RESET: The Global Tilt -Why You Must Rethink the FutureWhy You Must Rethink the Future

of Medical Technology

. Marcus EvansJune 26, 2014

Thomas M. Loarie, Executive Chairman

eMedonlineMedication Therapy Management PlatformMedication Therapy Management Platform

• Designed from the patient out

Value propositions• Value propositions • Proven behavior change• Data and analytics

• Scientifically based (Parks)• 98% Compliance98% Compliance • 10 controlled clinical studies • Managing patients taking up to 27 meds/day

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eMedonline

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Markets

• Care TransitionC C• Chronic Care Management

• Specialty Pharma• Clinical Trials• Analytics for Pharma & Providers

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Road Map

• The Evolution of Healthcare in My Lifetime • Global Drivers of Transformation• Reactions to Forces• Foundation of Globalization• Foundation of Globalization• Future Medtech Opportunities• What Does This Mean for You?

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Transforming Events 1960-2014

•For Profit Hospitals

House Calls Hospital •HMOs•Hospitals M&A

•Segmentation•Doc in the Box

M&A

1970 1980 1990 2000 20101960

Health Reform

Transforming Events 1960-2014

Cuts in Funding to AeroDefense •Health Reform

•TEFRA•DRGs

i

•Kessler FDA•M&A

•ACOs•M&A Hospitals

FDA A t •Segmentation•Marketing

M&A

Globalization

•FDA ActTransforming Events 1960-2014

1970 1980 1990 2000 20101960

Social Security Act of

•FDA Modernization Act CMS takes front seat

•The Great Recession•Implosion of Venture Capital

•GoldStandard•Emergence of Multi National Act of

1965•CMS takes front seat Venture CapitalMulti-National

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Global Drivers of Transformation

• Technological advances• Demographic changesg p g• Global Networks• Global economic shifts• Urbanization• Resource scarcityy• Climate

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Global Population 1950 - 2050

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Death of Silos & Growth of Global NetworksNetworks

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Virtual currency and payment systemssystems

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US Companies are BrokenMany Don’t Know ItMany Don t Know It

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Forces Disrupting the Balance in HealthcareHealthcare

A i l ti• > Aging population

• > Chronic disease• > Chronic disease

• > Public spendingp g

• > Taxpayer revolt

• > Global middle class

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25 %25 %

25 %25 %25 %25 %Of CostsOf CostsOf CostsOf Costs

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Big Need - Solutions to Manage Costliest Chronic DiseasesCostliest Chronic Diseases

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The Global Middle Class is Booming

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New Health Care Economy - US

• FFS to Value Based Pay• FFS to Value Based Pay

• Risk Shifting to Providers

• Care Mgmt Shifting to Doc

• Incomes Tied to Outcome and Volume

• Clinical and Economic Evidence

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Figure 3. Potential points of innovation

Shift delivery from discrete services based organizations (e.g. specialists) to team based models that address a patient’s overall need 

  

Care delivery model

Transition from dominant payment models (FFS or Global Capitation) to reimbursement models that reward providers for improving the value of care 

     

Payment model

Network model

Move from competitive single tier networks to multi‐ site networks that address adequacy yet support superior 

services delivery

Value-driven care

services delivery

   

 Transition from measurement of process based compliance and cost of charges to activity based cost accounting and

 Analytics

& outcomes

Clinical

integration

Reorganize provider facilities to focused factories with defined niche services and concentratedvolume tobased cost accounting and 

outcomes tracking concentratedvolume to

integrate care 

   

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Information Technology Integration technology that transitions from siloed systems leveraging 

aggregation of data, connectivity to all stakeholders and experts systems that allow for seamless sharing and engagement 

New EntrantsOf Fortune 50 companies, 24 are new entrants The top companies also include 14 traditional healthcare organizations 

Fortune 50 companies 7 Retailers

14 Traditional

5 TechnologyTraditional

healthcare companies  24 

New entrants

5 Technology

entrants

4 Finance $$$$ 

3 Telecommunications

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2 Automotive 3 Consumer products

Disruptors

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D-Rev Non-profit medical product development company p p p p y

Designs and delivers products for people living onDesigns and delivers products for people living on less than $4 a day.

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Disruptors

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Globalization of U.S. Medical Care

• Global distribution of U.S. developed devices and drugs

• OUS clinical researchOUS clinical research

• Reverse brain drain • physicians & engineers• physicians & engineers

• Manufacturing expanded OUS

• U.S. multi-nationals expanding OUS product research

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OUS p oduct esea c

Disruptors - OUS

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Destination Medicine

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Destination MedicineAKA Medical TourismAKA Medical Tourism

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Expansion into Emerging Markets

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Globalization U S based > research centers in ChinaU.S. based > research centers in China

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Generic Therapeutic DevicesA threat to legacy marginsA threat to legacy margins

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Globalization China based > U S presenceChina based > U.S. presence

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Globalization of Delivery

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Globalization of Delivery

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eHealthPredicting Asthma Attacksg

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“What is the Meaning of Your Life?gThe World is Asking You That

Question ”Question…-Viktor Frankl

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Shape Your Identity or It Will Shape You

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Global Experience

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The Two Most Important Days In Your LifeLife….

…are the day you are born and the day you find out why! - Mark Twainy

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