“SmartSurg is an application built to increase the profitability of ambulatory surgery centers.”

3

Product Summary

• Intelligent system that recommends to your staff where to go and what to do next

• Uses features such as:– Resource tracking– Electronic message boards– Artificial intelligence– Simulation modeling

• Why consider it?– Increase your capacity– Lower your cost of operations– Increase patient safety

4

In a Nut-Shell…

• Product built on “just-in-time” manufacturing concepts

• Changes the production ceiling from the scheduler or “boardman” to the number of procedure rooms or surgeons

• Efficiently alerts surgeons where to go next

• Built to maximize throughput and revenue

5

SmartSurg Benefits

• Increased procedure capacity • Increased patient safety

– Ability to track and measure Joint Commission and accreditation goals

– For example, goals 1A, 2B, 2C, & 2E can be met and documented

– Record “near misses”

• Reduction in operational costs due to efficiency gains

6

Product Specifications

• Real-time communications system• Interfaces with existing scheduling and

EMR systems– Provides “dynamic scheduling”

• Wireless patient and resource tracking– Communicates patient and resource status

• Proactive system decision-making– Artificial intelligence based on gaming theory

• Proactive monitoring of patient flow to minimize bottlenecks

7

Surgery Center Throughput

Maximum Patients Per Day

020406080

100120140160

After Modeling Study Average MarketSystem

SmartSurg

4 Performing Doctors 5 Performing Doctors 6 Performing Doctors

8

Client Net Revenue Projections

Estimated Annual Net Revenue

$0

$5,000,000

$10,000,000

$15,000,000

$20,000,000

After Modeling Study Average MarketSystem

SmartSurg

4 Performing Doctors 5 Performing Doctors 6 Performing Doctors

9

Net Results & Financial Impact% Increase in Capacity 15% Change in Net Earnings 31%% Increase in Volume 15% Change in Cost per Case -5%

Revenue / Case $530 $530Annual Volume 3750 4313

$1,987,500 $2,285,625Fixed Costs $245,300 $245,750Variable Costs $1,205,500 $1,334,313Total Costs $1,450,800 $1,580,063

EBITDA $536,700 $705,563Cost / Case $387 $366

Fixed Costs Existing Cost Change Forecast CostRent / Loan Repayment $21,500 0% $21,500Utilities $2,500 15% $2,875Equipment $36,800 0% $36,800Maintenance $500 15% $575Supplies $4,000 0% $4,000Adminstrative Salaries $180,000 0% $180,000

$245,300 $245,750

Variable CostsClinical Salaries $400,000 0% $400,000Support Staff Salaries $200,000 0% $200,000Drugs $300,000 15% $345,000Office Supplies $4,000 0% $4,000Marketing $1,500 0% $1,500Clinical Supplies $300,000 15% $345,000SmartSurg $0----------------------------------------------- $38,813

$1,205,500 $1,334,313

Work the numbers yourself with the worksheet included.

10

Communication in Today’s Outpatient Surgery Centers

• White boards used to communicate/track:– Patient location (i.e. exam room, phlebotomy, pre-

op, surgery, recovery)– Procedure to be performed– Physician assigned to patient– Patient drug allergies– Any other important step in the process

• Simple electronic message boards– Display location status– Offer no decision making or increase in capacity

11

Today’s Communication is Inefficient Communication• Patient status (i.e. IV needed,

patient ready for surgery, etc.)• Room status (i.e. room needs

cleaning, room cleaned, etc.)• Physician/staff direction (i.e.

physician should go to which room next, staff should bring which patient to which surgery room next)

12

Common Issues

• Inaccurate/slow white board updating causes poor communication which lead to lost capacity and process delays

• High patient volumes and higher cost per case force us to look for more efficient ways to do business

13

Other Solutions in the Marketplace• Wireless tracking systems• Various output devices to deliver

information (i.e. flat screens, PDAs, pagers, etc.)

• Ability to integrate with existing scheduling systems

• Ability to direct resources based on:– Schedule provided– RULES-BASED SYSTEMS

14

Limitations of These Systems

• Only as good as the “RULES”• Cannot implement a rule for every

situation• Rules may not reflect the “best

decision”• Inflexible to handle changes on the fly• Still requires administrator to analyze

data for basic decision making and bottleneck intervention

15

Comparison of Systems

SmartSurg is Not RULE BASED!– Other systems

• Collect and display information• Decisions are left to a human to make• Busy days and out of the ordinary occurrences

are not accounted for– SmartSurg

• Makes recommended action decisions and priority lists

• Collects and displays information• Uses planned schedule and adjusts constantly• Built for the days that go “unplanned”• Uses RF and/or IR technologies

16

System Comparison Chart

Issue SmartSurg Rules-based

Real-time Updates X X

ADOPS(Adaptive, Dynamic, Optimized Predictive

Scheduling)

X

Prioritization X X

Ability to Learn X

Adaptive Decision-making Ability

X

Artificial Intelligence X

100% Accurate Data – Always X

On the Fly Adaptability X

System can proactively avert bottlenecks

X

17

Product Design

RF/IR (Radio Frequency/Infrared) badges track patient location.

RF/IR receivers transmit signals from badges to network servers

Flat screens are located throughout the surgery center to display real-time status info. Touch screens are located

in all procedure rooms and post-op rooms.

Network servers analyze information.

18

Technology Components

• Data Model• Path Management Engine• Simulation Engine• Gaming Engine• Fuzzy Logic Engine

19

System Artificial Intelligence

Q: Two doctors leave procedure rooms at the same time with next patients ready for each, but only one procedure room available; which doc goes next?

A: The answer here depends on the situation; i.e. what if Dr. “X” is behind because of a difficult stick on an earlier patient or Dr “Y” has three patients in post-op that are waiting to be released . . .

20

Predictive Decision-Making

Q: Why does it matter if we choose patient A or patient B to go next at 9:00 a.m. when both are ready at the same time?

A: Decisions that are made in the morning may have a ripple effect on the afternoon schedule. SmartSurg constantly analyzes all potential outcomes of each decision and its potential impact on the rest of the day.

21

Additional SmartSurg Features

• All times are logged for reference and reporting

• Web reporting available• Real time operations management

package in development• You can be on the beach and watch

your patient flow (and resources) in real time!

22

The Intersection of Finance and Operations• Situation #1 – Demand > Capacity

– SmartSurg increases capacity– SmartSurg increases net profitability– Fixed costs remain constant– SmartSurg decreases cost per case even

after the charge for the system

• Situation #2 – Capacity > Demand– SmartSurg increases capacity but no

increase in volume– SmartSurg decreases cost of operations– SmartSurg decreases cost per case even

after the charge for the system

23

Next Steps

• Fill out estimate data sheet to find out how much SmartSurg could help you

• Fill out the economic value model worksheet

• Schedule a conference call to discuss the results

• If you feel SmartSurg is right for you, take advantage of our no risk guarantee

24

Demo and Discussion

For a demonstration, please callHealthcare Enterprise Solutions

866-319-8288