bluetooth to a cell phone which stores, transmits and analyzes the physiological data, and presents it to the user in an intelligible way.

Trend #5 Globalization of Healthcare Services The Healthcare World is Flat If it can be done virtually, it will The rise of medical tourism

The Healthcare World is Flat Too

Medical Tourism 150,000 Americans sought elective medical care outside the US in 2006 1.5 Million people sought care in other countries in 2006

Launch a Video Conversation Hey Dr. Jordan! Have time for a video chat?

5 Trends Summary Increasing personal responsibility Retailization Commoditization of providers Information everywhere Globalization of healthcare

Health Future Vision

Remote Monitoring Virtual Visit with Case Manager Hospital Rounding Medication Management

Locating Equipment In-Patient Visit Virtual Consultation Retail Clinic Services

Microsoft Corporation 49 Confidential and Privileged

HealthVault is NOT a PHR HealthVault is a way for individuals to collect, store, and share their health information It is a shared data platform that allows multiple applications to work with a person s health data to improve health management and outcomes HealthVault Account Wellness PHR PHR Jr. BMI Fitness Chronic Condition Microsoft Corporation Confidential and Privileged 50

Design Principles of HealthVault Privacy and Security Focused Inclusive of Industry Standards Free for Users and Developers Microsoft Corporation Confidential and Privileged 51

HealthVault Connection Center

Microsoft Corporation Confidential and Privileged 53

HealthVault Search

Microsoft Corporation 55 Confidential and Privileged

DISCOVER Quick links to refine results without doing a new search SAVE Tool that allows users to save and organize articles from various searches in one place (accessed via user name/password). LEARN Articles from leading industry resources that are related to the user s query ACT Advertising is served up based on the relevancy of the search, plus a desired call to action in the ad.

www.mscui.net

Commodity HIS Solutions Hospital de São Sebastião

Electronic Medical Record Medication Administration Labs Pathology Cardiology Procedure Documentation OR Management Emergency Department Imaging Pharmacy Dictation Charting Hemodynamics CPOE Clinical Notes Medication Dispensing PACS Orders Mobile Data ICU/Critical Care Nursing Workflow/ Documentation Advanced Analytics Image Distribution RIS Financial/ERP Enterprise Scheduling Contract Management Document Imaging Revenue Management Bed Management Business Decision Support Inventory Physician Practice Purchasing Medical Records Coding Registration Staff/Nurse Scheduling Outcomes Management Transcription Access Management Claims Management Call Management Lots of different systems that don t talk to each other Legacy systems from 30 years ago attempting to communicate with newer systems that have been just installed A multitude of vendors

Electronic Medical Record Medication Administration Labs Pathology Cardiology Procedure Documentation OR Management Emergency Department Imaging Pharmacy Dictation Charting Hemodynamics CPOE Clinical Notes Medication Dispensing PACS Orders Mobile Data ICU/Critical Care Nursing Workflow/ Documentation VIEWERS DATA CORE FUNCTIONS Advanced Analytics Image Distribution RIS Financial/ERP Enterprise Scheduling Contract Management Document Imaging Revenue Management Bed Management Business Decision Support Inventory Physician Practice Purchasing Medical Records Coding Registration Staff/Nurse Scheduling Outcomes Management Transcription Access Management Claims Management Call Management Azyxxi focuses on the key issue in medicine instant access to data Azyxxi adds a layer of extra value and intelligence to existing clinical and non-clinical systems by aggregating and unifying disparate data for comprehensive management and analysis It does not replace the EMR and other interactive systems because we currently do not support writing capabilities required for complex workflows and processes

Displays title of view A C 1 2 Details and values displayed in columns Navigation and function buttons Azyxxi Client Viewer 3 D E 4 Displays current patient count Navigation and function buttons A Filter B Sort C Timeframe D Data Scope E Info F Input G Forms B F G 5 6 7 8 9 10 11 12 Details and values displayed in colmns Patients displayed in rows 1 Name 2 Age/Sex 3 Date/Time In 4 Chief Complaint 5 Vital Signs 6 Past Medical History 7 Lab Results 8 Radiology Results 9 Medications Ordered 10 X-Ray Images 11 Dictations 12 CT Scan Images

5 Trends Summary Increasing personal responsibility Retailization Commoditization of providers Information everywhere Globalization of healthcare

5 Trends Impact Rising consumerism, and response Cost and quality transparency New service locations, delivery models Leaner operations Enabling technologies Knowledge-driven driven insight to information Advanced communication, collaboration Global competition, e-health, e self-service service

Will You Be Ready?

Resources www.microsoft.com/healthcare http://blogs/msdn.com/healthblog www.mscui.net www.azyxxi.com www.live.health.com www.healthvault.com