Healthcare Innovation at Cleveland Clinic. November 13, 2014 Karen Mihalik, Executive Director Sarah Stamp, Senior Director

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Healthcare Innovation at Cleveland Clinic November 13, 2014 Karen Mihalik, Executive Director Sarah Stamp, Senior Director

Cleveland Clinic 5.1M Patient Visits 43,890 Employee Caregivers 27 Institutes providing care in 120 subspecialties Locations Main Campus 8 Community Hospitals 16 Family Health Centers in NE Ohio Facilities in Florida, Nevada, Toronto & Abu Dhabi EMR Leader My Chart Top 4 Hospital by U.S. News & World Report

R.E. Jacobs Health Center 6.4M Patients Elyria Family Health Center Lorain Family Health And Surgery Center Lou Ruvo Center for Brain Health Las Vegas, Nevada Westlake Family Health Center H Fairview Hospital H Lakewood Hospital Strongsville Family Health and Surgery Center Lakewood Family Health Center H Lutheran Hospital Independence Family Health Center Brunswick Family Health Center H Euclid Hospital Cleveland Clinic H Marymount Hospital Wooster Family Health Center H South Pointe Hospital H Medina Hospital HC Cleveland Clinic Toronto S.T.J. Health Center Solon Family Health Center Chagrin Falls Family Health Center H Ashtabula County Medical Center Willoughby Hills Family Health Center H Hillcrest Hospital Beachwood Family Health and Surgery Center Twinsburg Family Health Center H Cleveland Clinic Florida

Main Campus

Cleveland Clinic Lou Ruvo Center for Brain Health

Cleveland Clinic Abu Dhabi 6

Cleveland Clinic Integrated Care Model Retail Venues Home Community- Based Organizations Care System CC Clinic Post-Acute (other) Independent Physician Offices MyChart Emergency Ambulatory D&T Skilled Nursing Facilities Rehab Hospitals 7

The Value Imperative Volume Value The shift to value is the centerpiece of our strategy 8

The New World Volume-Based Value-Based Payment Fee-for for-service Outcome Based Incentives Volume Value Focus Role of the Provider Information Acute Episodes Single Episodes Retrospective Populations Care Continuum Real-time & Predictive 9

Drivers of Value Unsustainable costs Variable quality outcomes Transparency Dissatisfaction 10

Value Definition Value = Outcomes Cost Outcomes Quality Health Status Process Experience Cost Event Episode Per Capita 11

Cleveland Clinic Culture Quality. INNOVATION. Teamwork. Service. Integrity. Compassion. We welcome change, encourage invention and continually seek better, more efficient ways to achieve our goals. "We are considering not only our duty to the patient of today, but no less our duty to the patient of tomorrow." George Crile, Sr., MD Co-Founder Cleveland Clinic

Cleveland Clinic Innovations We promote innovation and expand treatment of the sick through the deployment of technologies developed by Cleveland Clinic and our Healthcare Innovations Alliance Partners. Through commercialization,, we translate emerging diagnostics, therapies, devices, health IT and business solutions into beneficial medical products through spin-off companies, licenses and equity partnerships.

Promote Innovation via Commercialization Bring new innovations into widespread clinical practice Protect the intellectual property underlying the innovations Optimize the value returned for those innovations Grow the regional economy and beyond

Innovations Scorecard: 2013 2,500 Patent Applications 450 Royalty Licenses 67 Spin-Offs $768M in Equity Investments $68M to Inventors $150M in State Grants 1,200 Jobs Created World-Wide Wide Recognition

Portfolio Companies 2000-2003 2003 2004-2005 2005 2006 2007 2008-2009 2009 2010 2011 2012 2013 ART SARL CleveX Clear Catheter Solutions ATI Congruent Medical NaviGate icomet ivhr Renovo Biosciences AxioMed IntElect Tolera CardioNomi c OptoQuest Image IQ Custom Arthroplasty Solutions FlexLife Health Shield Biotech CardioMEMS Merlot Revasc Cleveland Heart Perfusion Solutions SironRX Custom Ortho Solutions Infuse fuseon Jace Medical Cleveland BioLabs CSF Therapeutics Alios Biopharma Navis Renovo Neural YouDocs Beauty Enspire DBS Ion-VAC Cancer Genetics Peritec PrognostiX Juventas Clear Catheter Systems Buckeye Ocular Enforcer PluronX i360medical Cleveland Diagnostics ValveXchan ge OrthoMems AngioQuest Cleveland HeartLab Sivan Panacela* RelateCare BioSil, USA VioQuest Explorys Incuron* Rindex Talis Z-Kat Zin Medical Intellis I-Lyte IPPC Ridgeway Clear Ventric Esperion *CBLI Spin-off Dissolved Therapeutics HIT Diagnostics Device Non-

*international A World Class Model * *

Core Incubator Functions Portfolio Management Viability Assessment - Target market / market size - Feasibility workflow and technical - Go-to to-market strategy Technology Development - IP protection - Project management - Funding resources Deal Transaction

Inventions by Type

Commercialization Pathways Direct License to Existing Company Industry Partner Joint Development Sponsored Innovation NewCo

Portfolio Highlights Industry Partner Cleveland Clinic Business Intelligence Dashboards Cleveland Clinic Bundled Payments

Finance Opportunities What improvements in processes have you successfully implemented? What challenges have you overcome working with vendors? What are your unmet needs?

Finance has an Impact on Value through Innovation! Value = Outcomes Cost Outcomes Quality Health Status Process Experience Cost Event Episode Per Capita 23

The future belongs to those who seize the opportunities created by innovation." Delos M. Cosgrove, MD CEO & President Cleveland Clinic