Integrated Health System PlanningAn exclusive Executive Circle Briefing

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Healthcare is undergoing a

“Copernican Shift”

Microsoft CorporationConfidential and Privileged

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FACILITY

The Traditional Healthcare UniverseConsumers (C1 to C5) are forced to interact with facilities – focused around the needs of the provider, not the consumer

In 1543, Copernicus was the first to propose that the Earth rotated around the sun, while accepted scientific thought at the time believed that the Earth was the center of the universe. Copernicus effectively “changed the center of the universe”.

C2

C5

C4

C1

C3

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Healthcare’s “Copernican Shift”Healthcare is undergoing a “Copernican Shift” – with the consumer now placed at the center of the orbits of various healthcare strategies

Home Prevention• Knowledge (Search) • Fitness (PHR)• Wellness (PHR)

Home Chronic Care• Knowledge (Search) • MTM (PHR)• Senior Care (Devices)

Clinic• Convenience (PHR)• Access (PHR)

Home Outpatient• MTM (PHR)• Monitoring (PHR)

Hospital• Hospital ERP (Azyxxi)• Full Enterprise

CONSUMER

Implications of the “Copernican Shift”The Copernican Shift is being driven by cost & access to information

– consumer behavior and attitudes are changing as increasing numbers of consumers are being forced to take on more personal financial responsibility for their health

Importantly, the Copernican Shift displaces both providers and consumers. Both parties are now in new orbits, without necessarily having access to the tools they need to fulfill their new roles

This has created a “Healthcare Gap” between providers and consumers

How can Microsoft make a positive difference in this evolving healthcare industry?

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How Can Microsoft Help?Microsoft is unusually well positioned to help solve both

the enterprise and consumer challenges of the healthcare industry

Our strong enterprise footprint, products, and relationships put us in a unique position to aid the enterprise

Our excellent consumer trust and ubiquity put us in a position of responsibility with the consumer

Microsoft will be the company that helps providers and consumers span the healthcare gap

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Why Microsoft?• When Microsoft makes an investment, we take a long-term view

• Seven years ago we recognized the need to invest in the health industry

• Today it represents a $1 billion U.S. growth market for Microsoft

• History of innovation; We invest $7 billion every year in R&D – the largest R&D budget in the software industry

• A significant amount of R&D spending is now focused on healthcare

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2000 2001 2002 2003 2004 2005 2006 2007

63 employees, 115 customers$320 million in sales

600 dedicated employeesPervasive in health around the world$1 billion in sales

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Our Footprint• 600 million people around the world start the day with Windows when they turn on their computers

• MSN Health + Fitness is the number two portal in the U.S. – a strong foundation for future health offerings

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MSN Health & Fitness

What’s Next?

Microsoft can be a cornerstone for our long-term health strategy, transforming how healthcare is managed and delivered

Microsoft CorporationConfidential and Privileged

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Provider Challenges

Microsoft CorporationConfidential and Privileged

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Library

Search

Revenue Cycle

Scanned Charts

Labs

Radiology

Old Records

EKGs

Challenges in Enterprise Healthcare

Microsoft CorporationConfidential and Privileged

Medication Management

OR Management

AmbulatoryEmergency Department

Registration

CPOE

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What is Azyxxi?

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EMRSystems

LabOR

ManagementImaging

Medication Management

Ambulatory EmergencyRevenue

CycleCPOE

Azyxxi DB

Personalized ViewsPersonalized Views

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Configurable by User

Orthopaedic Unit Nurse Finance Quality

Resource Planning Cardiologist Regulatory

Configurable by User

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Orthopaedic Unit Nurse

Orthopaedic Unit Nurse

Customized for an orthopaedic nurse to view patients assigned to their unit, their surgical status and key labs.

Snapshot of pre- and post-op patients

Anticipated date of surgery

Quickly scan latest platelet count in post-op patients on blood thinners

Nurses just one click away from past medical history

Easily see admission diagnosis and attending physician

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Configurable by UserFinance

Finance

Views customized by finance users to integrate and collect data from across all information systems to improve co-pay collections at the time of service.

Track success at collecting co-pays

Track success at collecting co-pays

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Benefits of Azyxxi

What You HaveHard working, disparate

information systems that aren’t feeding you the best results

What You NeedA single version of the truthAzyxxi doesn’t replace, but sits

on top of existing information systems

It provides integrated and customized views + analysis of clinical, financial, and administrative data

Why You Need Azyxxi•Azyxxi aggregates and

analyzes all relevant data for one, nearly instantaneous view

•Health workers can maximize the value of information and make the most informed decisions

•Informed decisions save your business money and most importantly, save patient lives

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ConsumerChallenges

Microsoft CorporationConfidential and Privileged

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Health: Advances Require a “Shift Left”The “total-system healthcare win” is in the home

Lower cost (good for plans, employers)

Higher quality of life (good for consumers)

The key focus for all competitors will be on home-based, consumer-centric healthcare solutions

HOME CARE FOCUS:

PreventionKnowledgeFitnessWellnessDr Communications

Chronic Care and OutpatientMedicationsMonitoringCommunityMedical

Communications

Source: Intel.com Cost of Care per Day

$1 $10 $100 $1,000 $10,000

0%

Qu

alit

y o

f L

ife

COMMUNITY CARE

Healthy,Independent Living

ChronicDisease Management

CommunityClinic

Doctor’sOffice

100%

Assisted Living

Skilled Nursing Facility

Specialty Clinic

Community Hospital

ICU

HOME CARE

ACUTE CARE

Specialty Pharmacy

SHIFT LEFT

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“Walled” “Open”

VS

PHR Philosophies

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My Health Data

Consumer Health Platform

Devices

My Health Data

Platform Services• User authentication• User mapping / identity• Data storage and access• Personalized search• Branded data and tools• Community building• Incentive infrastructure • Integration with other devices and services• Advertising infrastructure

3rd Party ApplicationsMS Apps

Family Health Record (FHR)

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FHR

PHR PHR PHR PHR PHRSelf

FHM has FULL

ACCESS

SpouseFHM has PARTIALACCESS

SeniorFHM may have

FULL or PARTIALACCESS

MinorFHM has

FULLACCESS

MinorFHM has

FULLACCESS

The “Family Health Manager” or FHM runs the FHR

PHRPet

FHM has FULL

ACCESS

“Seventy percent of our users are women storing information about kids, spouses, aging parents and themselves,” says Fotsch, who runs Medem Inc., on online business that links the needs of patients and doctors through the Web at iHealthRecord.com Source: USA Today – Saturday, January 6, 2006

Bridging the Healthcare Gap

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Healthcare Gap ConsumersProviders

Keystone

Microsoft HealthQ&ADiscussion

28Microsoft CorporationConfidential and Privileged