2020 s: The Years of Patient Centered Care and the Role of Internet of Everything (IoE)

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1 2020 s: The Years of Patient Centered Care and the Role of Internet of Everything (IoE) Ketan Paranjape General Manager Life Sciences Intel Corp.

2 Health and Life Sciences at Intel Where Information and Care Meet 2

3 Growth Forecasts IoE, Wearables IoT Install Base passes Ultramobile, Traditional PCs, and Mobile Phones combined Wearables IoT Ultramobile Traditional PC Mobile Phones Forecast: Internet of Things, Endpoints and Services, 2014 Wearable Predicted Compound Annual Growth Rates (CAGR) of 69% (CCS Insight) to 78% (IDC) Health and Life Sciences at Intel Where Information and Care Meet 3

4 Intel Health & Life Sciences Powering healthcare everywhere from the hospital to the home from leading medical centers to remote villages from MRI machines to wearables from device to cloud Intelligent Systems Workstations/Desktops Ruggedized Ultrabook ¹ Tablets Phones & Handhelds Wearables 4 One architecture across connected devices Enabling a Secure, High Performance, and Consistent User Experience 1. Ultrabook products are offered in multiple models. Some models may not be available in your market. Consult your Ultrabook manufacturer. Health & Life Sciences at Intel Where information and care meet

5 Care Networking shift from solo to team-based care across orgs & IT systems Care Anywhere shift from institutions to mobile, home-based, & community care. Care Customization shift from population-based to personbased treatment 5 Health & Life Sciences at Intel Where information and care meet

6 Care Networking shift from institutions to mobile, home-based, & community care. Care Anywhere shift from solo to team-based care across orgs & IT systems Care Customization shift from population-based to personbased treatment Skill shift to patients/family via web Community health worker training Care coordination SW tools Analytics for patient/risk stratification Clinical decision support for groups Real time quality analytics Placeshift care via telehealth Virtual visits on smart phones Real time diagnostics/monitoring Self care coaching agents Consumerization of medical devices Trusted mobility for clinicians Customized to behaviors, biology Genomics, proteomic data for individuals Health analytics Predictive modeling of individuals Precision therapies, drug customization Tissue generation & designer organs 6 Intel Health & Life Sciences Where information and care meet

7 Health Intel Enable data acquisition & integration to deliver Care Networking, Care Anywhere and Care Customization Consumer & Clinical Wearables Remote Health to Data Center Clinical Health to Data Center Privacy & Security Service Creation Platform 7 Health & Life Sciences at Intel Where information and care meet

8 Health and IoE OPPORTUNITY Top Sector for Economic Impact $22.4B Solution Spending ( 17) 200B Devices Global healthcare inefficiency is at least $731B/yr Clinical and operations inefficiencies account for $429B/yr 1IDC, Intel, United Nations 2IDC Digital Universe Study, December McKinsey Global Institute 2B Devices B Devices

9 Economic Impact of IoE Applications in 2025* $ Trillion, Annually ~ ~0.5 0% 20% 40% 60% 80% 100% Healthcare Manufacturing Electricity Urban Infrastructure Security Resource Extraction Agriculture Retail Vehicles Source: McKinsey Global Institute analysis 9

10 Worldwide Telehealth Patients Growing to 1.7 Million Visits by 2017 World Telehealth Patients (thousands) by Disease 2,000 1,800 1,600 1,400 1,200 1, The World Market for Telehealth An Analysis of Demand Dynamics 2012 INMedica, IMS Research Others Mental Health Hypertension Diabetes COPD CHF 10

11 Mega Challenges/Trends Aging Population Rising Costs Worker Shortage Inefficiency & Poor Patient Experience Payment Reforms Public Investments Consumerism Computing Transformations Personalized Medicine

12 What s Driving IoE in Healthcare? Pay for Outcome Bundled Payments Reduce Readmissions Avoid Never Events Reduce Cost of Chronic Care Identify Patients at Risk Win & Retain the Young Maintain Wellness Share & Monetize Data Clinical Trials Coming Soon: Patient Incentives

13 Care Coordination Solving Real Problems Aging Population 2B people over 60 by 2050 Rising Costs of Healthcare 50% increase in WW healthcare costs by 2020 Shortage of Healthcare Professionals 4.3M global shortage of doctors, nurses, and others today Before Care Coordination Paying for volume Paying only for onsite visits Providers working alone Quality measurements not required No incentive for preventive care After Care Coordination Paying for value Paying also for virtual and home services Providers working in teams Bonus depends on quality measurement Large incentives for preventive care For more 13

14 Carrots & Sticks Driving Coordinated & Virtual Care Post-hospital Discharge (CPT codes ) Non-face-to-face services including assessment and adherence support for with home health services, home caregivers, and patient ~$160-$230 per claim, 2.17M CMS claims ($600M) expected) 24x7 Chronic Care Management (Proposed CMS G-Code ) Care planning and coordination $41.92 per month per patient -> $500K! Many Practices Facing Financial Hardship Penalties for Readmissions (ACA HR 3590, Section 3025), Never Events COPD (chronic obstructive pulmonary disease), CABG (coronary artery bypass graft). PTCA (percutaneous transluminal coronary angioplasty), Orthopedic and other vascular conditions. 14

15 Virtual Care at Kaiser Permanente In-Person And Virtual Patient-Physician Visits, Kaiser Permanente Northern California, Use Of Online Applications at kp.org, Health Affairs, Pearl R Health Aff 2014;33: by Project HOPE - The People-to-People Health Foundation, Inc 15

16 Coordination Across the Continuum: Health Check Up Emergency Self Check & Control Data Exchange Personal Health Record Patient-centric Care Data Exchange Clinic Home Electronic Health Record Community Hospital Visiting Care Remote Diagnostic Pharmacy Long Term Care Academic/Research Hospital 16

17 Intel s Vision for Virtual Healthcare information finding the doctor instead of the doctor finding the information Wearable Health (BAN) - Activity Monitors - Sensors - Implantables Remote Health (PAN) - Home Monitoring - Clinical Trials - Independent Living Clinical Health - Medical Device interop - Asset Management Consumer IoT Solutions Gateway Edge Analytics Non- Consumer for Device Wearable Embedded Management Intel Connectivit Gateway Solutions y + Security Mobile Apps for Remote Monitoring Enterprise Network Gateway for Workload Consolidation Cellular API Service Creation, Deployment, Protection, Monetization, and Management Clinical Data Store Hosted Service db Service Creation Platform Intel Data Platform Compute Storage Network Things Data Capture Solutions Data Transmission Datacenter Cloud 17

18 Investment in Worldwide Standards IIC Steering Committee OIC Steering Committee System of Systems Frameworks & Architectures Public Private Partnerships Liaison Relationships Connectivity Frameworks Architectures & Specifications Open Source Communities China IoT National Standards Group IoT End to End Worldwide Standards 18

19 Continua Health Alliance Founded in June 2006 Supports the personal health market space 100 certified devices and growing Intel has a founding member, board seat ~150 member companies Not a standards body, but influences standard creation ISMC 2015 SMG University: Investing in you 19

20 Alerts Feedback Remote Patient Monitoring 2 Aggregate 3 Store & Analyze RHM/HCO 6 Intervene Services Cloud Data Aggregator 1 Collect Gateway Broadband/WiFi Cellular 4 RHM system Create & Expose EHR and data integration Care management Population health Non- Clinical Wearable Remote Monitoring for Chronic conditions or Readmission Avoidance Continua Validated: Omron BP Monitor (BP792IT) Omron Body Comp Monitor (HBF206IT) A&D Weight Scale (UC-321) A&D Blood Pressure (UA-767) Nonin Pulse Ox (9650) Gateway Android Continua Certified Local db API Stack MVP Security BT LE, SPP, HDP 3G USB WiFi ZigBee Secure and Authenticate Expose data through API creation Service creation platform Anonymize data (Token) Monetize anonymous data Partner Apps Dashboards Visualization Analytics Care Coordination Health Coaching Virtual visits Mobile Apps

21 Intel Health Strategy in IoE / Wearables Wearable/IoT Sensors Gateway Cloud Intel Analytics Service for IoE Products & Solutions Intel Gateway Solutions for IoE Intel Expressway Gateway Investments & Acquisitions Initiatives 21

22 Creating Intel IoE & Wearable PoCs Solution Components Solution Partners (later in 15) API Management and Service Creation Cloud and Data Center Cloud / DC IoT Analytics Edge Management System 3 rd Party Analytics E-Policy Orchestrator System & Service Integrators Device Integration Edge 3 rd Party Gateways

23 Partner Investment Examples Activity / Medical Monitoring Emergency Alerts 23

24 Accenture Partnership 77% More Provides services to more than three-quarters of Health and life science companies listed in the 2013 Fortune Global ,000 than 16,000 healthcare professionals globally working with clients in Health Insight Driven Health is one of Accenture s top 5 strategic priorities. The world's leading healthcare providers and health plans choose Accenture for a wide range of insight driven health services that help them use knowledge in new ways. I N S I G H T D R I V E N H E A L T H Health Administration Health Back Office Health Analytics Connected Health Health Managemen t Clinical Services Industry Segments Providers Hospitals Ambulatory Care Long-term Care Specialty/Lab/ Diagnostics Payers Health Plans Gov t Programs Benefit Services Global Insurers Public Health US Federal Agencies US State Agencies National Government Regional/Local Government Potential Use Cases: Remote Patient Monitoring Health Wearables Smart Health Devices Service Offerings: Connected Health Health Transformation and Performance Services Payment and Reimbursement

25 Intermountain Edge to Cloud IoE Testimonial Full Proof of Concept deployment including: Intermountain Healthcare Transformation lab Continua device data collection Mini HDMI, Mini Display Port WAN, 3+ concurrent sessions, Remote Access Intel Remote Access Intel Gateway Intel cloud solution Continua Sensing Devices Weighing scale Blood Pressure Gateway Device Intel NUC Moon Island pre-release software Cloud Device SouthFalls to be converted to Discovery Peak in future SoW Data Access Server (optional) Todd Dunn Director of Innovation Intermountain Healthcare Transformation Lab

26 Mimo Care Support for Independent Living Products MIMOCARE MIMOCONNECT Support independent living for elderly and vulnerable providing alerts to care givers and family Support for dementia: Text and voice messages Reminders Photo albums Music Talk to family and care givers 26

27 Mimo sensor network Gerry Hodgson CEO MIMO Care Bed/Chair pressure sensor Room temperature Fridge open and temperature Advantech UTX-3115 gateway and web server with edge analytics Home hub or 3G/4G Internet connection Remote monitoring and set up of triggers and alerts Hallway movement sensor USB Pendent alarm Moisture bed wetting Door open/close sensor Malcolm Linington ESS Solutions Architect Intel Corporation Data centre Server analytics

28 Yoga Systems - Your Smart Home. Connected and Interconnected! Yoga is an intelligent smart home platform that connects to anything you can think of: wired and wireless security sensors, cameras, thermostats, smart plugs, lights, entertainment systems, locks and appliances. Yoga lets you manage these items from anywhere, with any device possessing an internet connection. Yoga is a revolutionary operating system for your home, thus redefining the term homepage. 28

29 Yoga IoT Testimonial Yoga Systems, a leading developer of smart home technology, announces the release of the Yoga Tiny, a brand-new gateway for smart home systems and the Internet of Everything (IoE). Yoga Tiny is a secure home central unit based on Intel Gateway Solutions for the Internet of Everything (Intel Gateway Solutions for the IoT) using the Intel Quark SoC X1000 series with special security features. Priit Vimberg CEO Yoga Systems 29

30 Care Innovations* A joint venture of Intel Corporation and GE Healthcare Care Innovations creates technology-based solutions that give people confidence to live independently, wherever they are Intel s expertise in technology + GE s deep healthcare experience Rich history of innovating to solve hard problems Industry leadership and standard setting Proven world-class quality Care Innovations* QuietCare*¹ Care Innovations* Guide² QuietCare* uses advanced motion sensor technology that learns the daily activity patterns of residents and sends alerts to help professional caregivers in senior housing respond to potentially urgent situations. The Guide platform is a clinically driven, end-to-end remote care management platform designed for enterprise use by payers and at-risk providers, offering: Enterprise clinical care management In-home patient application EMR and/or clinical information system integration Care Innovations* Link Link is a medical alert system that connects you to caregivers at the push of a button, from anywhere in your home, any time of day or night. Care Innovations* Connect³ Connect Caregiver is a consumer offering that lets family caregivers easily organize and manage caregiving tasks and keeps crucial health information at their fingertips. 1. The QuietCare system is not an emergency response or alarm system and is not intended for providing medical care. Data from the QuietCare system should not be relied on as medical advice or clinical diagnosis. 2. The Care Innovations Guide requires an Internet connection to enable communications with the patient's care team and back-end data hosting. The Care Innovations Guide is intended for use by patients under the guidance of a healthcare professional and is not intended for emergency medical communications or real-time patient monitoring. The Guide is available by Prescription Only (Rx) in the U.S and has class II FDA clearance. 3. Care Innovations Connect is not an emergency response or alarm system and is not intended for providing medical care. * Other names and brands may be claimed as the property of others. 30

31 Care Networking shift from solo to team-based care across orgs & IT systems Care Anywhere shift from institutions to mobile, home-based, & community care. Care Customization shift from population-based to personbased treatment 31 Health & Life Sciences at Intel Where information and care meet

32 Decrease cost Improve patient experience Increase access 32

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