Session #1, March 6, 2018 Edward Marx, CIO, Cleveland Clinic

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Establishing and Nurturing a Culture of Innovation: Lessons Learned from Global Disruptors Session #1, March 6, 2018 Edward Marx, CIO, Cleveland Clinic 1

Cleveland Clinic Overview 2

Founders Dr. Frank E. Bunts Dr. George W. Crile 3 Dr. William E. Lower Dr. John Phillips

Organization Structure Not for Profit Group Practice Physician Leadership Salaried Annual Professional Review 1 Year Contract 4

Care for the Sick Investigate their Problems Educate those who Serve 5

Global Integration Cleveland Clinic London Cleveland Clinic USA Cleveland Clinic Abu Dhabi 6

Innovation the Cleveland Clinic Way Genetics Culture, Culture, Culture Entraprenual Spirit Incentivized Enablers Agile Development Structure Innovations Ventures 7

Cleveland Clinic Innovations Established in 2000 3,600+ Patent Applications ~58 Staff Members 500+ Licenses 1,200+ Issued Patents 2,000+ Jobs Created 79 Spin-off Companies 21 Monetized Spin-offs $168M +in State Grants $1B+ in Follow-on Equity Investment 8 $80M+ Returned to Inventors

Technologies Medical Devices 50% Therapeutics & Diagnostics 22% Health IT 23% Delivery Solutions 5% AtriClip TMA Targeting C3 Concussion App Communicate with H.E.A.R.T. 9

Cleveland Clinic Ventures Strategy Overview Support Cleveland Clinic s innovators in the development, financing and growth of spinout companies Source and invest in transformative healthcare technologies that address the strategic priorities of Cleveland Clinic Work with innovators, entrepreneurs and co-investors as a value-added partner leveraging the clinical excellence, innovation culture and extensive resources of Cleveland Clinic Further the mission, vision and values of Cleveland Clinic through portfolio investment activities Deliver superior investment returns to the Cleveland Clinic Foundation 10

CCV Invests Across 3 Distinct Stages R&D Stage Seed Stage Venture Stage Company Formation Validation Key Development Milestones Post-Proof of Concept Development of Clinical & Economic Value Proposition Regulatory & Commercial Pathway MVP Development of Business & Revenue Model Customer Acquisition Milestone Based Milestone & Strategic Based 11 Strategic and Financial Based

Collaborative Examples 12

E M E R G I N G C L I N I C A L S O L U T I O N S ehospital Remote bunker providing an additional clinical tier of monitoring for ICU patients 2 way audio and video capabilities between bunker and unit More than 200 total beds monitored from 7pm to 7am Bunker has access to Epic, can place orders, review labs and view imaging studies Bunker (think clinical air traffic control ) Risk Classified Patient List Video/Audio Camera and Patient TV Highjack Utilizes existing screen in the patient s ICU room to display on demand: Remote clinician video and audio Images, etc as directed by remote clinician in support of local staff Can power on TV and remotely adjust audio levels from ehospital bunker Bunker Doorbell 13

E M E R G I N G C L I N I C A L S O L U T I O N S VITAL SCOUT SCREENSAVER Provide high volume, floor based clinical data as a screensaver via a web based application. Display statuses of key vitals with PHI removed for use throughout the hospital system. Always On * HIPAA de identified information outside of Epic (location only) with the screen saver facilitates rapid recognition of patient changes; full workflow remains within Epic 14

E M E R G I N G C L I N I C A L S O L U T I O N S IRIS MOBILE ios mobile application, designed by Cleveland Clinic physicians, providing valuable insight into real time data contained within the EMR (MyPractice) securely on their Cleveland Clinic issued iphones. 15

E M E R G I N G C L I N I C A L S O L U T I O N S PATIENT GENERATED DATA Empower patients to be active participants in their care Increased patient engagement Allow providers to track and monitor patients remotely Ability to quickly identify specific and actionable patient trends Utilize patient outreach to effectively manage patient conditions Monitor specific health populations 16

E M E R G I N G C L I N I C A L S O L U T I O N S Sidekick Care Coordination App Enter and save patient data on the go Real time documentation Epic always the source of truth Color/Time stratification fr patient lists Bidirectional EMR/Mobile device integration Utilize ANY Epic flowsheet Customizable as adjunct to any workflow 17

E M E R G I N G C L I N I C A L S O L U T I O N S econsult 18

E M E R G I N G C L I N I C A L S O L U T I O N S 19

Questions Ed Marx / marxe@ccf.org 20

Innovation in a Danish Hospital Chief Innovation Officer Claus Duedal Pedersen 1

Agenda Our challenges Innovation strategies in a Danish hospital Tools and methods Examples 2

Danish Health Sector 5 regions 41 Public hospitals: 21000 Beds Public Health Insurance >10 private hospitals < 150 Beds 3400 GPs (2000 clinics) 804 Private specialists + 245 Part time 331 Pharmacies 2700 Dentists (1650 clinics) 1793 Physiotherapist (550 clinics) 225 Chiropractors 546 Psychologists 98 Municipalities - Home care nurses - Nursing homes - Rehabilitation - Prevention 3

Strategic Innovation at Odense University Hospital preparing for the future 4

OUH - a main centre in Danish healthcare OUH is one of four university hospitals in Denmark Represents approx. 10 % of Danish hospital services Covers 1,2 million citizens Key figures Budget per year: 900 million Employees: 10,000 Clinical departments: 50 Beds: 1,000 (New OUH: 750-800) Average Length of Stay: 3.6 days Discharged patients per year: 115,000 Outpatient visits per year: 1,1 million 5

6

Strategic Innovation at OUH Innovation Strategy Innovation Fund (267.000 ) Research Strategy for Innovation Unit for Health Technology Assessment OUH Board of Directors Innovation Council Dept. of Quality, Research, Innovation and Education Centre for Innovative Medical Technology (CIMT) Innovation Unit Professors and associated professors from hospital and university, PhD students, international experts and researchers University of Southern Denmark: The Faculty of Health Sciences the Institute of Clinical Research the Institute for Sport Sciences and Clinical Biomechanics Dept. of Public Health, Institute for general practice research The Faculty of Engineering The Maersk Mc-Kinney Moller Institute Faculty of Business and Social Sciences Department of Business and Economics: COHERE, Centre for Health Economics Research 7

The role of OUH Innovation and CIMT Develop, test, implement and evaluate effects of innovative medical technologies and telemedicine, through Collaboration between the hospital and university faculties Ensuring research based documentation for management decisions Key aspects: Associated professors (USA, Australia, Holland and Spain) Part time professors and assistant professors from clinical departments at OUH Network for PhD students (engineers, doctors, nurses, health economy, social sciences, therapists, etc.) Approx. 20 innovation consultants + 7 HTA consultants Publication of evidence! 53 peer reviewed 8articles published in 2017 8

Research and implementation hand in hand Participatory Design/qualitative research/action research Health Technology Assessment Method for Assessmentof Telemedicine Solutions (MAST) Technical development hardware + software Organizationaland userstudies 9

Partnering for innovation to create synergy: 1+1+1 = 1000! Focus on the core competence of each field: Health sector: Knowledge on how to deliver high quality health and care services. Identification of challenges. Synergy and innovation! 10 Industry: Technical and business knowhow. Application of a different mindset to facilitate change Science (academic institutions): Experts in research and idea generation. Support innovation with evidence and documentation

Focus areas for OUH Innovation Integrated Care across sectors Telemedicine, home monitoring, virtual visits Patient empowerment Process and treatment optimization through technology 11

New areas of interest Robots for hospital use Automation of manual procedures e.g. ultrasound scans Surgical robots Service and care robots Logistics and infection control robots (e.g. room disinfection using robot with UV-C light) Drones for hospital logistics Sensor technology/iot 12

My Patient Journey a platform for the patients, when they want and where they want -Information related to condition -Videos and text - Messaging service (integrated with patient record) - Automated individual messages -Contact information for hospital - Calendar upcoming hospital visits -Patient input: Weight, BP, diet/exercise, etc - Questionnaires/PROM - Video conference 13

Thank you Hospital of the future cdp@rsyd.dk 14

Establishing and Nurturing a Culture of Innovation: Lessons Learned from Global Disrupters Session #63, March 6, 2018 Cris Ross, CIO Mayo Clinic 1

Culture of innovation 2

3

Mayo Clinic 4

5

Institutional support Center for Innovation Mission: Transforming the Experience and Delivery of Health and Health Care Design centered thinking Next: Discover Translate Apply Integrating healthcare delivery research, innovation, informatics 6

An HIT example Six year journey Single enterprise systems Platforms for Innovation IT Transformation Seeking ecosystems and leverage points Blueprints from outside healthcare 7

Some innovation vectors Continuous/ Disruptive Christensen Repurposing a successful idea for a new use Pioneer / fast follower What is your competitive advantage? 8